RU2294719C2 - Method for treating the cases of acute blood circulation disorders in eye retina - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves applying infrared transpupillary laser radiation therapy directly to injured blood vessels. Treatment parameters are wavelength of 810 nm, radiation power of 300-400 mW, spot diameter of 0.8-1.2 mm, exposure time equal to 1 min. 1-2 treatment sessions are given with 1-2 months long pause.

EFFECT: enhanced effectiveness of subthreshold photocoagulation; recovered venous blood circulation; avoided coagulate production.

Description

The present invention relates to the field of medicine, namely to ophthalmology.

Acute circulatory disorders in the retina are among the most severe forms of eye pathology, leading to partial, and in some cases complete loss of vision. In recent decades, in connection with the general increase in vascular pathology, there has been a significant increase in the number of cases of acute circulatory disorders of the organ of vision. Despite the huge number of studies on the etiology of the pathogenesis and treatment of such conditions, it is still not possible to help the patient with guarantee.

It is known the treatment of acute circulatory disorders by prescribing drugs - anticoagulants, angioprotectors, fibrinolytic agents. However, this treatment is mediated, in addition, the risk of vitreous hemorrhage is rather high (L.V. Katsnelson, T.I. Forofonova, A.Ya. Bunin. Vascular eye diseases. - 1980. - P.126-146).

The closest is a method of treating acute circulatory disorders by laser coagulation. For this, photocoagulators are used - argon green, lambodime green, yellow on dyes, infrared diode in coagulation mode. Parameters are selected individually depending on the transparency of optical media, retinal pigmentation. Coagulation is carried out by the Grid method or combined Grid + coagulation of the affected area. In the case of neovascularization, panretinal laser coagulation is performed (Steven M. Bloom, Alexander S. Brocer. Laser Surgery of the Posterior Segment. 1990. - P.112-123). However, the known method is traumatic, as it has a high coagulating effect.

The technical result of the proposed method of treatment is to reduce the duration of rehabilitation, reduce complications due to the early restoration of venous circulation.

New in achieving the technical result is that they carry out laser infrared transpupillary thermotherapy of directly affected vessels with a wavelength of 810 nm, a radiation power of 300-400 mW, a spot diameter of 0.8-1.2 mm, and an exposure of radiation for 1 minute.

What is also new is that they conduct 1-2 treatment sessions with an interval of 1-2 months.

Laser infrared transpupillary vascular thermotherapy is a method of subthreshold photocoagulation, which uses a large area spot, low energy, long-term radiation exposure. The temperature in the radiation region rises by 4-9 degrees, so the proposed method does not have a coagulating effect. In the process, the authors selected the optimal radiation parameters in the treatment of acute circulatory disorders of the retinal vessels.

Comparative analysis with the prototype shows that the inventive method differs from the known one in that they carry out laser infrared thermotherapy of directly affected vessels with a wavelength of 810 nm, a radiation power of 300-400 mW, a spot diameter of 0.8-1.2 mm, radiation exposure over 1 minute, while 1-2 sessions of treatment are carried out with an interval of 1-2 months, which meets the criterion of "novelty."

A new set of features allows to reduce the rehabilitation time by 10-12 times, reduce complications due to the early restoration of venous circulation, the absence of coagulum, increases visual acuity, which meets the criterion of "industrial applicability".

The method is as follows.

All patients before treatment, as well as a week and a month after it, undergo an ophthalmic examination: visometry, biomicroscopy, optical coherence tomography (OCT) of the retina and optic disc. Before surgery, Sol.Dicaini 1% instillation anesthesia is performed. A laser infrared transpupillary thermotherapy is carried out directly on the affected vessels of the retina at a radiation power of 300-400 mW, with a wavelength of 810 nm, and a spot diameter of 0.8-1.2 mm. Duration of exposure - 1 minute. If necessary, the treatment is repeated after 1-2 months.

The method is illustrated by the following clinical example.

Patient EB, 60 years old, noted a decrease in vision since September 30, 2004. She did not conduct treatment. Upon receipt of 04.10.04, complaints of decreased vision of the OS.

Objectively: Vis OS - 0.2 n.k.

Fundus: optic nerve discs of usual color, veins are dilated, arteries are narrowed, Salus 1, along the upper temporal arcade of hemorrhage, mild exudate, edema. OST before treatment: DZN 250-300 microns, the thickness of the retina - 537-540 microns.

10/05/04. Laser infrared transpupilar thermotherapy of vessels was carried out: energy power 310 mW, spot diameter 0.8 mm, exposure - 1 minute.

10/07/04 There are no complaints, OS eye is calm. Vis OS 0.1 with correction + 1.5 ° = 0.5.

Fundus: without negative dynamics.

November 26, 2004. There are no complaints. Vis OS - 0.4 with correction + 1.0 ° = 0.65

The fundus: optic nerve discs of usual color, the borders are clear, the swelling has decreased, there are no soft exudates. Retinal OST: DZN 100-110 microns, the thickness of the retina is 400-430 microns.

Claims (1)

A method of treating acute circulatory disorders in the retina by laser irradiation, characterized in that they carry out laser infrared transpupillary thermotherapy of directly affected vessels with a wavelength of 810 nm, a radiation power of 300-400 mW, a spot diameter of 0.8-1.2 mm, exposure for 1 min, with 1-2 treatment sessions with an interval of 1-2 months.