Choroiditis

Description:

Choroiditis (chorioiditis; annate. chorioidea an idiovascular cover of an eye + - itis) - an inflammation of an idiovascular cover of an eye; the retina also is often involved in process - retinokhorioidit.

Choroiditis symptoms:

At the isolated choroiditis patients of complaints do not show therefore quite often it is revealed only at an oftalmoskopiya. When involving in process of a retina there are vision disorders. Depending on an arrangement of the chorioretinal center sharp decrease in sight, distortion of the considered objects and a photopsia,  or decrease in twilight sight, emergence of "the flying front sights" are noted, the scotomas corresponding to the location of the centers come to light.

The inflammatory centers in an idiovascular cover (single or multiple) found at an oftalmoskopiya to a thicket happen roundish, the optic disk from 1/2 to 11/2 diameters in size. At an active inflammation on an eyeground the grayish or yellowish centers with indistinct contours pro-mining (pressing) in a vitreous over which not interrupted lines of vessels of a retina are located are visible. Hemorrhages in an idiovascular cover, a retina and a vitreous are possible. Progressing of a disease leads to opacification of a retina in the field of the center. In some cases opacifications in back department of a vitreous develop. Under the influence of treatment the chorioretinal center is flattened, becomes transparent, gets more accurate contours; on its border pigmentation in the form of small points appears. Often on site the center small and average vessels of a horioidea disappear; the thinned idiovascular cover is appeared through by a sclera. The sharp ocherchennost of borders and pigmentation of the center demonstrate transition of an active inflammation to an atrophy stage.

At an arrangement of the chorioretinal center near an optic disk distribution of an inflammation on an optic nerve is possible. Peripapillary develops torioretinit (the okolososochkovy neuroretinitis of Janszen, yukstapapillyarny retinokhorioidit Janszen, a circinate retinitis). In such cases under review there is characteristic scotoma merging with physiological at an oftalmoskopichesky research the stushevannost of borders of an optic nerve is defined.

The described clinical manifestations of a choroiditis are not characteristic of a disease of any certain etiology and can be revealed at virus, streptococcal and other choroidites. Complications in the form of secondary dystrophy of a retina, exudative amotio of a retina, an optic neuritis with transition to an atrophy, extensive vitreous hemorrhages with the subsequent shvartoobrazovaniye are possible. Hemorrhages in own choroid and a retina can lead to formation of rough connective tissue hems and formation of a neovascular membrane that is followed by sharp decrease in visual functions.

Choroiditis reasons:

In development of a choroiditis the main role belongs to an infection — tubercular, toksoplazmozny, streptococcal, staphylococcal, virus, syphilitic, brucellous, etc., and also to helminths. The structure and functions of an idiovascular cover create the conditions promoting a delay in it the disease-producing factors brought with a blood flow and their toxins. Emergence of X. overcooling of an organism, an eye injury can provoke. In a pathogeny the main role belongs to immune responses. At the same time activators can play a releaser role, and the inflammation develops as autoimmune process.

Treatment of the Choroiditis:

Treatment is directed to a basic disease and stopping of inflammatory process, prevention of a recurrence and complications. At tubercular, toksoplazmozny, virus, staphylococcal, streptococcal and others X. carry out the specific desensitization (numerous administration of antigen in small doses) promoting also prevention of a recurrence. At all stages of treatment (in the period of an active inflammation, at aggravations, and also for their prevention) also the nonspecific desensitization including use of antihistaminic drugs is shown (Dimedrol, Suprastinum, tavegil, isopromethazine, Diazolinum, etc.). Great value as in treatment most X., and for sanitation of the centers of an infection in an organism have antibacterial agents which select depending on a disease etiology; use also antibiotics of a broad spectrum of activity. At activity of process and a recurrence include corticosteroid hormones in a complex of treatment (dexamethasone, Prednisolonum, a hydrocortisone, etc.). At an active inflammation and in the period of an aggravation in combination with corticosteroids appoint immunodepressants (Mercaptopurinum, Azathioprinum, a methotrexate, ftoruratsit, Cyclophosphanum). All medicines can be entered intramusculary, inside, retrobulbarno, suprakhorioidalno, and also by means of an electrophoresis. At all stages of treatment widely use vitamins C, B1, B6, B12.

Resorptional effect at exudate and hemorrhages in хориоидею, a retina, a vitreous enzymes (trypsin, fibrinolysin, a lidaza, papain, lecozimum, Streptodecasum) which enter intramusculary, retrobulbarno, by means of an electrophoresis have.

Cryocautery of an idiovascular cover is shown at secondary dystrophy after transferred X. for prevention of amotio of a retina. Retinas spend Lazerkoagulyation at hemorrhagic chorioretinites and for prevention of amotio of a retina.

At an active inflammation and a recurrence of a disease treatment is carried out in a hospital, then it is out-patient. The resort therapy can be carried out in sanatoria of the general type, at tubercular chorioretinites — in specialized sanatoria.