METHOD OF NAVIGATIONAL PANRETINAL LASER COAGULATION OF RETINA FOR PROLIFERATIVE DIABETIC RETINOPATHY Russian patent published in 2024 - IPC A61F9/08 A61B3/00 A61B3/125 

FIELD: medicine, ophthalmology.

SUBSTANCE: according to optical coherence tomography in angio mode (OCT-A) on a navigation laser unit (NLU) Navilas 577s, laser exposure is carried out in two sessions. The patient is first subjected to optical coherence tomography in angio mode (OCT-A) in the En Face mode, the topographic localization of ischemic zones is determined according to a comprehensive analysis using OCT-A of the superficial choroid plexus (SCP) and deep vascular complex (DVC) by switching the “Superficial” modes and “Deep”, in the “Montage” mode 18x18 mm in the OCT-A software, and angioscanograms are performed in four meridians 9x9 mm: “SN” superior nasal, “IN” inferior nasal, “IT” inferior temporal, “ST” superior temporal; A Navilas Contact 60 mm lens is used to deliver laser radiation. Next, a SuperQuad 160 contact corneal lens is installed on the eye, a color photograph of the fundus is taken on the NLU using software, a digital OCT-A 18x18 mm image is superimposed and compared with a color photograph of the fundus. After this, a treatment plan for the first session is drawn up, for which a pattern is selected in the NLU software, patches are applied, placing them at a distance of 0.5–1 diameters from each other, so as to completely cover the ischemic zones in the fundus within 55 degrees, in accordance with the plan formed on a color photograph, during the first session, in the central zone, excluding the foveal avascular zone (FAZ), LCS is performed in all identified ischemic zones within the vascular arcades. The diameter of the laser radiation spot is 200–250 microns, exposure is 0.05–0.1 s, power is 100–180 mW, wavelength is 577 nm. Then a treatment plan for the second session is drawn up, a pattern is selected in the NLU software, patches are applied placed at a distance of 0.5–1 diameters from each other, so as to completely cover the intact area of the retina, from 55 degrees to the periphery, the second session of LCS is performed. The diameter of the laser radiation spot is 300–390 microns, exposure is 0.05–0.1 s, power is 150–300 mW, wavelength is 577 nm, one month after treatment, OCT-A is performed in the “Montage” mode 18x18 mm and if the ischemic zones are destroyed, the patient is transferred to dispensary observation. In a particular case, if there are signs of progression of proliferative diabetic retinopathy, the first LCS session is repeated with the following parameters: laser spot diameter is 200–250 microns, exposure is 0.05–0.1 s, power is 100–180 mW, wavelength is 577 nm.

EFFECT: method ensures the disappearance of ischemic zones, desolation of newly formed retinal vessels, stabilization of the course of the disease, regression of retinal neovascularization, prevention of disease progression and reduction of the central thickness of the retina.

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