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Treatment of diseases of the retina

The pathological changes of the retina may not have clinical symptoms in the early stages and can be identified only with the inspection with the fundus lens allows visualization the extreme peripheral zone of the retina. There can be identified as primary degenerative changes (peripheral chorioretinal degeneration of the retina - the PDS, HRPDS) often require only observation in dynamics at intervals of 6-12 months, as well as requiring immediate intervention in pathological conditions (vitreochoreoretinal dystrophy, preruptures, ruptures and retinal detachment).

Timely implementation of laser photocoagulation (actually "welding" of the retina to the underlying tissues) degenerative lesions, preruptures, ruptures and retinal detachments in most cases will prevent the serious complications that can lead to total blindness. Laser photocoagulation is performed on an outpatient basis and lasts 10-15 minutes. Re-examination as a rule is required not earlier than 6-12 months.

Surgery of vitreous detachments and retinal breaks with endolasercoagulation and introducing of perfluororganic compounds, silicone oil allows coping with serious consequences of pathological conditions having occurred and to achieve a significant improvement in prognoses of the outcome of the disease.

Extrascleral filling allows treating retinal detachments and tears without penetrating into the interior of the eye, and thus significantly reduces the risk of postoperative complications.

Laser treatment of retinopathy of different etiology (diabetic, congenital, traumatic) can improve the nutrition of the retina, as well as to stop the processes that underlie the pathogenesis of the above mentioned diseases. So in diabetic retinopathy an extensive area of the retina (panretinal laser photocoagulation) undergoes to laser influence, stimulating growth factors of defective vessels, which subsequently self-destruct with the release of blood into the retina and the inner cavity of the eye, as well as the vessels themselves.

Panretinal laser coagulation in the early stages of diabetic retinopathy over the long term allows preventing blindness in these patients. Panretinal laser photocoagulation usually is made in several stages (3-5) with the interval (time varies considerably depending on the clinical picture) from 1 day to 2 weeks. After the laser treatment is necessary to administrate a local anti-inflammatory therapy (eye drops) for a period of 5-7 days. The effectiveness of the procedure depends on the degree of compensation of the underlying disease.

Laser treatment is an essential component of a comprehensive treatment of the effects of circulatory disorders of the retina, such as thrombosis, central retinal vein. The operation is performed on an outpatient basis in several steps (3-5) at intervals of 1-14 days depending on the clinical picture.

Intravitreal injection of inhibitors of vascular endothelial growth factors (antiVEGF - Avastin, Lucentis) in diseases involving neovascularization and macular edema (diabetic macular edema, thrombosis, age-related macular degeneration) allows quickly and effectively reduce the swelling in the retina, slow the progression of the pathological process, and sometimes even to stop him. The procedure is performed only in the operating room of a hospital, but in most cases does not require hospitalization for more than one day.


The 10th Minsk City Clinical Hospital