Eye diseases. Choroiditis (most important)

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Eye diseases. Choroiditis (most important)

Lecture notes, cheat sheets

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27. Choroiditis

Choroiditis is an inflammation of the choroid itself.

The cause of the inflammatory process of the choroid is an infection (tuberculous, streptococcal, staphylococcal, viral, syphilitic, brucellosis). Choroiditis can be endogenous and exogenous. Endogenous are caused by tubercle bacillus, viruses, the causative agent of toxoplasmosis, streptococcus, brucellosis infection, etc. The occurrence of exogenous choroiditis occurs as a result of involvement in the inflammatory process of the choroid in traumatic iridocyclitis and diseases of the cornea. Choroiditis is divided into focal and diffuse.

Patients with choroiditis do not have eye pain and visual disturbances. Therefore, it is detected only with ophthalmoscopy. When involved in the process of adjacent parts of the retina (chorioretinitis), visual impairment occurs. When the chorioretinal focus is located in the central parts of the fundus, there is a sharp decrease in vision and distortion of the objects in question, and the patient notes a sensation of flashes and flicker (photopsia). With damage to the peripheral parts of the fundus, twilight vision decreases, sometimes "flying flies" are observed before the eyes. With inflammation in the fundus, grayish or yellowish foci with fuzzy contours are visible, protruding into the vitreous body; retinal vessels are located above them, without interruption. During this period, hemorrhages in the choroid, retina and vitreous body are possible. Under the influence of the treatment process, the chorioretinal focus flattens, becomes transparent, acquires clearer contours, the choroid becomes thinner, and the sclera shines through it. With ophthalmoscopy, a white focus with large vessels of the choroid and pigment lumps is visible against the red background of the fundus, which indicates the onset of the stage of choroidal atrophy. When the chorioretinal focus is located near the optic nerve head, inflammation may spread to the optic nerve. A characteristic scotoma appears in the field of view, merging with the physiological one; with ophthalmoscopy, blurring of the boundaries of the optic nerve is determined. Peripapillary choreoretinitis develops, or Jensen's parapapillary neuroretinitis. With tuberculous lesions of the choroid, such clinical forms as miliary, disseminated, focal (with central and peripapillary localization of the focus) choroiditis, choroidal tuberculoma, and diffuse choroiditis are more common. With toxoplasmosis, focal choroiditis develops, with congenital toxoplasmosis, central focal choroiditis develops. With acquired syphilis, diffuse choroiditis occurs.

The treatment complex includes pathogenetic, specific and non-specific hyposensitizing agents, physiotherapeutic and physical methods of influence (laser coagulation, cryocoagulation).

Specific hyposensitization is carried out in order to reduce the sensitivity of sensitized eye tissues in tuberculosis, toxoplasmosis, viral, staphylococcal and streptococcal choroiditis. Antibacterial therapy plays an important role in the treatment of choroiditis. With an unknown etiology (cause) of choroiditis, broad-spectrum antibiotics are used.

Author: Shilnikov L.V.

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