Central serous chorioretinopathy (CSC) is a disease of complex origin and unknown etiology. Traditionally, two clinical forms of CSC are verified in accordance with the activity and duration of the pathological process: classic acute form and chronic CSC. Nowadays, there is no unified concept accepted for the management of patients with this disease, particular difficulties exist in cases of chronic CSC. This literature review highlights current trends and approaches to the treatment of CSC patients — from focal laser photocoagulation to physical methods oh therapy. The therapeutic approach as a whole depends on the form of the CHS. In most cases of the acute form of CSF, spontaneous regression, spontaneous adhesion of RPE detachment and retinal neuroepithelium are noted within several months from the onset of the disease. Therapy for the chronic form of this disease is still a difficult task and a controversial issue. Direct laser coagulation of the retina at the oozing point is recognized as the most effective method of therapy for acute typical form of CSF. In the chronic form of CSC, photodynamic therapy, transpupillary thermotherapy and subthreshold micropulse laser exposure are used. The goal of drug therapy for CSF is to activate the processes of resorption of serous fluid from the subretinal or subpigmented space, reduce the activity of pathological processes in the choroid, and improve trophism and metabolism. The currently used methods of treating chronic CSH have a number of disadvantages and variable efficacy. The existence of treatment-resistant cases is the subject of further research and clinical research. The development of new physical and physiopharmacological methods of treatment for CSF is perspective.

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Age-related macular degeneration (AMD) is the leading cause of blindness in people over 55 in developed countries. Moreover, the number of these patients will increase growth as life expectancy increases. It is estimated that late AMD accounts for half of blindness and low vision cases in European countries. A myriad of studies is currently underway to discover cutting-edge, effective therapeutic modalities. Gene therapy is a novel alternative to regular intravitreal injections of anti-VEGF agents for late wet AMD. This technique’s heart is a specific gene delivery to target cells to generate natural VEGF inhibitors. Gene therapy affecting the complement system to deactivate its end product, the membrane attack complex, is reasonable in late atrophic AMD. Studies on stem cell therapy for late atrophic AMD undergo as well. It was demonstrated that retinal pigment epithelium (RPE) cells derived from human embryonic stem cells or induced pluripotent stem cells express typical RPE markers that can phagocytize photoreceptor segments. Electrical stimulation and magnet therapy are already introduced into clinical practice to rehabilitate patients with late AMD. Magnetic and electrical fields improve impulse transmitting, activate intracellular and tissue regeneration of the retina. Recent findings are promising but require further in-depth studies. Keywords: age-related macular degeneration, retinal scar, gene therapy, stem cells, physiotherapy, rehabilitative medicine. For citation: Drakon A.K., Kurguzova A.G., Sheludchenko V.M., Korchazhkina N.B. Non-medical treatment for late age-related macular degeneration. Russian Journal of Clinical Ophthalmology. 2021;21(4):215–219 (in Russ.). DOI: 10.32364/2311-7729-2021-21-4-215-219.

Objective. To evaluate the preliminary results after micropulse cyclophotocoagulation in patients with primary open-angle refractory glaucoma (POAG) and neovascular glaucoma. Methods. Retrospective study of adult patients with glaucoma, with at least 6 months follow-up after the only one session of micropulse laser therapy. The study included 16 patients, 17 eyes with refractory primary open-angle glaucoma (POAG) and neovascular glaucoma. Follow up period was 6 months. The same surgical technique was used in all cases. The wavelength of the laser beam was 810 nm, the total exposure was 160 s, the energy was 2000 mJ, 31,3% of active cycle, the pulse duration was 0.5 ms, the period was 1.1 ms. Results. The average decrease in IOP was 26.6%. No complications identified Conclusions: micropulse transscleral cyclophotocoagulation has been shown to be safe and effective in lowering IOP in patients with refractory glaucoma. However, further study of this method is required. Key words: micrоpulse transscleral cyclophotocoagulation, glaucoma, intraocular pressure.