FIELD: medicine.
SUBSTANCE: invention relates to medicine, specifically to ophthalmology. For treatment of central venous branch (CVB) thrombosis complicated by macular edema laser retinal coagulation is performed. Preliminary optical coherence tomography (OCT), including angio-mode, and fluorescent angiography (FAG) for determining the region of edema, followed by a color photograph of an eye ground on a navigation laser unit (NLU) Navilas 577s using software to superimpose and compare digital images of OCT and/or FAG with a color photograph of the eye ground. If the edema is localized and spread from the region of vascular arcades to the foveal avascular zone (FAZ), laser coagulation is performed, for this purpose, patterns are selected in software of NLU Navilas 577s and placed on a matched eyeball with OCT and/or FAG data in staggered order at distance of 2–3 diameters from each other, completely covering the edema zone – in the presence of an edema in the area of vascular arcades with pre-macular zone distribution, the following parameters are selected: spot diameter – 100, 200 mcm, exposition – 0.05–0.1 s, power – 80–300 mW. In the presence of edema in the macular area, excluding the avascular region, the following parameters are selected: spot diameter – 50, 100 mcm, exposition – 0.01–0.05 s, power – 50–150 mWt. In the presence of the edema in the FAZ, the treatment is carried out in a selective microimpulsive mode, a pattern of several applicants is selected closely to each other and placed on a matched eyeball photo with OCT and/or FAG data, completely covering the edema area. To determine individual energy parameters required for treatment, micro-pulse mode parameters are calculated, which are calculated by Navilas 577s computer simulation at NLU: microimpulse duration – 50–150 mcs, pulse interval – 2,000 mcs, packet duration – 10–30 ms, number of pulses in packet – 5–15, spot diameter – 100 mcm, power – 0.4–1.9 Wt, length waves – 577 nm, then each patient is tested: three applicants are applied on an intact retina in an upper or lower vascular arcade: with transparent optical media – microimpulse duration – 50 mcs, duration of micropulse packet – 10 ms, power – from 0.4 to 1.9 Wt, with step of 0.1 Wt. In the presence of low-intensity opacity of optical media – duration of the microimpulse – from 50 to 150 mcs, with step of 10 mcs, duration of the packet of microimpulsions – 10 ms, power – 1.9 W; while reducing transparency of optical media – duration of the microimpulse – from 50 to 150 mcs, with step of 20 mcs with duration of the packet of microimpulsions of 20 ms, power – 1.9 W. After testing, all patients are examined short-wave autofluorescence and selected applicants applied with minimum energy parameters, in which visualized injuries of retinal retinal pigment epithelium on autofluorescence, they are placed into pre-selected patterns and treated.
EFFECT: method provides resorption of edema and hemorrhages, reduced thickness of retina, disappearance of cysts, increased visual acuity and light sensitivity, as well as reduced duration or complete elimination of long-term use of drug preparations and multiple intraocular injections of angiogenesis inhibitors.
1 cl, 3 ex
