Chorioretinal dystrophy - Causes, Symptoms, Diagnosis and Treatment

Chorioretinal dystrophy - Involution degenerative changes affecting mainly horiokapillyarny layer of the choroid, retinal pigment layer and extending therebetween glassy plate (Bruch membrane). Symptoms include chorioretinal dystrophy distortion of straight lines, the emergence of the field of view of blind spots, flashing lights, loss of visual acuity, the ability to read and write. The diagnosis of chorioretinal dystrophy confirmed by data ophthalmoscopy, visual acuity test, test Amsler, campimetry, laser scanning tomography, perimetry, electroretinography, fluorescein angiography of retinal vessels. When chorioretinal dystrophy provide medical, laser, photodynamic therapy, electrical and magnetic stimulation, as well as vitrectomy, retinal neovascularization and vazorekonstruktsiyu area.

  • Reasons chorioretinal dystrophy
  • Symptoms chorioretinal dystrophy
  • Diagnosis chorioretinal dystrophy
  • Treatment chorioretinal dystrophy
  • Chorioretinal dystrophy - Treatment

  • Chorioretinal dystrophy


    Ophthalmology chorioretinal degeneration (age-related macular degeneration) refers to the vascular pathology of the eye and is characterized by gradual irreversible changes in the macular region of the retina with a significant loss of central vision in both eyes in patients older than 50 years. Even in severe cases of chorioretinal degeneration does not cause total blindness since peripheral vision remains in the normal range, but completely lost the ability to perform accurate visual work (reading, writing, transport management).

    Pathogenesis distinguish the following forms of age chorioretinal degeneration: dry atrophic (nonexudative) and wet (exudative). Dry chorioretinal dystrophy - an early form of the disease occurs in 85-90% of cases, is accompanied by atrophy of the pigment epithelium and the gradual decline in vision, and other eye damage develops not later than 5 years after the initial illness. In 10% of the dry chorioretinal degeneration becomes more severe and swift wet form, complicates the detachment of the pigment and neuroepithelium of the retina, hemorrhages and scar deformation.

    atherosclerosis and impaired microcirculation in horiokapillyarnom layer of the choroid, the damaging effect of UV radiation and free radicals in the pigment epithelium, metabolic disorders.

    In the risk zone for chorioretinal dystrophy fall person older than 50 years, predominantly female, with light pigmentation of the iris; immune and endocrine disorders, hypertension; tobacco abuse; have undergone cataract surgery.

    hyperopia or astigmatism, signs metamorphopsia relatively positive scotoma (translucent spots in the visual field of the eye), photopsias. To detect small elevation of the retina in the form of a dome in the macular region (detachment zone), having clear boundaries, friends become less distinguishable. At this stage, the process can be stabilized, possibly independent detachment fit.

    At the stage of exudative detachment of the neuroepithelium complaints, mostly remain the same, the visual acuity is reduced to a greater extent blurred the boundaries marked detachment of the retina and swelling of the raised area.

    For stage neovascularization characterized by a sharp decline in visual acuity (0.1 and below) with the loss of the ability to read and write. Exudative hemorrhagic detachment of pigment and neuroepithelium shown formation of a large white and pink or gray-brown with clearly delimited focus pigment clusters, newly formed vessels, cystoid retinal changes, protruding into the vitreous. When you break the newly formed blood vessels marked subpigmentnye or subretinal hemorrhage, in rare cases - the development hemophthalmus. Vision keeps at a low level.

    Scar stage chorioretinal dystrophy occurs with the formation of fibrous tissue and scar formation.

    check visual acuity, ophthalmoscopy, Amsler test of distortion, campimetry (the study of the central field of vision).

    The most informative diagnostic methods with chorioretinal dystrophy are and optical coherence tomography retinal laser scanning, computer perimetry, electroretinography, fluorescent angiography of retinal blood vessels, allowing to identify the earliest signs of defeat. In addition, can be used to test color vision tests, the contrast of view, the size of the central and peripheral visual fields.

    It is necessary to conduct the differential diagnosis of chorioretinal degeneration with choroidal black cancer.

    elektrookulostimulyatsiyu and magnetic stimulation, which allows to stabilize and partially offset the state, t. To. complete recovery of normal vision impossible.

    Drug therapy in the form of nonexudative chorioretinal dystrophy includes intravenous, parabulbarno introduction of antiplatelet and anticoagulant direct and indirect action, angioprotectors, vasodilator drugs, antioxidants, hormones, enzymes and vitamins. Running low intensity laser stimulation of the retina emission semiconductor laser defocused red spot.

    In exudative form chorioretinal dystrophy is a local and general dehydration therapy and sectoral retinal photocoagulation laser to destroy the subretinal neovascular membrane, the elimination of edema, macular area, which helps to prevent further spread of the degenerative process. Promising methods of treatment of exudative chorioretinal dystrophy are also photodynamic therapy, thermotherapy transpupillary retina.

    Surgical treatment of chorioretinal dystrophy is a vitrectomy (at nonexudative form to remove subretinal neovascular membranes), and revascularization surgery vazorekonstruktivnye (at nonexudative form to improve the blood supply to the retina). Indicator acuity, favorable treatment is 0.2 or higher.

    The prognosis for vision in chorioretinal dystrophy generally unfavorable.