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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">helmholtzeyeinstitute</journal-id><journal-title-group><journal-title xml:lang="ru">Российский офтальмологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Ophthalmological Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-0076</issn><issn pub-type="epub">2587-5760</issn><publisher><publisher-name>Real time Publishers</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21516/2072-0076-2023-16-1-82-89</article-id><article-id custom-type="elpub" pub-id-type="custom">helmholtzeyeinstitute-1173</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Вариант комбинированного лечения хронической центральной серозной хориоретинопатии, осложненной хориоидальной неоваскуляризацией I типа</article-title><trans-title-group xml:lang="en"><trans-title>A variant of combined treatment for chronic central serous chorioretinopathy complicated by type 1 choroidal neovascularization</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Терещенко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tereshchenko</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Александр Владимирович Терещенко — д-р мед. наук, директор</p><p>ул. Святослава Федорова, д. 5, Калуга, 248007</p></bio><bio xml:lang="en"><p>Aleksandr V. Tereshchenko — Dr. of Med. Sci., director</p><p>5, Svyatoslav Fedorov St., Kaluga, 248007</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ерохина</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Erokhina</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елена Владимировна Ерохина — врач-офтальмолог, заведующая 2-м диагностическим отделением</p><p>ул. Святослава Федорова, д. 5, Калуга, 248007</p></bio><bio xml:lang="en"><p>Elena V. Erokhina — ophthalmologist, head of the diagnostic department #2</p><p>5, Svyatoslav Fedorov St., Kaluga, 248007</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сидорова</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sidorova</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Юлия Александровна Сидорова — канд. мед. наук, заведующая отделением лазерной хирургии донной патологии глаза</p><p>ул. Святослава Федорова, д. 5, Калуга, 248007</p></bio><bio xml:lang="en"><p>Yuliya A. Sidorova — Cand. of Med. Sci., head of the department of laser surgery of eye fundus pathology</p><p>5, Svyatoslav Fedorov St., Kaluga, 248007</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трифаненкова</surname><given-names>И. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Trifanenkova</surname><given-names>I. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ирина Георгиевна Трифаненкова — д-р мед. наук, заместитель директора по научной работе</p><p>ул. Святослава Федорова, д. 5, Калуга, 248007</p></bio><bio xml:lang="en"><p>Irina G. Trifanenkova — Dr. of Med. Sci., deputy director</p><p>5, Svyatoslav Fedorov St., Kaluga, 248007</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Калужский филиал ФГАУ НМИЦ «МНТК "Микрохирургия глаза" им. акад. С.Н. Федорова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kaluga branch, S.Fyodorov Eye Microsurgery Clinic</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>16</day><month>03</month><year>2023</year></pub-date><volume>16</volume><issue>1</issue><fpage>82</fpage><lpage>89</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Терещенко А.В., Ерохина Е.В., Сидорова Ю.А., Трифаненкова И.Г., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Терещенко А.В., Ерохина Е.В., Сидорова Ю.А., Трифаненкова И.Г.</copyright-holder><copyright-holder xml:lang="en">Tereshchenko A.V., Erokhina E.V., Sidorova Y.A., Trifanenkova I.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://roj.igb.ru/jour/article/view/1173">https://roj.igb.ru/jour/article/view/1173</self-uri><abstract><p>Цель работы — оценить эффективность комбинированного лечения пациентов с хронической центральной серозной хориоретинопатией (ЦСХРП), осложненной хориоидальной неоваскуляризацией (ХНВ) I типа, с применением субпорогового микроимпульсного лазерного воздействия (СМИЛВ) и интравитреального введения ингибиторов ангиогенеза (ИВВИА). Материал и методы. Обследовано 37 пациентов (20 мужчин и 17 женщин) с монолатеральной хронической рецидивирующей ЦСХРП, осложненной ХНВ I типа. Возраст пациентов на момент первого обращения составил 43,6 ± 6,7 года (от 35 до 57 лет). В ретроспективную группу вошли 15 пациентов (15 глаз), лечение которых начинали с ИВВИА — до 5 инъекций с интервалом в месяц. Пациентам с отсутствием эффекта данной терапии за сутки до 6-й инъекции выполняли сеанс СМИЛВ. При сохранении отслойки нейросенсорной сетчатки (НСС) комбинированное лечение (СМИЛВ + ИВВИА) повторяли ежемесячно до полного прилегания НСС с последующим переводом пациентов на монотерапию анти-VEGF препаратами с постепенным увеличением интервала между инъекциями. В основную группу были включены 22 пациента (22 глаза), лечение которых начинали с однократного ИВВИА. При отсутствии резорбции отслойки НСС пациентам за сутки до второго ИВВИА проводили сеанс СМИЛВ. Комбинированное лечение повторяли ежемесячно до полной резорбции отслойки НСС. После купирования отслойки НСС дальнейшее лечение продолжали с помощью ИВВИА с постепенным увеличением интервала между инъекциями. Результаты. Количество инъекций ингибитора ангиогенеза в основной группе (от 5 до 8, в среднем 6,1 ± 0,8) было значительно выше, чем в ретроспективной (от 8 до 10, в среднем 8,80 ± 0,77). Максимально корригированная острота зрения повысилась в обеих группах, при этом в основной группе достигнуты лучшие показатели центральной светочувствительности, что связано с прилеганием отслойки НСС в более короткие сроки. Площадь ХНВ I типа, а также толщина хориоидеи к концу срока наблюдения в основной группе были значительно ниже, чем в ретроспективной. Осложнений после комбинированного лечения не зафиксировано ни в одном случае. Заключение. Предложенная комбинация лазерного воздействия с последующим введением ингибитора ангиогенеза является безопасным методом лечения осложненных форм ЦСХРП, позволяющим ускорить резорбцию субретинальной жидкости и сократить количество этапов лечения.</p></abstract><trans-abstract xml:lang="en"><p>Purpose: to evaluate the effectiveness of combined treatment of chronic central serous chorioretinopathy (CSCRP) complicated by type 1 choroidal neovascularization (CNV) by subthreshold micropulse laser exposure (SMILE) and intravitreal injection of angiogenesis inhibitors ( IIAI). Material and methods. 37 patients (20 men and 17 women) with monolateral chronic recurrent CSCRP complicated by type 1 CNV, aged 35 to 57 (ave. 43.6 ± 6.7 yrs.) at the moment of first referral, were divided into two groups. The retrospective group included 15 patients (15 eyes) whose first phase of treatment consisted in IIAI (up to 5 injections with an interval of one month). Those who showed no treatment effect were given a SMILE procedure one day before the 6th injection. If neurosensory retinal detachment persisted, the combined treatment (SMILE + IIAI) was repeated monthly until the neurosensory retina could be fully attached, whereupon the patients were transferred to monotherapy with anti-VEGF injections, gradually increasing the interval between the injections. The main group included 22 patients (22 eyes), whose treatment began with a single IIAI. If no neurosensory retinal detachment resorption occurred, the patients received a SMILE procedure one day before the second IIAI injection. The combined treatment was repeated monthly until neurosensory retinal detachment completely resorbed, then the treatment continued with IIAI alone with a gradual increase of intervals between the injections. Results. The number of IIAI in the main group (5 to 8, ave. 6.1 ± 0.8) was significantly lower than in the retrospective group (8 to 10, ave. 8.8 ± 0.77). Best corrected visual acuity increased in both groups, but the main group showed a better central photosensitivity, which is associated with the faster reattachment of neurosensory retina. By the end of the follow-up period, the area of type 1 CNV, and the thickness of the choroid were significantly lower in the main group as compared to the retrospective group. The combined treatment did not cause a single case of complication. Conclusion. The proposed combination of laser exposure followed by IIAI is a safe method for treating complicated forms of CSCRP, which quickens the resorption of subretinal fluid and reduces the number of treatment procedures.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хроническая центральная серозная хориоретинопатия</kwd><kwd>субпороговое микроимпульсное лазерное воздействие</kwd><kwd>интравитреальное введение ингибиторов ангиогенеза</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic central serous chorioretinopathy</kwd><kwd>subthreshold micropulse laser exposure</kwd><kwd>intravitreal injection of angiogenesis inhibitors</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Liew G., Quin G., Gillies M., Fraser-Bell S. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin. Exp. 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