How central chorioretinitis of the eye is manifested and treated

1 General concepts of pathology

Chorioretinitis is a disease that is based on 2 pathologies - choroiditis and retinitis. The disease is characterized by an inflammatory process that occurs in the posterior vascular region of the ocular mucosa in a retinal lesion. The latter is due to the fact that feeding of retinal layers is provided by chorio-capillary vessels, and because of their inflammation, infection of the retina begins.

Central serous chorioretinitis can be:

1. Infectious-allergic. The cause of the appearance of this form is the defeat of viral, fungal and parasitic microorganisms.
2. Infectious. The reasons are the same as in the case of an infectious-allergic type.
3. Non-infectious-allergic.
4. Post-traumatic.

In addition, chorioretinitis develops as a result of systemic diseases. A pathology that has a severe form can trigger serious enough complications, for example, hemorrhage and opacification in the vitreous, retinal hemorrhage and others, which immediately has a negative impact on vision.

2 Treatment Scheme

Treatment of the disease involves the following activities:

1. Conducting retro and parabulbar injections.
2. Admission of etiotropic drugs for relieving the cause of the disease. Antibacterial agents are used in the infectious etiology of the disease, for example, in the case of the syphilitic form of chorioretinitis, a long penicillin course is used. Also interferons and preparations against the virus are prescribed, if chorioretinitis has a viral etiology.
3. Use of medicines with anti-inflammatory effect.
4. Purpose of detoxification( haemodesis).
5. Immunotherapy with immunostimulants or immunosuppressors.
6. Use of desensitizing treatment with drugs with antiallergic effect.
7. Carrying out physiotherapy with electrophoresis. Excipients - lidaz and fibrinolysin.
8. Application of retinal laser ligation to localize inflammation.

3 Medical therapy

Treatment should be conducted in a timely manner, each patient needs an individual approach. Local therapy has practically no positive effect, except for the use of retro and parabulbar injections. It is worthwhile to consider each of the therapy items in more detail.

As mentioned earlier, etiotropic treatment is used to eliminate the chorioretinitis factor. In the case of bacterial microorganisms, antibiotic substances with a wide range of effects are used until a specific pathogen is identified, and then, after taking into account the level of sensitivity of bacteria, certain drugs will be prescribed. In the case of the appearance of viral chorioretinitis, interferons, preparations with antiviral effect and inducers of interferonogenesis are used. Treatment of syphilis-type diseases involves the prescription of antibiotic preparations from the penicillin group, which should be taken within 1 month.

In the presence of intolerance, a macrolide or cephalosporin group is appointed, as well as Doxycycline. When diagnosing toxoplasmosis, use pyrimethamine with folic acid, Sulfadimezin with vitamin B12.The tubercular form of chorioretinitis is treated with a phthisiatrician. If there is a chronic course of the disease, the following drugs will be prescribed: Streptomycin, Rifampicin, Isoniazid, Kanamycin and hormonal medications. Herpetic form of the disease should be treated with Acyclovir, and cytomegalovirus form - Ganciclovir, administered by intravenous drip.

It should be noted that not only anti-inflammatory drugs are prescribed, but also hormonal drugs. For example, it may be necessary to administer intravenously or intramuscularly Diclofenac, hydrocartisone, dexamethasone. To conduct parabulbar injection, it is used once every 14 days for Diprospan. Detoxification is carried out by haemodesis or glucose 5% solution by intravenous route by a drip.

Immunotherapy involves the use of immunosuppressors depending on the level of inflammation. In the case of active chorioretinitis, fluorouracil or Mercaptopurine is used. Immunostimulants are used in case of HIV infection, for example, Levamisole. The conduct of hyposensitization involves the use of antihistamines, for example, Erius, Suprastin or Claritin.

To increase the body's resistance, vitamin or multivitamin courses are prescribed. Locally, enzymatic substances can be used to resolve a foci of inflammation, for example, Hemase, Lidase, retrobulbar Fibronolysin.

If there is no response to treatment, in the case of a severe or prolonged course of the disease, extracorporeal detoxification techniques, such as hemorrhage or plasmapheresis, are used.

Physiotherapy treatment is of great importance in the rapid recovery of the body. The best efficacy is electrophoresis with fibrinolysin or Lydase.

To slow the spread of the inflammatory process, laser coagulation of the retina is used, which limits chorioretinal inflammation from healthy tissue. If a chorioretinal membrane or detachment is formed, vitrectomy is performed.