Abstract

SA.10.07

The optimization of the management of patients with choroidal neovascularisation caused by pathological myopia

Rykov S. A., Pasyechnikova N. V., Suk S. A., Saksonov S. G., Korol A. R.
Eye Microsurgery Center Kiev, The Filatov Institute of Eye Diseases & Tissue Therapy, Odessa
Presenter: Dr. S. G. Saksonov

Objective: The development of choroidal neovascularisation (CNV) complicates the course of a number of retinal diseases. The capacity ranges mentioned by authors are not differentiated in relations to occult or classical membranes, especially in PM.
Aim: Improve the efficiency of treatment in cases of classical choroidal neovascularisation under Pathological Myopia by applying Transpupillar Thermotherapy and using the estimated laser capacities depending on the diameter of irradiation retina spot.
Methods: We observed 27 patients (31 eyes) with classical choroidal neovascularisation in Pathological Myopia. . The average observation period was 10 months (ranging from 6 to 14 months) All the patients were taking through a set of ophthalmological examinations: defining visual acuity, perimetry, Amsler test, color photography of eye fundus, Fluorescent angiography (FA), Optical coherent tomography (OCT). Subfoveal localization occurred in 68,5% (21 eyes) cases, uxtafoveal in 35,5% (10 eyes).Visual acuity with the best correction was from 0,05 through 0,4. All the patient have undergone 2-3 sessions of TTT within 4-5 weeks. Calculations of the laser radiation output capacity depending on the radiation spot diameter allow to reduce the neuroepithelium damage. Diod laser with 810 nm wave length was used. The follow-up examinations were conducted with the interval of 3-4 weeks after TTT sessions and later on every 1 or 2 months.
Results: A complete regression of CNV was observed in all patients during 3-4 months after treatment which was confirmed by FA and OCT data. Amsler test showed regression or significant reduction in metamorphopsia and positive dynamic central and paracentral scotoms. It was accompanied by the stabilization of visual acuity in 25 patients (29 eyes) and visual acuity improvement by 0.1-0.2 in 2 patients (3 eyes). After 7-8 months after treatment 3 patients (3 eyes) had a recedive of CNV which required repeated TTT sessions with the following regression of CNV and visual acuity stabilization.
Conclusions: The submitted methodology allows to reduce the impact of laser irradiation on the retinal neuroepithelium.

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