Combined method of treatment of central serous chorioretinopathy in combination of subthreshold microimpulse laser 577 nm with injections of enriched platelet autoplasm

The article presents the results of treatment of patients with central serous chorioretinopathy using a subthreshold microimpulse laser (SMILV) of 577 nm with injections of enriched platelet autoplasma. We treated 10 eyes which were examined and treated in 10 patients. The first stage was performed by SMIL on a Supra 577 nm laser device (Quantel Medical) over the entire area of the macular edema. The second stage on the next day after SMILV, the patient undergoes pterygoal injections of enriched platelet autoplasma into the region of the regional lymphatic reservoir with a course of 3 units. With an interval of 72-96 hours. The exposure and its operating cycle (duty cycle) were selected individually for each patient, depending on the height of the edema and the degree of pigmentation of the fundus, and the transparency of the optical media of the eyeball. The results of the study were evaluated before laser intervention and after 1 month. All of patients s were treated with standard ophthalmologic examination including visometry, tonometry, ophthalmoscopy on a slit lamp with aspherical lenses 78 D in all patients before treatment and in dynamics after 1 month. Fluorescence angiography, optical coherence tomography on a CIRRUS instrument HD-OCT (500023J6) ver. 8.0.0.518; Photoregistration and microperimetry on the MAIA instilment (CenteVue, Italy), OCT-angiography. Visual acuity before treatment averaged 0.69 D, after treatment averaged 0.8 D, the height of macular edema was, before treatment, an average of 349 nm after treatment, on average, 301 nm. SMILV using a 577 nm yellow diode laser (Quantel medical) is an effective and safe procedure in the treatment of patients with central serous chorioretinopathy. With central serous chorioretinopathy, it is possible to perform laser treatment at the parafoveolar infiltration point, with diapedes leakage, and also in the chronic form of the disease with diffuse hyperfluorescence regions and the absence of an explicit filtration point. The possibility of using a combined method for the treatment of SMIL with vlane injections of platelet autoplasma in the treatment of central serous chorioretinopathy is more effective, pathogenetically grounded and safe.

subthreshold microimpulse laser treatment, central serous chorioretinopathy, macular edema in central serous chorioretinopathy, platelet autoplasma

1. Мутиков И.В., Мазунин И.Ю. Наш опыт в лечении центральной серозной хорио-ретинопатии (ЦСХРП) с юкстасубфовеолярной локализацией точки фильтрации с помощью субпорогового микроимпульсного инфракрасного лазерного воздействия (СМИЛВ) // IV Всерос. семинар «круглый стол» - «Макула 2010»: тез. докл. - Ростов-на-Дону, 2010. - С. 452-453.

2. Щуко А.Г., Злобина А.Н., Юрьева Т.Н. Этиопатогенетические подходы к диагностике и лечению острой и хронической центральной серозной хориоретинопатии: Обзор литературы // Офтальмология. - 2013. - № 2. - С. 14-19.

3. Carvalho-Recchia C.A., Yannuzzi L.A., Negrao S. [Corticosteroids and central serous chorioretinopathy // Ophthalmology. - 2002. - Vol. 109. - P. 1834-1837.

4. Гацу М.В. Эффективность фотодинамической терапии при хронических формах центральной серозной хориоретинопатиию. Причины неудач // VI Всерос. семинар - круглый стол «Макула-2014»: тез. докл. - Ростов-на-Дону, 2014. - С. 139-155.

5. Balles M.W., Puliafito C.A., Amico D.J. Semiconductor diode laser photocoagulation in retinal vascular disease // Ophthalmology. - 1990. - Vol. 97. - P. 1553-1561.

6. Балашевич Л.И. Создание и изучение эффективности применения аргонового и диодного лазеров при патологии глазного дна: Автореф. дис. д-ра мед. наук. - СПб., 1996. - 42 с.

7. Мутиков И.В., Мазунин И.Ю. Наш опыт в лечении центральной серозной хориоретинопатии (ЦСХРП) с юкстасубфовео-лярной локализацией точки фильтрации с помощью субпорогового микроимпульсного инфракрасного лазерного воздействия (СМИЛВ) // IV Всерос. семинар - круглый стол «Макула 2010»: тез. докл. - Ростов-на-Дону, 2010. - С. 452-453.

8. Francisco Arnalich, Alejandra E. Rodriguez, Avaro Luque - Rio, Jorge L. Alio. Solid Platenet Rich Plasma in Corneal Surgery // Ophthalmol. Ther. 2016 June; 5 (1): 31-45.

9. Sanchez A.R., Sheridan P.J., Kupp L.I., Is platelet-rich plasma the perfect enhancement factor. A current review. Int. J. Oral Maxillofac. Implants. 2003; 18: 93-103.