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Clinical and ophthalmic evaluation of the effectiveness of comprehensive treatment regimen for central serous chorioretinopathy

Year: 2020, volume 16 Issue: №2 Pages: 662-668
Heading: Ophtalmology Article type: Original article
Authors: Stanishevskaya О.М., Chernykh V.V., Bratko V.I., Bratko G.V., Poveshchenko O.V.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences
Summary:

The purpose of the study is to evaluate the clinical-ophthalmological effectiveness of the developed complex treatment for central serous chorioretinopathy (CSC) using subthreshold micro-pulse laser (SMILV) exposure with a wavelength of 577 nm combined with platelet autoplasm (TP) injections in the pterygopalatine fossa, which is the region of hemolymphocirculation. Material and Methods. The study was conducted on 60 patients (60 eyes) with CSC. Patients were divided into 2 groups: in the comparison group patients received treatment with SMILV with a wavelength of 577 nm only, while in the main group they received treatment with SMILV and subsequent TP injections. The patients were prescribed 3 injections into the pterygopalatine fossa on the side of the affected eye, which is the region of the hemolymphocirculation, with the 72-hour-long interval between injections. SMILV was carried out on a Supra 577 nm laser (Quantel Medical, France) over the entire area of macular edema. Results. The results of the application of the developed and patented treatment for patients with CSC with the use of SMILV 577 nm combined with enriched TP injections are presented in the study. Comparative analysis of clinical and ophthalmic effectiveness of the proposed method of treatment was compared with monotherapy with SMILV 577 nm 1, 3, 6 and 12 months after treatment. Conclusion. This method has been developed and introduced into clinical practice for combined treatment of patients with CSC. The study demonstrates great clinical and ophthalmic effectiveness of the combined treatment.

Keywords: subthreshold micropulse laser treatment, platelet autoplasma

Bibliography:
1. Yu L, Shao Y, Chai Y, et al. Retinal microvasculature alteration in central serous chorioretinopathy. Molecular Medicine Reports 2018; 17: 2335-40. DOI: 10.3892/mmr. 2017.8126.
2. Chen G, Tzekov R, Li W, et al. Subfoveal choroidal thickness in central serous chorioretinopathy: A meta-analysis. PLoS ONE 2017. DOI: 10.1371/journal, pone. 0169152. DOI: 10.1371/journal, pone. 0169152.
3. Kim JY, Chae JB, Kim J, Kim DY Mineralocorticoid receptor antagonist treatment for steroid-induced central serous chorioretinopathy patients with continuous systemic steroid sreatment. J Ophthalmol 2018. DOI: 10.1155/2018/4258763.
4. Mehta PH, Meyerle C, Sivaprasad S, et al. Preferred practice pattern in central serous chorioretinopathy. Br J Ophthalmol 2017; 101: 587-90. DOI: 10.1136/bjophthalmol-201 6-309247.
5. Akopyan VS, Kachalina GF, Pedanova EK, et al. Evaluation of chorioretinal complex tissue response on subthreshold micropulse yellow laser (577-nm) photocoagulation of retina in experiment. Fyodorov Journal of Ophthalmic Surgery 2015; 3: 54-8.
6. Piccolino FC, De La Longrais RR, Manea M, Cicinelli S. Posterior cystoid retinal degeneration in central serous chorioretinopathy. Retina 2008 Jul-Aug; 28 (7): 1008-12. DOI: 10.1097/IAE. 0b013e31816b4b86.
7. Hisatomi T, Sakamoto T, Goto Y, et al. Critical role of photoreceptor apoptosis in functional damage after retinal detachment. Curr Eye Res 2002; 24:161-72. DOI: 10.1076/ceyr. 24.3.161.8305.
8. Zacks DN, Hanninen V, Pantcheva M, et al. Caspase activation in an experimental model of retinal detachment. Invest Ophthalmol Vis Sci 2003; 44:1262-7. DOI: 10.1167/iovs. 02-0492.
9. Luthert PJ, Chong NH. Photoreceptor rescue. Eye 1998; 12: 591-6. DOI: 10.1016/s0002-9440 (10) 64078-3.
10. Breukink MB, Dingemans AJ, den Hollander Al, et al. Chronic central serous chorioretinopathy: long-term follow-up and vision-related quality of life. Clin Ophthalmol 2016 Dec 20; 11: 39-46. DOI: 10.2147/OPTH. S115685.
11. Sanchez-Avila RM, Merayo-Lloves J, Fernandez ML, et al. Plasma rich in growth factors eye drops to treat secondary ocular surface disorders in patients with glaucoma. Int Med Case Rep J 2018; 11:97-103. DOI: 10.2147/IMCRJ. S153918.
12. Minihan M, Goggin M, Cleary PE. Surgical management of macular holes: results using gas tamponade alone, or in combination with autologous platelet concentrate, or transforming growth factor p2. Br J Ophthalmol 1997; 81: 1073-9. DOI: 10.1136/bjo. 81.12.1073.
13. Avila MY, Igua AM, Mora AM. Randomised, prospective clinical trial of platelet-rich plasma injection in the management of severe dry eye. Br J Ophthalmol 2018. DOI: 10.1136/bjophthalm 01-2018-312072.
14. Panda A, Jain M, Vanathi M, et al. Topical autologous platelet-rich plasma eyedrops for acute corneal chemical injury. Cornea 2012; 31: 989-93. DOI: 10.1097/ICO. 0b013e3182114661.
15. Alio JL, RodriguezAE, Ferreira-OliveiraR,etal.Treatment of Dry Eye Disease with Autologous Platelet-Rich Plasma: A Prospective, Interventional, Non-Randomized Study. Ophthalmol Ther2017; 6: 285-93. DOI: 10.1007/s40123-017-0100-z.
16. Sanchez-Avila RM, Merayo-Lloves J, Riestra AC, et al. Treatment of patients with neurotrophic keratitis stages 2 and 3 with plasma rich in growth factors (PRGF- Endoret) eye-drops. Int Ophthalmol 2018; 38: 1193-204. DOI: 10.1007/sl 0792-017-0582-7.
17. Marquez-de-Aracena R, Montero-de-Espinosa I, Munoz M, Pereira G. Subconjunctival application of plasma platelet concentrate in the treatment of ocular burns: Preliminary results. Arch Soc Esp Oftalmol 2007; 82: 475-81. DOI: 10.4321 /s0365-66912007000800005.

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All articles of the authors: Stanishevskaya O.M. , Poveshchenko O.V. , Chernykh V.V. , Bratko V.I. , Bratko G.V.

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