Inflammation of vascular and mesh shell - eye chorioretinis: causes, symptoms, treatment. Central Serous Chorioretinite: What is the treatment and forecasts of acute chorioretinite

The date: 19.10.2019

Chorioretinite eyes is inflammation of the rear section of the vascular casing of the eyeball. The process can be involved and retina. The disease passes in acute and chronic forms. It can be both congenital and acquired during life.

Toxoplasmatic chorioretinite is considered congenital, infection occurs inside the womb. The manifestations of the disease will not always be noticeable at birth or at an early age, they can give themselves much later. Along with the defeat of the eye, other disorders occur. Most often the nervous system is suffering.

Usually, several states lead to the formation of this disease:

Tuberculosis, syphilis, herpes, oral cavity and respiratory infections.
Radiation.
Incixation of the body.
Allergic reactions.
The state in which human immunity is weakened, it may be observed after prolonged treatment and the carriers of the HIV virus.
Eye injury.

Chorioretinitis is the back will take

Basic symptoms

The central serous chorioretinite can manifest itself in different ways, it all depends on localization. Only an experienced doctor will be able to understand the cause and appoint treatment.

Central chorioretinite is characterized by disorders in the macular zone. Eye lesions can be observed near the optic nerve, a toothed line or equator. Chorioretinite can be multifocal, focal, diffuse.

Depending on these characteristics, the patient appears characteristic symptoms. In some cases, the process proceeds asymptomatic and does not complain about anything. You can detect any violations in this case only with careful diagnosis.

If the disease still makes itself felt, then the vision is noticeably deteriorating.
The picture before your eyes is no longer so clear as before.
Perhaps the appearance of pellets, glare, outbreaks, dark spots.
In some cases, objects before their eyes can visually distort.
Focus at night, it becomes more difficult every day.

If there are several similar symptoms, you must urgently consult a doctor for help.

In case of toxoplasmable, choriorette can observe scar damage, white foci talking about the presence of inflammation. In the sharp period, it is difficult to notice such changes, their borders are fuzzy.

With an active process, serious consequences are possible - retinal detachment, thickening of tissues, they have a gray or yellowish tint.

Clinical characteristic

This disease is rarely purchased over the course of life, most often this pathology is congenital. The wines of everything infection, which was transferred to the child inside the womb. This form almost always affects not only vision, but also other internal organs.

Most risks the central nervous system. Like any chronic disease, chorioretinite is accompanied by exacerbations and remissions when the patient is noticeably better.

The foci of the disease is not blurry, they are pronounced, differ in coarse pigmentation and have clear boundaries. In some cases, damage can be invisible, but this does not indicate their absence.

When after remission, the disease appears again, new manifestations can be in the same place. New processes can resemble a glassy body. The process of retinal detachment and hemorrhage is sufficiently dangerous, can lead to the formation of a neovascular membrane.

If syphilis became the cause of the disease, the clinical picture will be inhomogeneous. Pigmentation and fibrosis sites can alternate and intersect. With the tuberculosis of the manifestation of lesions, the defeat is always secondary.

Primary changes are not on the auditorium, but on the lungs. After treatment, the scars may form on the site of the foci. The manifestations of the disease associated with tuberculosis do not have special distinctive features.

Chorioretinite against the background of infection with HIV infection occurs due to the weakening of the immune system. The clinical picture is pronounced. The foci of lesion is vast, treatable with difficulty. A great risk to completely lose sight.

Diagnostics

Diagnose the disease is independently impossible. Changes that can be seen with the naked eye are not always talking about the presence of precisely chorioretinite. In addition, the first time the symptomatology is weakly pronounced, so without medical diagnosis can not do.

To confirm or denial the diagnosis, a set of activities is carried out:

The doctor checks visual sharpness. With chorioreset, vision always worsens.
Computer perimetry. It helps to identify how much the sensitivity of the retina is reduced and there are dark spots.
Bomicroscopy. This procedure helps to determine whether changes are present on the vitreous body.
Research in the transmitted light will help identify the presence of clouds.
Ophthalmoscopy. It helps to consider even the most deep lesions. With a special lenses occur. It helps to see clear borders of the defeat and reveal pigmentation.
With the help of angiography, vascular changes are determined.
Electroretinography diagnoses the retinal state.
With the help of optical tomography, the doctor determines the intensity of inflammation.
To identify cloues on the eyeball and other changes after ultrasound.

Additionally, you need to hand over blood and urine test. It is necessary to confirm or refute the presence of hepatitis, syphilis, HIV infection, herpes. All this helps determine the blood test. Fluorography checks the state of the lungs. Mantu reaction is required if there is indications for this.

If necessary, it is necessary to consult an allergist, a venereologist, a dentist, a therapist and some other doctors.

Applicable treatment

The treatment of chorioretinite should be carried out in a timely manner individually. Typically, injections and local therapeutic procedures are prescribed. In addition, a number of additional drugs are appointed:

Etiotropic. Medicines are aimed at eliminating the main causes of the disease. In order to identify the pathogen, the specialist prescribes an antibiotic of a wide range of action. If there is viral infection in the body, antiviral drugs takes the patient. Antibiotics of the penicillin group are effective if the cause of the disease is syphilis. Usually the course of treatment is 1 month. It is treated with folic acid and sulfadimesin. In case of violations caused by tuberculosis, a phthisiarator is needed.
It is possible to treat the disease using anti-inflammatory and hormonal medicines intramuscularly, intravenously or intake.
During poisoning and detection of toxins, disintellation is carried out.
With a weakened immunite, immunostimulants are accepted. The patient needs to lead a healthy and active lifestyle, to eat properly, use foods that increase immunity to be more in the fresh air.
To strengthen the resistance of the body, vitamins of group C and B are prescribed.

Additionally, enzymes are accepted, which accelerate the resorption of the focus of inflammation. Physiotherapeutic procedures contribute to recovery. Laser budget is necessary to limit the focus of inflammation. When detaching the retina is carried out vitratectomy.

The dose of drugs depends on the clinical picture. With chorioreset, the treatment must be carried out comprehensively, only then the results can be obtained.

Conclusion

Chorioretinite is a dangerous disease. In the absence of proper treatment it is possible to obtain the retinal detachment, retinal bleeding, complete loss of vision. In order to avoid such consequences, it is important to diagnose the disease on time and begin drug and therapeutic treatment.

Video

Chorioretinite is an inflammatory ailment with an acute or chronic flow, which strikes the rear department of the vascular shell of the eye. The process is also involved in the retina. The blood circulation system in the backyard of the eye is arranged so that the vessels here form a wide bed. This anatomical feature leads to a slowdown in blood circulation in this area.

For this reason, all infectious agents penetrating into the human body are often delayed on the back surface of the eye. The inflammatory process first strikes the capillaries that feed the mesh shell with blood, and later goes to the vascular shell.

Etiology

The following factors can provoke the progression of chorioretinite:

penetration into the shell eye of infectious agents;
autoimmune pathology;
penetration of viruses eyes in fabric, and;
immunodeficiency states;
injuries eye varying severity;
allergic reactions;
complications of myopia;
long exposure to radiation.

Classification

Classification depending on the area in which the inflammatory process is localized:

central serous chorioretinite. In this case, inflammation affects the macular area of \u200b\u200bthe eye;
equatorial. Inflammation is localized near the eye equator;
peripapillary. The process is localized in close proximity to the visual nerve;
peripheral. Inflammation occurs on the toothed line.

Depending on the number of inflammatory foci:

focal chorioretinite. There is one focus of inflammation;
multifocal disseminated. Inflammation is observed immediately in several sections of the eye;
diffuse. Many inflammatory foci are formed, which tend to merge.

Depending on the nature of the proceeding of the pathological process:

acute;
chronic.

Symptomatics

At the initial stages of the progression of the chorioretinite, the vision is observed, and in a few days, a dark spot appears in the field of view. Also not excluded a change in color perception. Next, the clinical picture is complemented by the following symptoms:

"Flies" before your eyes;
chicken blindness. This symptom is characterized by a decrease in visual acuity at dusk;
photosensitivity increases significantly;
distortion of vision. In medicine, this condition is called metamorphic;
periodically, "flash" arise before eyes;
clouding retina;
pain feelings in the eyes.

Features of chorioretinites

Toxoplasmosis chorioretinite in most clinical situations is congenital. Infection occurs even during the intrauterine development of the fetus. Infectious agents are affecting not only the sections of the eye, but also the TsNS tissues, vital organs. The pathological process of wave-like - periods of exacerbation alternate with the periods of remission. This state is very dangerous, because without proper treatment there may be detachment of the mesh shell.

Tuberculosis type progresses only against the background of the primary lesion of the lungs. Specific tuberculos are formed on the eye day. After treatment, scars remain on the surface.

Syphilic chorioretinite manifests itself quite specifically. On the eye day there is an alternation of pathological sites. There are places with, but also there are sections with pigmentation.

Diagnostics

In case of manifestation in the patient, these symptoms should go to the medical institution for comprehensive diagnostics. The standard survey plan includes the following techniques:

assessment of visual acuity;
perimetry;
refractometry;
biomicroscopy;
ophthalmoscopy using a special goldman lens;
fluorescent angiography;
electricaloretinography.

It is possible to identify the cause of the progression of chorioretinite using the following diagnostic techniques:

analyzes for the presence of antibodies to infectious agers (, so on).

Treatment

The doctor ophthalmologist is engaged in the treatment of chorioretinite. Best for the time of treatment, put the patient in the hospital so that specialists have the opportunity to constantly monitor his condition. The treatment plan includes:

the use of anti-inflammatory drugs;
parabulbar and retrobulbar injections;
etiotropic treatment. The main goal is to eliminate the cause of pathology. For this, antiviral, antibacterial drugs are prescribed to the patient;
disintellation therapy;
immunotherapy;
desensitizing therapy;
physiotherapeutic treatment.

In severe cases, doctors resort to retina laser -ugoagulation. This modern treatment technique allows localization of the inflammatory process.

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Diseases with similar symptoms:

The retina dystrophy is a dangerous illness, in which the mesh eye shell is amazed. Whatever the reason for the occurrence of this disease in humans, with a late and unskilled treatment, the outcome of the dystrophy is one - atrophy or complete dieting tissues from which the retina consists. Because of this, the patient will have irreversible impairment of vision, right up to blindness. It is worth noting that the timing of vision loss is directly dependent on the type of disease. The retina's retina dystrophy flows pretty slowly, but as its progression is progression, the patient's condition is only worsening.

Keratokonus - from the point of view of ophthalmology is considered extremely rare ailment, affecting the cornea of \u200b\u200bthe eye. The disease is equally found in the face of both sexes, but the main risk group is children and adolescents. The factors that caused the formation of pathology currently remain unknown, but clinicians put forward several theories regarding its origin.

Central chorioretinite is an eye disease.There are several varieties of this ailment. Each of them is accompanied by characteristic symptoms and has its reasons.

In addition, other forms of violation are disturbed: depending on the severity of the flow - sharp and chronic, depending on the method of manifestation - congenital and acquired.

The disease accompany the characteristic symptoms.

The first sign, which indicates the beginning of the ailment - blurred vision, and in a few days - the appearance of a dark spot before his eyes, in some cases - a violation of color perception. In addition, the following symptoms are characterized:

reduction of visual acuity, especially at dusk;
"Flies" and "Flashing" before your eyes;
distorted vision;
the retina is muttered;
photophobia;
painful feelings in organs of vision.

The disease is preceded by certain reasons.

Back to the category

The most common reasons are the following:

tuberculosis, then diagnosed tuberculosis chorioretinite;
syphilis;
supercooling;
injury organ of vision;
disorders of intrauterine development, then diagnose congenital chorioretinis;
complications after transferred diseases: influenza, meningitis, pneumonia;
allergic reactions to radiation, intoxication, etc.;
slowing blood flow, in which the bed of the vessels becomes broad, as a result of which vessel metastasis develop.

As a result, one of these reasons may be infected with the eye.

Back to the category

The treatment of chorioretinite must be carried out, otherwise it can cause a significant impairment of vision. The purpose of therapy is to eliminate the cause that provoked the development of the disease. Therapy includes the following activities:

Medical therapy. Ophthalmologists prescribe the following groups of drugs:

anti-inflammatory;
antiallergic;
drugs normalizing capillary permeability;
antibiotics.

Physiotherapy. Labeloagulation proved its effectiveness, which helps to eliminate the defects of the basal plate.

At the very first atypical symptoms, it is worth contacting an ophthalmologist, since the disease can cause a retinal detachment, retinal hemorrhage, clogging of the retinal veins and other serious disorders, up to blindness.

Back to the category

Disease develops, as a rule, due to intrauterine infection. In most cases, the congenital chorioretinite is diagnosed. It is accompanied by characteristic symptoms:

All symptoms that accompanies serous chorioretinite.
Chorioretinal foci, which are located on the rear pole of the eye. They have a major size, can be atrophic or scar. This feature is observed in the inactive stage of the disease.
The foci of white, which can be in any eye zone, but usually appear on the border of old foci, which arose with an inactive stage. This feature indicates that the disease is in the active phase.
Foci without clear boundaries that may have any size. It is possible to close in the vessel focus. This is a sign of an acute period of the inflammatory process.
Pathological changes in the vitreous body, infiltration of the layers of the vitreous body of cell suspension, the formation of membranes - all this is the indicators that the destructive process has spread to the internal layers of the retina, and the halide membrane began to collapse.

It is worth noting that the treatment is not always the patient. If the foci is small, and the disease proceeds asymptomatic, then self-esteem is possible: for six months, these foci can solve themselves. If the foci is expressed or the reactivation of the inflammatory process is observed, treatment must be carried out. His goal is to destroy microorganisms that provoke inflammation. Therapy includes the following activities:

Medical therapy:

nonspecific anti-inflammatory therapy with corticosteroid group drugs;
specific therapy at which the preparations of group of sulfonamide groups and folic acid have shown their effectiveness.

https://youtu.be/qxjhchm14js.

The peculiarity of the treatment of this form of the disease is to combine non-specific and specific therapy.

Such a complex name of the eye disease, as a central serous chorioretinite, is explained by the difficulty of its etiology. The fact is that it originates in the central part of the rear wall of the vascular (serous) the shell of the eye.

Initially, the symptoms were described in detail in 1866 by the German doctor A. Background Gref, where the name was assigned the name - the central recurrent retinit.

The author suggested that the inflammatory retinal process is based on. In the modern version, the term "chorioretinitis" implies two diseases at once: retinit and choroidite. The first is the inflammation of the retina, and the second is characterized by inflammation of only the vascular shell of the eye.

However, choriocapillary are inextricably linked with all the retina. Therefore, with a combination of the most negative factors, the forecast for the late diagnosed disease is adversely. It can lead to a complete retinal detachment, and, it means to blindness.

Scientists of the whole world were lost in guesses about the origin of the disease, trying to explain its frequency to affiliate to any race, sex or age.

However, today the central chorioretinite ranks 4th among all ophthalmological pathologies of the Eye DNA, the reasons for which there are a lot:

allergic;
infectious (viral, bacterial);
hormonal;
toxic;
neuronal;
immunodeficient;
hereditary;
post-traumatic.

It should be noted that in men of middle age, the disease is still diagnosed much more often. Ophthalmologists note that among many provoking factors strongly affects the development of chorioretinite high levels of steroid hormones.

The medical literature describes many facts when the disease arose against the background of taking corticosteroids used to treat other systemic or autoimyluine diseases. Women can influence the reception of replacement hormonal drugs during menopause.

If the central serous chorioretinite is detected on time, the positive feedback will be provided. But the complexity is the diagnosis process itself, which is possible only on special equipment in an ophthalmic clinic. After all, at the initial stage, a person does not immediately lose sight. Its reduction occurs on the hundredths of units.

It feels at an early stage with a small binding of visible items. A few days later, a person can be affected to see a dark blurry spot or not distinguish between color. With bright light, there is a thread in the eyes, but also sees in the dark as it happens when "chicken blindness".

To identify the illness at an early stage, the doctors use an ophthalmoscope of a gulstrand, applying an additional binocular nozzle. In some cases, it is possible to clearly install the pathological zone in the center of the Eye DNA only with the help of the biomicroscopy method (determines the deformation in the vitreous body). The blood test is taken as an additional study, perimetry is carried out in order to identify dark spots, FALD (fluorescent angiography of the Eye DNA). Sometimes optical tomography is used.

But sometimes even such an integrated examination of the eye does not provide information about the cause of pathology. Only after 5 weeks from the beginning of the disease on an ophthalmoscope, you can see small point foci of brown. As it increases, they acquire a yellow shade. Experts argue that this is the indicators of the place where the process of retinal detachment has already gone. In some patients there may be 2-3 focus of choroidal origin. They are somewhat larger than the previous ones, and are located groups.

Since all changes occur on the rear wall of the eyeball, then externally outside it does not appear, except that the sick begins to complain about a sharp decline in vision.

With the positive treason, treatment on special equipment can be seen as swelling on the retina gradually decreases. But at the site of the sites of the once affected retina, the mark remains in the form of altered pigmentation.

Depending on the severity of the disease, it can last from 2 weeks to 8 months. Lightweight and timely treatment allows you to completely restore vision. But sometimes it is still after treatment somewhat lower than it was.

Despite the long-term study of this disease, medicine has not yet have a clear idea of \u200b\u200bthe etiology and pathogenesis of its development. It is very difficult to determine the true cause of the serous lesion of the posterior wall of the eyeball, and it can be a positive dynamic that it can be the fight against the main disease that caused such a defect. And yet there is some definite progress in this direction.

Medical therapy includes a group of anti-inflammatory drugs (if necessary and hormone-containing):

Diclofenac;
Indomethacin;
Dexamethasone;
Hydrocortisone;
Prolong Diprospan.

If the reasons for the occurrence of inflammation toxic, then the disinfectants may be needed. Their role is performed by droppers with hemodez or glucose (5%).

In immunodeficiency states - Immunostimulators:

Formuracyl;
Mercaptopurin;
Levamizol (with HIV).

Almost always apply antiallergenic drugs: suprastin, claritine and them like, multivitamin complexes, special enzymes in the form of injection injection.

Antibiotics are needed. What exactly determined depending on the pathogenic flora of the pathogen of the disease and the reaction of the body. Since the treatment should begin immediately, an antibiotic of a wide range of action is first assigned, and after obtaining laboratory data, drug correction is performed.

For example, chorioretinite due to syphilis requires the use of a penicillin group, and the virus nature of the disease is treated with interferons. In case of toxaplasmosis, sulfonamides are effective in combination with folic acid, and phthisiatric therapy is carried out in parallel with tuberculosis form.

In addition to medicines, use:

magnetophoresis;
enzyme electrophoresis;
laser retinal coagulation.

Physiosocations are already needed at the last stage of cure, at the stage of acceleration of recovery. Coagulation is carried out in the case when there is a need to eliminate the lesions of the basal plate.

This procedure is done only in the absence of acute flow of chorioretinite.

To understand all the intricacies of treating this complex ophthalmic disease for only experienced specialist. Therefore, there can be no self-treatment and the use of folk agents and speech.

The launched shape of the central serous chorioretinite can lead if not to the retinal detachment, then to the blockage of its venous bed or retinal hemorrhage. In any case, it threatens blindness. The only thing that is allowed to apply at home is plants to help with traditional treatment capable of expanding vessels.

These are:

bark of slash;
valerian;
fruits hawthorn.

The root of Valerians and the bark of the flavory will be required 10 g, and the fruits of Boyarka 20. This amount is taken on a glass of boiling water. Only Valerian should be boiled 30 minutes, the flake is insteaded for two hours, and Boryaku is an hour. Any infusion is taken by small portions - 10 ml, but several times a day (3-5). May be helpful: nine, lily of the village, Chinese lemongrass.

It is useful, along with this, increase the number of vitamins, micro and macroelements in nutrition, ensure rational food and day mode.

More than other eyes are needed vitamins like riboflavin, thiamine, carotene, PP, B12, folic acid.

As a preventive measure, it is important for the hygiene body, as necessary, in time, to carry out therapeutic and prophylactic procedures of the oral cavity and LOR organs.

Chorioretinite - the main symptoms:

Spots before our eyes
Pain in the eyes
Lightning before our eyes
Reduction of visual acuity
Distortion of vision
Increased photosensitivity
Network clouding

Etiology

The following factors can provoke the progression of chorioretinite:

penetration into the shell eye of infectious agents;
autoimmune pathology;
penetration of influenza viruses, herpes and HIV
immunodeficiency states;
injuries eye varying severity;
allergic reactions;
complications of myopia;
long exposure to radiation.

Classification depending on the area in which the inflammatory process is localized:

central serous chorioretinite. In this case, inflammation affects the macular area of \u200b\u200bthe eye;
equatorial. Inflammation is localized near the eye equator;
peripapillary. The process is localized in close proximity to the visual nerve;
peripheral. Inflammation occurs on the toothed line.

Depending on the number of inflammatory foci:

focal chorioretinite. There is one focus of inflammation;
multifocal disseminated. Inflammation is observed immediately in several sections of the eye;
diffuse. Many inflammatory foci are formed, which tend to merge.

Depending on the nature of the proceeding of the pathological process:

acute;
chronic.

Chorioretinite

"Flies" before your eyes;
chicken blindness. This symptom is characterized by a decrease in visual acuity at dusk;
photosensitivity increases significantly;
distortion of vision. In medicine, this condition is called metamorphic;
periodically, "flash" arise before eyes;
clouding retina;
pain feelings in the eyes.

Tuberculosis type progresses only against the background of the primary lesion of the lungs. Specific tuberculos are formed on the eye day. After treatment, scars remain on the surface.

Syphilic chorioretinite manifests itself quite specifically. On the eye day there is an alternation of pathological sites. There are places with fibrosis, but also there are sections with pigmentation.

In case of manifestation in the patient, these symptoms should go to the medical institution for comprehensive diagnostics. The standard survey plan includes the following techniques:

assessment of visual acuity;
perimetry;
refractometry;
biomicroscopy;
ophthalmoscopy using a special goldman lens;
fluorescent angiography;
electricaloretinography.

It is possible to identify the cause of the progression of chorioretinite using the following diagnostic techniques:

general blood analysis;
blood biochemistry;
analysis of urine;
analyzes for the presence of antibodies to infectious agers (hepatitis, syphilis, other).

the use of anti-inflammatory drugs;
parabulbar and retrobulbar injections;
etiotropic treatment. The main goal is to eliminate the cause of pathology. For this, antiviral, antibacterial drugs are prescribed to the patient;
disintellation therapy;
immunotherapy;
desensitizing therapy;
physiotherapeutic treatment.

In severe cases, doctors resort to retina laser -ugoagulation. This modern treatment technique allows localization of the inflammatory process.

Most authors regard the central serous chorioretinite as a polyethological disease, which is due to a variety of infectious, allergic, toxic and vascular factors. In the pathogenesis of this process, the leading role belongs to defects in the basal plate and vasomotor disorders, which is the pathological permeability of not only capillaries, mesh and vascular shells, but also separate sections of the basal plate.

The development of the disease is characterized by boding vision, which in a few days is replaced by the appearance of a dark spot in front of the eye. Photopsy and metamorphycia are often observed. The decrease in visual acuity varies from the tenths to the hundredths of the unit. Transient hypermetropium, central scotoma, violation of color, can be detected.

When ophthalmoscopy in the first stage of the disease in the macular region, the retina is observed with a round or oval shape with a size of 0.5 to 2 disk diameters. The focus is somewhat forward, the vessels of its edge make a light bend. The borders of the hearth are underlined by light reflex. The degree of clouding can be different - from barely caught to the intensive gray. The hearth is not always localized in the fusal zone, its location can be eccentric, paramaqual.

After a few days or months, the disease passes into the second stage, which is referred to as the stage of precipitates. During this period, visual acuity is gradually increasing, but relative scotoma is still preserved. On the Eye Day, the clove of the retina is absorbed, only white-gray fine-point cameras remain - precipitates.

In the third stage, the central scotoma and metamorphopia disappear. Visual acuity is usually restored. The swelling of the retina and precipitates may dissolve without a trace, but the dispiring remains more often. The macular region acquires a cracked pattern by small pigment sticks, yellowish flat and small sections of the discoloration of the pigment epithelium.

The process affects one or both eyes, often recurrences, so the forecast is not always favorable. In the conditions of outpatient reception, the diagnosis of central serous chorioretinite is difficult due to weak symptoms. In these cases, special research methods - biomicroscopy, ophthalmic chromoscopy and fluorescent angiography - help to identify additional features characteristic of this disease and conduct differential diagnosis with retrobulbar neuritis, youthful dystrophy of stains and other diseases. The characteristic features of the central serous chorioretinite include the expansion of the optical cutting of the retina with the presence of a transudate between the pigment epithelium and the retina, micropreitates, small defects in the basal plate, detected with fluorescent angiography in the form of dye seeping points, so-called fluorescent flags.

The treatment of central serous chorioretinite must be comprehensive with the obligatory accounting of the etiology of the process. Pathogenetic treatment is the blockade of the defects of the basal plate by the method of laseroagulation. The retina edema usually disappears on the 4-10th day after laser exposure. In all cases, drugs normalizing capillary permeability (ascoruta, aevit), various kinds of dehydration agents (40% glucose solution, a 10% sodium solution of chloride intravenously, phonuroid, glycerin), vasodilators (but-shpa, nicotinamide). To improve trophic processes in the retina, vitamins, cocarboxylase, as well as ATP and heparin in small dosages are shown. In the period of pronounced edema, corticosteroids in the form of retrobulbar injections are especially shown.

The collective name of a whole group of diseases associated with inflammatory processes affecting the vascular shell of the eye is the concept of will lead. Chorioretinite eyes is one of the forms of such pathology. In this regard, the disease received another name - the rear will take, because it affects this particular eye department. If there is no proper treatment or it is late, then inflammation goes into a chronic form. Eye diet occurs, since choriocapillary vessels supplying it with useful substances are inflated. This leads to complications that threaten the patient's vision. Chorioretinitis, what it is and because of what is manifested, it is necessary to consider in more detail.

Inflamed vessels with chorioretinate are not able to fully nourish the organ of view. This is due to some features of the structure of the eye. Since in this area, the blood vessels are located on a wide bed, the blood movement slows down. There is a lot of branching. Stagnation in the circulatory system allows you to develop with pathogenic microorganisms that have fallen in it. Infectious agents in large quantities are delayed in the backyard of eyeballs. The rapid reproduction of microorganisms leads to the further development of inflammation.

The spread of the rear uveit occurs gradually. First, the chorioretinite strikes the capillary network that is powering the blood of the retina. Then it affects the larger vessels.

The causes of the development of an inflammatory process affecting the vascular shell (called choroiditis), to which the inflammation of the retinth (retinit) is also joined, may be:

The common causes of the development of chorioretinite are the infhection of the organism near the viruses.

The disease is injured by the organ of vision, as well as the states leading to the weakening of immunity. This factor is manifested due to prolonged treatment, as well as with HIV infection.

Most often, the penetration of the causative agent in the eye vessels occurs through blood flow. In this case, it is said that chorioretinitis is acquired. But the disease can be manifested in congenital form. This happens when intrauterine infection.

Small children are more often detected chorioretinite toxoplasmatic. At the same time, clinical manifestations of the disease are very rarely arising immediately after birth. Often the innate disease is diagnosed only to seven years, when the child passes a medical examination to school.

An autoimmune disease is considered a rather rare form of the rear uveitis - birdshot chorioretinopathy. The process of inflammation of the vessel shell, as well as the retina develops with this pathology in progressive form. At the same time, often shows the resistance to treatment.

Classification

Such an inflammatory process may flow in acute or chronic form. The chorioretinite is also classified according to several main features, which is defining both the form and type of illness. These characteristics should be considered separately.

Classified chorioretinite on the form of the flow, the distribution area, the number of foci, stages and pathogens.

Distribution area

Pathology may arise in different areas of the organ of vision. Under this feature, the disease is divided as follows:

If the macular department is affected (refers to a yellow spot), then the disease is called - the central serous chorioretinite of the eye.
When the pathology is spreading near the disk of the optic nerve - peripapillary lesions. In the event of an exudate focus, which has an oval shape, in the same area, the disease is considered as YUKSTA-papillar chorioretinite. In this case, the retinal vessels occurs, and the vitreous body is affected.
Equatorial. This type of pathology is characterized by inflammation of the vascular shell, located near the Equatorial area of \u200b\u200bthe eye.
Peripheral. With this development of inflammation affect the area of \u200b\u200bthe border of the toothed line.

Number of foci

The process of inflammation can only be localized in one place. However, its development is sometimes observed immediately on several sections of the eyeball. By the number of foci, the disease is classified:

Focal view. The inflammatory process is concentrated in one place.
Multifocal. Several sections of the eye are affected immediately.
Diffuse view of pathology. Such a development of inflammation leads to a variety of lesion foci. In some cases, they merge together.

Feeding, chorioreset inflammatory process concentrates in one place.

Duration of manifestation

Under this criterion, the disease is manifested in two types with a different duration:

Acute chorioretinite. The disease takes up to ten days.
Chronic form. The disease can proceed much longer than three months.

Basic pathogens

The etiology of the disease is also of great importance for classification. Depending on this, the feature is distinguished:

infectious nature of infection;
allergic manifestation, the causes of manifestations are not related to infection;
post-tramatic - the disease has developed due to injury;
infectious and allergic type of lesion.

Infectious chorioretinite is divided into subspecies depending on the causative agent.

The infectious type of pathology is manifested more often than other categories. At the same time there are four types of varieties.

Toxoplasmosis is a congenital type. The infection of the child occurs in the process of intrauterine fetus development. The cause becomes toxoplasmosis in the mother. This is a chronic disease. The lesion focus is brightly separated by contour.
The tuberculosis type of pathology is a secondary disease. It develops only in the event of a tuberculosis of lungs. After the treatment, a sorioretinal scar remains in a reminder of the disease. Over time, in some cases, it may dispersed.
Syphilitic chorioretinite. Spread place - eye bottom. At the same time, two types of foci are clearly distinguished by their alternation: fibrous and pigmentation. Such alternations allow you to confidently determine the syphilitic defeat.
Purulent. AIDS - "culprit" manifestations of this type. In this form, purulent discharges are distributed over other sectors of the eye. In this variety, the immunodeficiency appearance is separated separately, in which the large area is affected.

It should be noted that the remaining species almost do not have special distinctive features. However, it is worth allocating a myopic chorioretinite separately. It manifests itself with highly pronounced myopia due to frequently repeated hemorrhages in the shell and retina organ of vision. In this case, the condition of proper lighting should be clearly performed, if necessary, work at close range.

Toxoplasmatic chorioretinite is congenital. The kid is infected from the mother.

Stages

Characteristic features of the initial stage are:

the appearance of weak outlines of the foci of a yellowish shade;
along the network of vessels, purulent releases are formed;
there are small hemorrhages.

In the future, when developing inflammation it is possible to observe:

the formation of the outlines of foci;
the appearance of pigmentation;
atrophy like retina and vascular surface occurs at the placement.

Atrophy of the retina and vascular surface testifies to the last stage of the disease.

Symptoms

Inflammation flowing in the grid of vessels is not manifested by any significant symptoms. An unpleasant feeling occurs only after the infection affects the retina. When the focus of the defeat in the center of the Eye DNA, complaints appear on substantially reduced vision, as well as the distortion of objects. Characteristic appearance before bright outbreaks. A few days after the retina was affected, a blot color spot appears in the scope of vision. This manifestation does not depend on what eye was amazed - right or left.

The sharp form of pathology is accompanied by the following symptoms:

there is increased sensitivity to light;
in front of the eyes swim "flies";
in the darkness of the acuity of vision significantly decreases, "chicken blindness" manifests itself;
in the eye area there is a pulling pain;
often flow spontaneously tears.

If the vision has deteriorated significantly in the dark - this is a symptom of peripheral inflammation. In the manifestation of several symptoms, the likelihood of identifying a diffuse type of pathology increases. In the case of purulent chorioretinite, strongly pronounced symptoms appear.

Diagnostics

Put the diagnosis - chorioretinite - only a doctor, having the results of diagnostic research on hand.

It is impossible to diagnose such a disease independently. The unarmed eye is not able to recognize the chorioretinite. This requires special devices and devices.

The following measures are being implemented for diagnosis:

Check of visual acuity. With this pathology, the patient always begins to see worse.
Computer perimetry is performed. This check allows you to determine whether there are dark spots and what is the sensitivity of the fiber.
Biomicroscopy is produced. The procedure is necessary to identify changes in the vitreous body.
In the transmitted light, the presence of clouds.
Ophthalmoscopy is performed to identify deep lesions. The border of the lesion is determined, and the pigmentation is revealed.
Vascular changes make it possible to determine angiography.
Diagnostics of the retinal state is performed using electrooretology.

Diagnostic measures also include the implementation of such procedures as optical tomography and ultrasound. The patient will be issued a direction for urine, blood and reaction of the Mantu. Flourography is also needed to check the state of lungs.

Treatment, possible complications and forecast

Often the cause of chorioretinite, as well as symptoms, and the treatment is assigned appropriate. Chorioretinite therapy is purely individually. Local procedures and injections are needed. Medications should be noted by etiotropic agents. Their orientation should be on the main cause of pathology. An antibiotic has a wide spectrum to detect the pathogen.

Therapy of chorioretinite is aimed primarily for treating the cause of pathology.

With viral infection, the reception of antiviral drugs is required. The syphilis uses antibiotics from the penicillin group. Most often, treatment lasts a month. Sulfadinezin and folic acid are used.

Treatment is carried out using anti-inflammatory drops (brkinxinak), as well as hormonal means (MaxiDEX) both intramuscularly or intravenously and admission inside. In case of detection of toxins (with poisoning), it is necessary to carry out disinfecting and the use of antiallergic drugs (claritine). Pregnancy is a contraindication to use most drugs. In this state, diprosun is used to relieve inflammation.

Often requires drugs that strengthen immunity (cycloferon). To increase the resistance of the body, vitamins C, B. are prescribed.

It should be remembered that in the immunodeficiency form of pathology, bad complications are possible, and the consequence and forecast for the patient unfavorable. Full blindness can manifest.

In the absence of positive results it is possible to use operational intervention. In recent years, the laser is increasingly used for this. The duration of the operation does not exceed twenty minutes.

Any universal people's way to cure such pathology does not exist. In addition, such treatment can lead to irreversible consequences. However, it is possible to help traditional therapy, in coordination with the attending physician, the use of fresh carrot juice, infusion of hawthorn or Valerian, branch of the bark of the flavory and the tincture of Echinacea.

Prevention

In the case of the diagnosis of "Choriretinit", the question is possible, it is possible to cure the disease, the patient emerges first. With timely started therapy, the forecast is favorable. It is this approach that is the basis of prevention. In addition, it is necessary to be regularly examined by an ophthalmologist.

It should be not forgotten that a non-serious attitude to the therapy of the patient himself can lead it to blindness.

Nov 28, 2017 Anastasia Tabalina