The first experience of subthreshold microimpulse laser action of 577 nm in monotherapy and in combination with injections of enriched autologous platelet plasma in treatment of central serous chorioretinopathy
O.M. STANISHEVSKAYA, V.V. CHERNYKH, A.N. TRUNOV, V.I. BRATKO, G.V. BRATKO, M.A. MALINOVSKAYA, I.Yu. EFREMOVA
Novosibirsk Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 10 Kolkhitskaya Str., Novosibirsk, Russian Federation, 630071
Stanishevskaya O.M. — ophthalmologist of the 4th Ophthalmological Department e-mail: stanishevskaya.olya@gmail.ru
Chernykh V.V. — D. Med. Sc., Professor, Director, tel. (383) 341-01-55, e-mail: rimma@mntk.nsk.ru
Trunov A.N. — D. Med. Sc., Professor, Head of the Scientific Department, tel. (383) 340-37-14, e-mail: trunov1963@yandex.ru
Bratko V.I. — D. Med. Sc., Head of the Department of efferent therapy, tel. (383) 340-37-14, e-mail: bratkovova@mail.ru
Bratko G.V. — Cand. Med. Sc., ophthalmologist and senior research of the Scientific Department, e-mail: gbratko@yandex.ru
Malinovskaya M.A. — Head of the 4th Ophthalmological Department, e-mail: stanishevskaya.olya@gmail.ru
Efremova I.Yu. — Ophthalmologist of the 4th Ophthalmological Department, e-mail: reiherdt@mail.ru
The article presents the results of treatment of patients with central serous chorioretinopathy (CSC) using subthreshold microimpulse laser treatment (SMLT) of 577 nm as monotherapy and in combination with injections of enriched platelet autoplasma. The effectiveness of the use of SMLT of 577 nm with injections of an autologous plasma into the region of the pterygoid fossa as compared with SMLT monotherapy in the treatment of CSC was asessed. The issues of modern treatment of CSC are considered. Patients in the 1st group received SMLT monotherapy of 577 nm. In the combined treatment, SMLT with a wavelength of 577 nm was applied first. The second stage after the laser exposure to the patient was performed by injecting an autologous plasma into the region of the pterygoid fossa in the amount of 3 pieces, the next day at a frequency of 72 to 96 hours. The selection of laser radiation parameters in each specific case is individual, taking into account the edema height and the degree of pigmentation of the fundus, as well as the transparency of optical media. The final result was evaluated after one month. Mean visual acuity before treatment in group 1: up to — 0,69D, after — 0,8D, height of macular edema to SMLT 349 nm and after — 301 nm. In group 2, the average visual acuity before SMLT + TA 0.79D, after 0.9 D, the height of the macular edema up to — 401 nm after treatment of 258 nm. According to the dynamics and results of treatment, it is shown that the effectiveness of 5757 nm (Quantel Medical) is favorable. Considering the safety of the 577 nm SMLT technique, this type of laser surgical treatment can be used for diapede leakage and for liqueur in the paramacular region. Combined treatment with pterygopalatine injections of autologous plasma in comparison with SMLT 577 nm in monotherapy gives a faster result in the dynamics of decrease in macular edema and increase of photosensitivity.
Key words: subthreshold microimpulse laser treatment (SMLT), central serous chorioretinopathy (CSC), macular edema in central serous chorioretinopathy (ME in CSC), platelet autoplasma (PA).
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