FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to ophthalmology. Intravitreal administration of angiogenesis inhibitors and laser coagulation are carried out. In the treatment of active choroidal neovascular membranes (CNVM), the patient is preliminarily subjected to optical coherence tomography (OCT), which determines the central retinal thickness (CRT). And if the value of the CTS index is more than 350 microns, an angiogenesis inhibitor is administered, which is used as ranibizumab at a dose of 0.5 mg or aflibercept at a dose of 2 mg. OCT is performed 2 weeks after the administration of an angiogenesis inhibitor, and if the CTS is more than 350 mcm, then the indicated sequence of actions is repeated until the CTS reaches 350 µm or less, when the CTS reaches 350 mcm or less, OCT-A is performed in the En mode. Face to determine the exact location, boundaries and area of the CNVM. Next, a color photograph of the fundus is performed on a navigation laser unit (NLU) Navilas 577s, using software, digital OCT-A images are superimposed and compared with a color photograph of the fundus. Laser coagulation is carried out over the entire area of the CNVM within certain boundaries. In this case, the applicators are applied close to each other using the following parameters: laser radiation spot diameter - 100 mcm, exposure - 0.05-0.1 s, power - 80-240 mW, wavelength - 577 nm. One month after the treatment, OCT-A is performed, and in case of scarring of the CNVM, the patient is transferred to dispensary observation. If there are signs of continued growth of CNVM, repeated laser coagulation is performed with the above parameters until complete scarring.
EFFECT: method makes it possible to stop the growth of CNVM with its gradual regression, reduce the thickness of the retina, increase visual acuity and photosensitivity, as well as reduce the duration or completely eliminate the long-term use of drugs and multiple intravitreal injections of anti-VEGF.
1 cl, 3 ex
