FIELD: ophthalmology.
SUBSTANCE: invention can be used for laser treatment of the AP-ROP at the stage of early clinical manifestations and the stage of manifestation, ROP of the I zone and using Navilas 577s navigation laser system. After the field of view of the retinal camera of the navigation system 1/6 reaches the retina, including the first, second and third zones, simultaneously with the visualization of the marginal vessels of the vascularized zone of the retina, the proliferation shaft and the avascular zone up to the dentate line, the obtained retinal area is photographed. On the screen of the device in the planning option, the blocking zone is indicated — the entire first zone of the retina. In the testing option, single test applications are placed with different power parameters — first near the dentate line, then at the conditional border of the beginning of zone 3, afterwards at the conditional border of the middle of the second zone and at the border of the avascular zone of the retina. Choose the parameters of laser exposure: power, spot diameter, exposure, interspot distance. At the same time, in each subsequent test applicator, the power value is increased to obtain coagulates of II–III degree of intensity according to the L'Esperance classification during subsequent coagulation of the retina. Then, in the planning mode, the option of applying appliques in 2 rows is selected. A straight line is drawn from the border of the beginning of the avascular zone of the retina to the jagged line along the borders of this 1/6 part of the retina. Next, testing and coagulation are carried out along the boundaries indicated in the planning mode. Then, after repeated photo registration of the same 1/6 part of the retina in the planning mode, a map of laser treatment of the avascular zone of the retina is drawn, which is displayed on the image of the retinal area obtained as a result of photo registration in the form of circles of future laser coagulates located at the same interspot distance from each other in a checkerboard pattern. Further, in the treatment function, the same retinal image is obtained as in the treatment map. A treatment card is applied to it and laser coagulation of the avascular retina is performed automatically according to a previously created treatment card. At the same time, in case of AP-ROP at the stage of early clinical manifestations, navigational transpupillary laser coagulation of the entire avascular zone of the retina is performed with the application of laser applications of the II degree of intensity according to L'Esperance classification with a laser spot diameter on an ophthalmic coagulator of 295 microns, an exposure of 20 ms, an interspot distance of 0.5 of the coagulate diameter. In case of AP-ROP at the stage of manifestation and in case of ROP of the I zone, navigational transpupillary laser coagulation of the entire avascular zone of the retina is performed with the application of laser applications of the III degree of intensity according to L'Esperance classification with a laser spot diameter on an ophthalmic coagulator of 295 microns, an exposure of 30 ms, an interspot distance of 0.25 of the coagulate diameter. In the same way, navigational laser coagulation of the avascular zone is performed in all remaining parts of the avascular retina.
EFFECT: accuracy of applying laser applications to the entire area of the avascular retina in a checkerboard pattern with the same distance between coagulates, eliminating the possibility of laser exposure in other areas of the retina in the absence of the need to use a single pulse mode or various shapes of patterns, minimizing the total energy load on the retina of a premature infant, and achievement of a stable regression of active ROP while observing the terms of treatment.
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