In the modern world, a huge number of ailments of various organs are known. The eyes are no exception. When the first symptoms appear, you should consult a professional doctor. Chorioretinitis of the eye is an inflammatory process affecting the posterior sections of the vascular membranes of the eyeball. Pathology can also spread to the retina. This disease greatly reduces the rate of blood circulation processes. This fact is explained quite simply: the largest number of infectious agents lingers precisely on the back of the eyeball. In this review, we will take a closer look at what chorioretinitis of the eye is, how to treat this disease, as well as preventive measures.
Disease development
So what do you need to know about this? The chorioretinitis of the eye spreads gradually. Initially, the disease affects the network of capillaries that provide blood to the retina. After that, it passes to a network of large vessels. Inflammation can occur in both acute and chronic forms. The disease can be classified according to a number of symptoms. Foreach type of ailment has its own signs.
Chorioretinitis of the eye can manifest itself at any age. In a child, it can be a complication of infectious diseases, and in adults it can develop as a result of improper use of optical correctors or due to contact with chemical reagents.
Classification
Let's take a closer look at this. The choriorenitis of the eye can be classified depending on a number of signs that determine the form and type of development of the disease. These include:
- number of outbreaks;
- distribution area;
- pathogens;
- duration of manifestation.
Depending on the distribution area, they are divided:
- Central serous chorioretinitis of the eye (appears in the macular area).
- Peripapillary (appears near the optic disc).
- Equatorial (inflammation of the choroid near the equatorial part of the organ of vision).
- Peripheral chorioretinitis of the eye (appears at the border of the dentate line).
The disease can manifest itself in one or more areas of the eye. On this basis, the disease can be conditionally divided into:
- focal chorioretinitis of the eye: when inflammation is concentrated in only one area;
- multifocal: an inflammatory process localized in several areas at once;
- diffuse chorioretinitis: characterized by a lot of inflammation with possible fusion.
Pathology can alsovary in duration. The acute form is said to be when the disease manifests itself before one trimester. A chronic ailment worries for a longer time, at least three months.
Chorioretinitis of the eye can also be classified depending on what has become the causative agent of the pathology. On this basis, the disease is divided into:
- infectious chorioretinitis;
- post-traumatic;
- non-infectious-allergic;
- infectious-allergic.
Most often we are talking about an infectious type of disease. There is also a congenital pathology - toxoplasmic chorioretinitis. In this case, infection occurs in the womb with toxoplasmosis. Not only the eyes, but also other organs are affected. The foci of the disease are represented by pronounced contours with strong pigmentation.
By the nature of occurrence, the ailment under discussion is divided into the following types:
- Tuberculosis: a secondary disease that develops only when infected with tuberculosis. It manifests itself in the occurrence of disseminated tubercles. After the treatment, chorioretinal scars may remain.
- Syphilitic: appears in the fundus, characterized by alternating fibrous foci of atrophy and pigmentation foci.
- Purulent: due to immunodeficiency. The main danger of this form is the spread of exudate to other sectors of the eyes. An immunodeficient variety is distinguished, which is characterized by a large area of damage, necrotic and hemorrhagic character. Passing this formthe disease is quite severe and may even end in complete blindness.
The other varieties of the disease have practically no distinguishing features. Myopic chorioretinitis can be especially distinguished. It usually develops in the region of the yellow spot located on the surface of the retina. The cause of the formation of the disease are recurrent hemorrhages in the retina.
Stages
How does chorioretinitis of the eye manifest itself? Symptoms depend on the stage of the disease. The initial stage is characterized by:
- the appearance of grayish-yellow lesions with weak contours;
- formation of exudate along the network of vessels;
- appearance of small hemorrhages.
In the progressive stage of the disease, lesions with pronounced outlines, strong pigmentation, and retinal atrophy appear.
Reasons
Let's look at them in more detail. What causes chorioretinitis of the eye? Usually this pathology is a consequence of the following diseases:
- autoimmune diseases such as arthritis and diabetes;
- infectious diseases: syphilis, toxoplasmosis, herpes virus;
- immunodeficiency diseases;
- exposure to toxins;
- viral diseases;
- damages and injuries;
- allergic reactions;
- prolonged exposure to radiation;
- development of complications.
Symptoms
So, what should you pay attention to first of all? As a rule, the symptoms of the disease are most pronounced in the placesource of occurrence. You can diagnose the disease by the following signs:
- foggy field of vision;
- deterioration of visual acuity;
- appearance of dark areas;
- presence of outbreaks;
- flickering sparks during visual review;
- distortion of the outlines and sizes of the objects in question;
- difficulty navigating at night;
- retinal opacity;
- increased sensitivity to bright light sources;
- appearance of soreness in the eye area;
- changing color perception.
These signs indicate the development of eye pathology, therefore, if one of the manifestations is detected, it is necessary to seek help from a qualified doctor and conduct a diagnosis. It should also be borne in mind that some types of the disease are asymptomatic. These include peripheral varieties.
Diagnosis
How is chorioretinitis eye disease detected? What is it and what is its peculiarity? To confirm the diagnosis, the patient is offered to undergo the following examinations:
- visual acuity check: central chorioretinitis of the eye is characterized by a deterioration in foresight, while it will be impossible to correct it in the future;
- periometry;
- refractometry;
- biomicroscopy: this examination helps to detect the presence of deformities of the vitreous body;
- transmitted light examination: may reveal vitreous opacities;
- ophthalmoscopy:allows you to determine the degree of development of the disease;
- fluorescein angiography: detects changes in the fundus vessels (appearance of shunts and microaneurysms);
- electroradiography: allows you to determine the condition of the retina and determine whether it is performing its functions;
- optical coherence tomography: shows the presence of morphological features of the focus of inflammation;
- Ultrasound: detects the state of optical media.
Specialists
Which doctor helps eliminate chorioretinitis of the eye? Treatment of this disease should take place under the supervision of several qualified specialists at once. If necessary, you can seek advice from a general practitioner, an infectious disease specialist, an immunologist, a venereologist, an allergist, a phthisiatrician, an ENT specialist, a dentist.
If the central chorioretinitis of the right eye was found in a child, then you should contact the pediatrician.
Treatment
This aspect should be given special attention. How can this disease be cured? It should be understood that treatment for chorioretinitis is selected individually. Local therapy in this case may be extremely ineffective. The exception is parabulbar and retinobulbar injections.
Conservative drug treatment usually includes two groups of drugs:
- etiotropic: eliminate the provoking factor;
- antibiotics: used when the causative agent is bacteria.
If the cause of chorioretinitis of the eye isviruses, interoferons, inducers of interferonogenesis and antiviral drugs are usually prescribed for treatment.
The syphilitic variety of the disease under discussion is treated with antibiotics of the penicillin group. If the patient has intolerance to this type of drug, he may be prescribed a course of doxycycline, macrolides and cephalosporins. The attending physician should deal with the determination of the dosage of these medicines.
In inflammatory processes, "Pyrimethamine", "Sulfalimezin" can be prescribed. For the treatment of tuberculous chorioretinitis, the help of a Phthisiatrician will be required. In the chronic form of the disease, a course of Isoniazid, Streptomycin, Kanamycin, as well as hormone therapy can be prescribed.
An obligatory part of the treatment is anti-inflammatory therapy. It may include taking drugs such as Indomethacin, Hydrocotison, Diclofenac, Lexamethasone. They are usually taken orally, as their action is activated in the gastrointestinal tract. For intramuscular and intravenous administration, Didrospan may also be prescribed.
Detoxification methods of treatment include "Hemodez" and 5% glucose solution. These drugs are administered intravenously.
Depending on the severity of the inflammation, immunotherapeutic agents may also be prescribed. For example, with the active form of the disease, immunosuppressants such as Fluorouracil and Merc altopurine are used, andalso immunostimulants.
Hyposensitizing therapy may be possible when taking antihistamines. These include Erius, Suprastin and Claritin. Also, to improve the body's resistance, the attending physician may prescribe the intake of B vitamins, ascorbic acid and multivitamin complexes.
If the pathology manifests itself over time, then extracorporeal detoxification methods can be used to treat it. These include plasmapheresis and hemosorption. Physiotherapy can also speed up the healing process. An excellent effect is given by electrophoresis along with the intake of "Fibrinolysin" and "Lidase".
If the disease has given serious complications, or the inflammatory process has spread too much, surgery may be required. To slow down this process, laser coagulation of the retina can be performed. This procedure is performed to limit chorioretinal lesions from unaffected areas. If the chorioretinal membrane is formed or the retina is detached, vitrectomy is necessary.
Possible Complications
This aspect should be read first. Now that we know approximately what chorioretinitis of the eye is, how to treat this disease, we should analyze possible complications. With inadequate therapy or an advanced stage of the disease, chorioretinitis can turn into serious problems. These include:
- formation of neovascularmembrane;
- retinal detachment;
- appearance of retinal hemorrhages;
- Retinal venous thrombosis leading to blindness.
Prevention measures
So what do you need to know about this? To prevent the development of a disease such as chorioretinitis of the eye in a child or adult, it is enough to adhere to the following recommendations:
- contact a specialist at the first symptoms of any disease;
- regular visits to the ophthalmologist's office to check the he alth of the eyes; visits to the doctor can be made as early as 3 months after birth;
- try not to hurt your eyes;
- observe eye hygiene;
- timely sanitize foci of inflammation in the sinuses and mouth.
It should be borne in mind that with the progression of the disease and the untimely provision of medical care, the risk of developing various kinds of complications, up to subsequent disability, is very high.
Conclusion
Chorioretinitis is a rather complex and intractable disease. This term refers to inflammation of the posterior retina and choroid. The main symptom of the disease is the appearance of floaters and flies in the eyes. There may also be a decrease in visual acuity and a violation of dark adaptation, or the so-called night blindness. There are many varieties of this pathology: tuberculous, post-traumatic, infectious, syphilitic, central chorioretinitis of the right eye. This disease can occur at any age. It is worth noting thatyoung children are at risk, as they are particularly susceptible to infectious and viral diseases.
Drug therapy for this condition usually includes antibiotics and anti-inflammatory drugs. Also, the doctor may prescribe biogenic stimulants, reparants, mydriatics and glucocorticosteroids. Usually, the patient is advised to take vitamin complexes for general strengthening of the body. Physiotherapeutic methods of treatment also give a good effect. Severe cases may require surgery.
