FIELD: medicine; ophthalmology.
SUBSTANCE: navigational laser treatment of macular druses in age-related macular degeneration is carried out on Navilas 577s navigation laser unit (hereinafter – NLU). The localization of druse zones is determined according to data of optical coherence tomography, and selective micro-pulse laser exposure is performed outside the foveal avascular zone with laser applications applied at a distance of one application diameter from each other with following parameters of a micro-pulse mode: a wavelength of the yellow spectrum, micro-pulse duration is 50-100 mcs, a duty cycle is 0.5-4.7%, power is 0.4-1.9 W, a spot diameter is 50-150 mcm, a number of pulses in a package is 1-20. In the foveal avascular zone with following parameters: a wavelength of the yellow spectrum, micro-pulse duration is 50-80 mcs, a duty cycle is 0.5-2.5%, power is 0.8-2.0 W, a spot diameter is 80-130 mcm, a number of pulses in a package is 1-10, a pattern of one or three applicates is selected, placing them at a distance of 0.25 of the spot diameter from each other, completely covering the druse zone, including the foveal avascular zone, when spreading druses to it. Before selective micro-pulse laser exposure, the topographic localization of druse zones is determined according to data of analysis of OCT-angiograms at a level of retinal pigment epithelium and choriocapillaris by selection of a “choriocapillaris” layer in an En Face mode in software. Then, a color photograph of the fundus is performed on NLU, using software, and this OCT angiogram is superimposed on the color photograph of the fundus. Then, using NLU software, necessary parameters of the micro-pulse mode of laser radiation are set. In NLU software, a pattern of one or three applicates is selected at a distance of one spot diameter from each other, and they are arranged in such a way that to completely cover druse zones in the color photograph with superimposition of the OCT angiogram, including the foveal avascular zone, when spreading druses to it. Then, selected capacities are installed in NLU software, and the treatment is carried out.
EFFECT: method allows for reduction in a length and a height of macular druses and stabilization of a process for 6 months, stabilization of visual acuity and photosensitivity, as well as reduction in the duration or completely exclusion of long-term use of drugs, and the absence of disease progression.
1 cl, 3 ex
