Combined Heliox inhalation and intranasal Semax electrophoresis boosts visual recovery after retinal detachment surgery

Despite successful anatomical reattachment of the retina, patients undergoing endovitreal surgery for rhegmatogenous retinal detachment (RRD) often experience persistent functional deficits, including reduced visual acuity and macular sensitivity. Standard surgical interventions, such as vitrectomy with silicone oil tamponade, address the physical separation but may not fully mitigate the subsequent neurodegeneration or optimize functional recovery. There is a critical need for adjunctive therapies that can enhance retinal neuroprotection and accelerate visual rehabilitation post-surgery. Semax, a synthetic peptide derived from ACTH(4-10), is recognized for its neuroprotective and neurotrophic properties, making it a candidate for improving retinal outcomes.

This study included 42 patients (42 eyes) with primary macula-off RRD of up to 30 days duration, all of whom underwent vitrectomy with silicone oil tamponade. Patients were randomized into two groups post-surgery. Group 1 (23 patients) received a course of combined physiotherapeutic treatment (CPT) starting on day 5. This CPT involved respiratory heliox therapy (inhalation of Heliox 21 containing 21% O2 and 79% He) for 15 min, followed by endonasal electrophoresis with a 1% Semax solution for 10 min, once daily for 8 procedures. Group 2 (19 patients) received nasal instillations of 0.1% Semax drops daily, also starting on day 5. The primary endpoints assessed functional effectiveness via best-corrected visual acuity (BCVA), macular light sensitivity, central retinal thickness, and ganglion cell complex over a 12-month follow-up.

Patients in group 1, receiving the combined physiotherapeutic approach, demonstrated a higher level of recovery in key functional parameters compared to group 2 (Semax nasal drops alone). This superior recovery was evident by month 6 of the 12-month follow-up period.

Specifically, the combined therapy led to a higher level of recovery of functional best-corrected visual acuity (BCVA) and fundus microperimetry parameters. The study analyzed the functional effectiveness by evaluating changes in BCVA (a standard measure of visual sharpness), macular light sensitivity (which assesses the retina's ability to detect light stimuli), central retinal thickness, and the ganglion cell complex (structural indicators of retinal health). While specific quantitative improvements were not detailed in the abstract, the qualitative finding indicates a clinically meaningful difference in visual function restoration for patients receiving the combined therapy, suggesting a more robust rehabilitation outcome.