FIELD: medicine.
SUBSTANCE: invention relates to the field of medicine, namely, to ophthalmology, and can be used for the treatment of central serous chorioretinopathy (CSChRP). Optical coherence tomography (OCT) with En Face mode and fluorescent angiography (FAG) are performed to identify defects and retinal pigment epithelium (RPE) defects that correspond to filtration points. Make a color photograph of the fundus with the Navilas 577s navigational laser unit (NLU). Using the NLU Navilas 577s software, superimpose the OCT and/or FAG data on a color photograph of the fundus and completely compare them. Select a pattern in the software of the NL Navilas 577s from one or more applicators, close to each other, and arrange them so as to fully cover the defects and detachments of the RPE corresponding to the filtration points. To determine the individual energy parameters required for treatment, computer simulation is preliminarily carried out by numerically solving the heat equation with an estimate of the proportion of denatured protein, by the result of which the energy parameters are determined from the range of the selective and effective micropulse regime realized on the NL Navilas 577s: duration of the micropulse is 50 mcs, interval between pulses is 2,000 mcs, duty cycle is 2.4 %, duration of the packet is 10 ms, number of pulses in the packet is 5, spot diameter is 100 mcm, power is 0.4 to 1.9 W, wavelength is 577 nm. Power is selected for each patient individually, depending on the degree of pigmentation of the fundus and transparency of optical media by testing and applying three appliqués of each power in steps of 0.1 W to an intact retina in the region of the upper or lower vascular arcade. With transparent optical media and pronounced pigmentation, testing is performed with a power in the range from 0.4 to 1.2 W, with transparent optical media and medium pigmentation – from 0.8 to 1.6 W, with transparent optical media and a weak degree of pigmentation – from 1.0 to 1.9 W, in the presence of low-intensity opacities of optical media, regardless of the pigmentation – from 0.8 W to 1.9 W. After testing, all patients undergo a short-wave autofluorescence study and select applicants applied with minimal power, causing visible damage to the RPE. Energy parameters with minimum power, at which the applicants are visualized on autofluorescence, are installed in pre-selected patterns and treated.
EFFECT: method provides topographically oriented laser treatment, targeted delivery of laser radiation, a selective effect on the RPE, the adhesion of the detachment of RPE and neuroepithelium, restoration of visual acuity and photosensitivity due to individual selection of energy parameters of the microimpulse mode on the Navilas 577s laser.
1 cl, 4 ex
