Abstract
The purpose is to determine preoperative OCT predictors and, based on the data obtained, to develop a treatment strategy for patients with a chronic form of central serous chorioretinopathy (CSCRP) complicated by choroidal neovascularization (CNV) type 1. Material and methods. A retrospective analysis of 53 patients with a chronic form of CSCRP complicated by CNV type 1 was carried out, 30 men (56.6 %) and 23 women (43.4 %). The first (control) group included 27 patients for whom inhibitors angiogenesis intravitreal injection (IAIVI) monotherapy was effective, and a positive clinical response after the first IAIVI was observed. The second (main) group included 26 patients in whom IAIVI as monotherapy did not lead to the sensorineural retina reattachment, and combined treatment was performed: one day before IAIVI, selective micro-pulse laser exposure (SMPLE) was performed. All patients underwent optical coherence tomography (OCT) and OCT in angio mode (OCTA) on the device “RTVue XR Avanti Angiovue” (Optovue, USA). Results. In patients with a chronic form of CSCRP complicated by CNV type 1, the main OCT predictors indicating the predominance of the role of one of the two co-existing pathologies are the initial thickness of the choroid and the area of CNV type 1. The initial pachychoroidal vascular change, which has a value of more than 490 microns, and the area of CNV not exceeding 0.300 mm2, indicate the predominance of CSCRP as the main mechanism of transudative detachment of the sensorineural retina and require combined treatment (SMPLE + IAIVI). Conclusion. The identified predictors contribute to the timely selection of a pathogenetically sound treatment method, which accelerates the resorption of subretinal fluid and promotes faster sensorineural retina reattachment, thereby improving the functional results of the treatment. Keywords: central serous chorioretinopathy, choroidal neovascularization, optical coherence tomography, selective micro-pulse laser exposure, angiogenesis inhibitors intravitreal injection.
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