TRANSPUPILLARY THERMOTHERAPY OF THE OPTIC NERVE AS A METHOD OF CHOICE IN THE TREATMENT OF THE CENTRAL RETINAL VEIN OCCLUSION

• Main Authors: A. G. Shchuko, M. V. Akulenko, T. N. Iureva, V. V. Bukina, A. A. Pashkovskiy
• Format: Article
• Language: Russian
• Published: Publishing house "Ophthalmology" 2015-10-01
• Series: Офтальмохирургия
• Subjects: central retinal vein occlusion; transpupillary thermotherapy of the optic disk
• Online Access: https://www.ophthalmosurgery.ru/jour/article/view/75
• ISSN: 0235-4160; 2312-4970

Purpose. To give the pathogenetic rationale and an evaluation of clinical efficacy of transpupillary thermotherapy of the optic disk in the central retinal vein occlusion.Material and methods. The ophthalmological examination was performed with a profound study of regional hemodynamics, layer-by-layer structure of the retina, their electrical sensitivity and neuroconductivity of 15 patients with central retinal vein occlusion before and after transpupillary thermotherapy of the optic disk.Results. As a result of transpupillary thermotherapy of the optic nerve in patients with central retinal vein occlusion, immediately after treatment twice increase occurs in visual acuity, retinal thickness significantly reduced in the central and peripapillary area and speed index of blood flow improved in the central retinal vein system. After one month there are positive changes in the arterial bed – the speed of blood flow improves in the ophthalmic artery and short posterior ciliary arteries. By 3-6 months this leads to the decrease of retinal thickness and improving оf electroretinogram and visual evoked potentials to the level of the fellow eye. It was revealed that after thermotherapy of optic disc the perfusion in the vessels of the retina and optic nerve has improved, which was accompanied by a decrease in height and area of ischemic edema in the peripapillary area, an improvement of impulses conductivity along nerve fibers. In contrast to conservative therapy and laser coagulation visual function improvement occurred in 89% of cases, after a single session of transpupillary thermotherapy of optic nerve, the negative dynamics in the early and late postoperative period wasn’t identified.Conclusions. Transpupillary thermotherapy of the optic disk is a highly effective and pathogenetically proved and safe method of treatment, which directionally impacts on the regional hemodynamics, enables to achieve positive structural and functional changes in the visual system of the central retinal vein occlusion.