Serous central chorioretinitis and other forms of the disease. Central serous chorioretinitis Acute central chorioretinitis of the right eye case history

The disease is a consequence of slowing blood flow in the back of the eye. It is explained by the fact that the vessels in this area form a wide bed, in which the blood flow slows down and various infectious agents settle more easily.

Causes

The following causes are usually responsible for the development of chorioretinitis:

contact of the shell of the eye with an agent of an infectious type and the inability to protect itself from external influences;
pathologies of the autoimmune type;
contact with the ocular membrane of viral agents such as HIV, herpes, influenza;
decrease in the body's defenses (pronounced immunodeficiency);
eye trauma of varying severity;
allergic type reactions;
advanced myopia;
exposure to radiation for a long time.

Treatment of pathology will often depend on the cause that led to its development. In order for the therapy to be carried out correctly, they turn to a specialist who can influence not only the symptoms, but also the main factor in the formation of the disease.

Classification

In medicine, the disease is divided into several varieties. The classification is based on the multiplicity of foci, the area of inflammation and the type of course.

The division by area of inflammation is as follows:

central serous chorioretinitis (characterized by damage to the macular region of the eye);
equatorial, in which the focus of inflammation is located in the region of the equator of the visual organ;
peripapillary, characterized by inflammation in the immediate vicinity of the optic nerve;
peripheral, in which the pathological process passes along the dentate line.

According to the multiplicity of foci, they distinguish:

focal chorioretinitis, in which you can find a single focus of inflammation, located anywhere;
multifocal disseminated pathology, in which several inflammatory foci are detected affecting several areas of the visual organ;
diffuse, in which a large number of foci are formed, tending not only to grow, but also to merge.

According to the type of course, pathology is divided into acute and chronic.

Separately, a disease provoked by toxoplasma, tuberculosis, syphilis and HIV infection, as well as neurochorioretinitis, is distinguished. These types of chorioretinitis may have their own specific clinical picture.

For example, toxoplasmic chorioretinitis is mostly congenital. With toxoplasmosis, the disease can go into remission, which will then be replaced by an exacerbation. In addition to the eyes, other organs and systems are also affected. Timely and most complete treatment is needed to prevent retinal detachment.

The tuberculous type of the disease is most often characterized by a secondary lesion after the lungs. On the fundus, it is possible to detect specific tubercles, which, after treatment, leave scars. Scars can either dissolve over time or remain for life.

With syphilis, a picture is determined, called “salt and pepper” by ophthalmologists. The lesions alternate with normal areas and foci of fibrosis, which creates a specific pattern that makes it possible to diagnose syphilitic eye damage by 100%.

Against the background of HIV, cytomegalovirus damage develops. In fact, the immunodeficiency virus does not affect the eyes, but it reduces the body's defenses, which allows other infections to freely provoke the development of pathology. Neurochorioretinitis is characterized by severe symptoms that need to be stopped in a short time.

Symptoms

Symptoms of the disease depend on its form. Peripheral pathology often proceeds without any complaints and is detected by chance during a routine examination.

Central chorioretinitis may be characterized by:

the appearance of "flies" before the eyes;
complaints about, i.e., decreased visual acuity at dusk;
a strong increase in photosensitivity;
signs of metamorphopsia (distortion of vision);
pain in the eyes with their tension, blinking;
clouding of the retina;
complaints about the occurrence of characteristic "flashes" in the field of view.

Signs of chorioretinitis of the eyes can be ignored by the patient for a long time until their severity is strong enough to see a doctor.

Which doctor treats chorioretinitis?

The treatment of the disease is mainly carried out by an ophthalmologist. Depending on the cause of the pathology, phthisiatricians, infectious disease specialists, immunologists-allergists and other specialists may additionally be involved.

Diagnostics

If there are symptoms of damage to the choroid of the eyes, before prescribing treatment, the doctor will conduct a diagnosis to make sure that the diagnosis is correct.

The following diagnostic methods are used:

determine whether there is a decrease in visual acuity;
carry out perimetry - the study of visual fields;
do refractometry - determination of the optical properties of the organ of vision;
conduct biomicroscopy, which allows diagnosing diseases using a special ophthalmic slit lamp;
examine the eye in transmitted light;
perform ophthalmoscopy.

At the discretion of the doctor, an additional angiography for a more detailed examination of the vessels, retinal tomography or ultrasound is possible.

Additionally, in order to establish the causes of the pathology, general urine and blood tests are performed, fluorography is done, an analysis for antibodies to various viruses may be recommended. In some cases, a CT scan of the chest, Mantoux test is performed.

Treatment

Treatment of chorioretinitis largely depends on what cause contributed to its development. Locally, pathology is practically not treated, since this type of therapy has not shown itself to be effective. Different groups of drugs are used, which are selected individually.

Etiotropic therapy is aimed at eliminating the underlying cause. The person may be prescribed antibiotics, antivirals, interferon inducers, or interferons. Bacterial pathology is treated first with broad-spectrum antibiotics, and then a narrowly targeted drug is selected.

Anti-inflammatory drugs are prescribed. Diclofenac, Hydrocortisone, Dexamethasone can be used. Hyposensitization is recommended with Suprastin, Erius and other similar drugs.

Additionally, at the discretion of the doctor, use:

detoxification therapy, drugs are administered intravenously, hemodez or a regular glucose solution will do;
immunotherapy, can be used as immunosuppressants for diseases of the autoimmune type, and immunostimulants for viral or bacterial infections;
vitamin therapy, active use of B vitamins, vitamin C is recommended;
local administration of enzymes that help eliminate the inflammatory focus.

All drugs are recommended to be taken either systemically or as injections of the parabulbar or retrobulbar type. Treatment can vary and change along the way. If no visible effect is observed, the patient is recommended extracorporeal detoxification, hemosorption, plasmapheresis.

Complications

If treatment is carried out untimely or incorrectly, various complications may develop. Most often, the consequences of chorioretinitis are observed:

retinal hemorrhages of recurrent type;
neovascular type membrane;
thrombosis of veins that provide outflow of blood from the retina;
complete blindness.

You can prevent the development of complications if you consult a doctor for help in a timely manner.

Prevention

Chorioretinitis is a disease that can be prevented if you follow a few simple rules. Recommended:

avoid injury to the eye;
contact an ophthalmologist in a timely manner if any eye disease is suspected;
timely treat other pathologies of organs and systems that may be complicated by chorioretinitis;
for preventive purposes, visit an ophthalmologist at least once every six months.

Chorioretinitis is a dangerous disease, for which there can be many reasons. Independent attempts to treat pathology are unacceptable, since the maximum that a person can do at home is to alleviate the symptoms, but not to act on the factors that led to the formation of the pathology.

At the first symptoms of damage to the vessels of the eyes, it is necessary to consult an ophthalmologist. Timely consultation with a specialist will not only significantly facilitate treatment, but also protect a person from possible complications, one of which is complete and irreversible blindness.

Useful video about chorioretinitis

Chorioretinitis is a type of posterior uveitis, an inflammatory process, most often of an infectious origin, occurring in the choroid and retina of the eye. When the process affects only the choroid, and does not affect the retina, the disease is called retinochoroiditis.

Pathology begins gradually. Under the influence of the infectious process, the blood supply to the eye worsens. First, the infection affects the small vessels that feed the retina, and then spreads to large vessels. The disease affects people of all ages. In a child, chorioretinitis often develops under the influence of infection.

Causes

Most often, the cause of the development of chorioretinitis is an infection that directly affects the retina and choroid of the eye. It can be provoked:

Also, the cause of chorioretinitis can be various immunodeficiency conditions, including those provoked by severe infections, such as HIV, or long-term use of drugs that depress the immune system.

In some cases, chorioretinitis of the eye develops due to:

mechanical damage;
somatic reasons;
prolonged exposure;
exposure to toxic substances;
sometimes as an allergic reaction of the body.

Trauma to the eye can cause chorioretinitis

Classification

The disease is classified according to various criteria. The most commonly used classifications are:

sign of the affected area;
pathogen;
duration;
the nature of the flow;
the number of foci of infection.

Distribution area

The disease is divided depending on the site of inflammation:

In cases where the inflammatory process occurs in the macula, central serous chorioretinitis develops.
If the area of \u200b\u200bdistribution of the pathology is located near the exit of the optic nerve in the macula, then peripapillary chorioretinitis develops.
When fluid accumulates in the region of the optic nerve head, juxtapapillary chorioretinitis is diagnosed.
If the lesion affects the central part of the choroid, then they talk about the equatorial view.
In the case when the process occurs along the edges of the dentate line - in a peripheral form.

Causal factor

On this basis, distinguish:

infectious;
allergic;
post-traumatic;
infectious-allergic chorioretinitis.

The most common form of the disease is infectious. It, in turn, is classified according to the causative agent of infection.

With toxoplasmosis, chorioretinitis has a chronic congenital form. This type of disease is characterized by the formation of:

infiltrates;
the formation of foci of the pathological process in the vitreous body;
detachment of the retina;
the formation of many new vessels, characterized by increased fragility, and, as a result, multiple retinal hemorrhages.

Tuberculous chorioretinitis develops as a secondary form of tuberculosis, and can develop against the background of the tuberculous process of any localization.

Central chorioretinitis in tuberculosis is characterized by the formation of:

massive foci of exudation;
perifocal edema;
may be accompanied by hemorrhages and spillage of exudate into the vitreous body.

Complications of tuberculous chorioretinitis include:

atrophy of the optic nerve;
recurrent hemophthalmia;
vitreous fibrosis.

With syphilitic chorioretinitis, multiple foci of pigmentation are visible in the fundus. There is vasoconstriction and pallor of the optic disc. According to these signs, a congenital form of syphilis is often detected.

The nature of the flow

According to the nature of the course, the form of the disease is distinguished:

acute;
chronic.

Number of foci of infection

According to the number of foci of the pathological process, there are:

focal (with one area of the lesion);
multifocal (with several sites);
diffuse (with many lesions).

Clinical picture and features

As chorioretinitis progresses, the symptoms become more pronounced. The disease is manifested by the appearance of:

fog;
floating spots;
periodic flickering of "flies" and colored flashes before the eyes;
increased sensitivity to light;
uncontrolled tearing;
distortion of the shape and size of perceived objects;
change in color interpretation.

Visual acuity decreases, this symptom is especially pronounced in conditions of insufficient lighting. Chorioretinitis is also manifested by pain and redness of the affected eye.

Toxoplasmic chorioretinitis in most cases is a congenital pathology with a chronic course. The disease affects not only the organs of vision, but also the brain.

Tuberculous chorioretinitis is a secondary form of tuberculosis. The penetration of mycobacteria provokes the formation of tuberculomas in the fundus. Over time, at the site of tuberculoma, fibrous tissue grows in places of ruptures between the retina and choroid, adhesions and scars form. If the chorioretinitis is tuberculous, then it does not have specific manifestations.

The development of chorioretinitis against the background of HIV infection is most often provoked by cytomegalovirus. There is an extensive area of damage, characterized by tissue death and numerous hemorrhages of the affected vessels. This is the most difficult form of chorioretinitis to treat.

With severe myopia, myopic chorioretinitis develops. This form of the disease develops against the background of multiple regular retinal hemorrhages, the pathological process, as a rule, is localized in the macular region.

Diagnostics

If at least one of these symptoms appears, you should consult an ophthalmologist. The sooner the cause of the onset of symptoms is established and the disease is diagnosed, the more successful the therapy will be.

To identify the cause of the disease, carry out:

general and biochemical blood tests;
Wasserman reaction;
tests for specific pathogens, such as the herpes virus, HIV infection, toxoplasmosis.

If a tuberculous origin of the pathology is suspected, a mantoux reaction and fluorography are performed.

To make a diagnosis, carry out:

study of visual acuity;
determination of the boundaries of the field of view and detection by cattle, a study of the refractive ability of the eye (it does not change with choriretinitis);
various studies of the eyeball;
assessment of the state of the vitreous body;
angiography of the vessels of the eye;
study of the bioelectrical activity of the retina to determine its condition,
ultrasound examination of the eye.

Treatment Methods

Chorioretinitis is treated with antibiotics and corticosteroids. Local treatment, as a rule, does not give a pronounced effect.

Tuberculous chorioretinitis can be cured only if the tuberculous process is eliminated in all areas of localization. If the disease is provoked by the penetration of toxins, then detoxification treatment is prescribed.

In addition to etiotropic therapy, symptomatic treatment is also used. To do this, use anti-inflammatory, antihistamines. To support immunity in immunodeficient forms of chorioretinitis, the following are prescribed:

immunomodulators;
vitamin complexes;
enzyme preparations.

Treatment can be carried out using physiotherapeutic methods. Most often resort to drug electrophoresis with enzyme preparations.

Laser coagulation

In severe cases, surgical treatment may be used. To stop the spread of the pathological process, its edges are cauterized. This method is called laser coagulation. With such a complication as retinal detachment, vitreotomy or scleroplasty is used.

Chorioretinitis requires serious, adequate, timely treatment, since in its absence, various complications develop, which are much more difficult to cure. Left untreated, you can become completely blind.

In recent years, an eye disease such as chorioretinitis has become increasingly common. We can say that it consists of two diseases - retinitis and choroiditis. At the beginning of the development of the disease, an inflammatory process begins in the posterior vascular membrane.

Since the choriocapillary vessels are connected to the entire retina, problems and inflammation in them will affect the entire retina. Therefore, the disease chorioretinitis extends to the entire eye.

At the same time, the causes of the disease are very diverse. These include viral, bacterial forms. Also, this disease can appear due to systemic diseases: HIV, syphilis, etc.

The problem of this disease is such that the symptoms, regardless of the complexity of the disease, are very serious, the course is problematic and severe. It can cause huge complications of eye diseases. Such as, hemorrhage in the vitreous body, retinal opacity, as well as other equally painful problems. These complications lead to a deterioration in vision, and also, when the cases are especially severe, its complete loss, subsequently, a complete loss of ability to work.

To date, there are acute and chronic forms of chorioretinitis. Depending on when it manifested itself, under what circumstances, the disease is congenital or acquired.

Toxoplasmic chorioretinitis is more common congenital. The child becomes infected while still in the womb. This species also affects the nervous system. Retinal detachment is common, with old lesions visible in comparison to new lesions.

Infectious diseases often occur after eye damage: trauma, severe hypothermia. Allergies, influenza, meningitis - all this can also be the cause of the development of chorioretinitis.

Causes of chorioretinitis

Infection (HIV, syphilis, tuberculosis) also includes local infections (mouth, nose, etc.).

radiation exposure.

Toxic contamination (decomposed blood particles).

Allergies.

Autoimmune diseases.

Injuries, hypothermia.

Immunodeficiency (after suffering from HIV or other serious illnesses).

Symptoms of the appearance of chorioretinitis

The initial telltale sign of serous chorioretinitis is a slight blurred vision. And after a couple of days, a dark spot appears before the eyes. Sometimes there is such a symptom as a change in the perception of colors in the patient.

At the first, not severe stages, patients notice flashes of light before their eyes, vision falls, this is typical for a purulent form.

"Night blindness" develops - poor vision during darkness and dark time of the day, metamorphopsia. There is severe pain in the affected eye, clouding of the retina. High threshold of photosensitivity, flies before the eyes.

In the anterior part of the eye, symptoms as such are not observed, while the posterior part of the eye undergoes changes, and may also be in several foci.

Focal chorioretinitis is possible in the center of the posterior part of the eye (central serous chorioretinitis), on its periphery. Sometimes there is a possibility of damage to other parts of the eye. These include the equatorial or peripapillary form of the disease. Symptoms of this disease are determined by the position of the focus of the disease.

Regardless of which of the above forms and types of disease the patient has, he must consult a doctor. This is a serious, difficult disease, it will bring dire consequences in the absence of proper treatment.

Possible diagnosis of chorioretinitis

The peculiarity of this disease is that it is difficult to determine it on your own, and as soon as a diagnosis is made, it is urgent to start treatment. But you can’t make your own conclusion, this can only be done by an experienced specialist, and then, prescribe the appropriate treatment.

The conclusion of chorioretinitis can be made due to the patient's complaints, as well as after additional studies, such as ophthalmoscopy, FAGD, blood tests, perimitria to detect dark spots, to determine deformities in the vitreous - biomicroscopy, the use of a Goldman sleeve in ophthalmoscopy and a complete examination of the patient. But, unfortunately, even these measures do not always lead to the correct medical conclusion.

Treatment of chorioretinitis

Medical treatment of chorioretinitis

The treatment of this disease is long. It requires a careful approach to treatment, as well as scrupulousness in matters of one's health. It is very dangerous, so you can not let it take its course. In case of inattention, unwillingness to follow the instructions of the doctor, disregard for the disease, a drop in vision is likely, or even complete incapacity of the damaged eye.

Basically, anti-inflammatory, anti-allergic drugs are prescribed in the treatment. Since the problem is with the impermeability of capillaries, then the means are prescribed to improve this function. Antibiotics, physiotherapy, ultrasound therapy, magnetophoresis are often used.

Due to the fact that the main cause of chorioretinitis is the consequences of other diseases, then treatment should be aimed primarily at eliminating the root cause.

A common and effective method of treatment is a laser. It eliminates the blocking of defects in the basal plate. But it is worth noting that laser coagulation also has negative aspects, such as: severe swelling of the eye, which will not go away for about 7 days. This method is used even in cases where the symptoms are not pronounced in the patient.

Folk remedies for the elimination of chorioretinitis

This disease is very serious and dangerous, but you can try to treat it with a variety of herbs and folk remedies. There is a large group of natural plants capable of dilating blood vessels. But we note right away that this is by no means the main treatment, but just an addition to the medication and prescribed by the doctor.

Recipes for brewing herbs.

Pour 10 g of valerian root with a cup of boiling water, boil for half an hour, then let it brew for about half an hour. The resulting remedy is taken 10 g several times a day.

Hawthorn fruits are also excellent in the treatment of such diseases. To prepare the medicine, you need: 20 g of fruits, pour them with a cup of boiling water, and let the resulting liquid infuse. Take several times a day, 10 g half an hour before meals or one hour after.

Hazel bark perfectly dilates blood vessels. To prepare it, take 10 g of bark, pour 0.25 liters of boiling water, let stand for 2 hours and consume 10 g several times a day.

Prevention of the appearance of chorioretinitis

First of all, general hygiene and care for your body. It is necessary to ensure that the diseases that subsequently develop chorioretinitis do not appear, or treat them quickly and efficiently, these are infectious and immunodeficiency diseases. Their timely diagnosis and, if they occur, high-quality treatment are important. Sanitation of such groups of organs as ENT, as well as the oral cavity is important.

With the right behavior with your body, not hypothermia and hygiene, you do not need to be afraid of this disease.

Chorioretinitis is an inflammatory disease with an acute or chronic course that affects the posterior choroid of the eye. The retina is also involved in the process. The circulatory system in the posterior part of the eye is arranged in such a way 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 that enter the human body often linger precisely on the back of the eye. The inflammatory process first affects the capillaries that feed the retina with blood, and later passes to the choroid.

Etiology

The following factors can provoke the progression of chorioretinitis:

penetration into the membranes of the eye of infectious agents;
autoimmune pathologies;
penetration of viruses into the tissues of the eye, and;
immunodeficiency states;
eye injuries of varying severity;
allergic reactions;
complications of myopia;
prolonged exposure to radiation.

Classification

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

central serous chorioretinitis. In this case, the inflammation affects the macular area of the eye;
equatorial. Inflammation is localized near the equator of the eye;
peripapillary. The process is localized in close proximity to the optic nerve;
peripheral. Inflammation occurs along the dentate line.

Depending on the number of inflammatory foci:

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

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

spicy;
chronic.

Symptoms

At the initial stages of the progression of chorioretinitis, blurred vision is observed, and after a few days a dark spot appears in the field of vision. Also, a change in color perception is not ruled out. Further, the clinical picture is supplemented by the following symptoms:

"flies" before the eyes;
chicken blindness. This symptom is characterized by a decrease in visual acuity at dusk;
photosensitivity is significantly increased;
vision distortion. In medicine, this condition is called metamorphopsia;
periodically before the eyes there are "flashes";
clouding of the retina;
pain in the eyes.

Features of chorioretinitis

Toxoplasmic chorioretinitis in most clinical situations is congenital. Infection occurs during the intrauterine development of the fetus. Infectious agents affect not only parts of the eye, but also the tissues of the central nervous system, vital organs. The pathological process is undulating - periods of exacerbation alternate with periods of remission. This condition is very dangerous, because without proper treatment, detachment of the retina can occur.

Tuberculous type progresses only against the background of the primary lesion of the lungs. Specific tubercles are formed on the fundus of the eye. After treatment, scars remain on the surface.

Syphilitic chorioretinitis manifests itself quite specifically. On the fundus there is an alternation of pathological areas. There are places with, but there are also areas with pigmentation.

Diagnostics

If the patient shows these symptoms, you should go to a medical facility for a comprehensive diagnosis. The standard examination plan includes the following methods:

assessment of visual acuity;
perimetry;
refractometry;
biomicroscopy;
ophthalmoscopy using a special Goldman lens;
fluorescein angiography;
electroretinography.

The cause of the progression of chorioretinitis can be identified using the following diagnostic methods:

tests for the presence of antibodies to infectious diseases (, other).

Treatment

Chorioretinitis is treated by an ophthalmologist. It is best to place the patient in a hospital for the duration of treatment, 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. Its main goal is to eliminate the cause of the pathology. For this, the patient is prescribed antiviral, antibacterial drugs;
detoxification therapy;
immunotherapy;
desensitizing therapy;
physiotherapy treatment.

In severe cases, doctors resort to laser coagulation of the retina. This modern method of treatment allows localizing the inflammatory process.

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Diseases with similar symptoms:

Retinal dystrophy is a dangerous disease in which the retina of the eye is affected. Whatever the cause of this disease in humans, with untimely and unqualified treatment, the outcome of dystrophy is one - atrophy or complete death of the tissues that make up the retina. Because of this, the patient will have irreversible visual impairment, up to blindness. It should be noted that the timing of vision loss depends on the type of disease. Retinal dystrophy proceeds rather slowly, but as it progresses, the patient's condition only worsens.

Keratoconus - from the point of view of ophthalmology is considered an extremely rare disease that affects the cornea of the eye. The disease is equally common in 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 serous chorioretinitis is a polyetiological disease that is provoked by allergic, infectious, vascular and toxic factors. The pathogenetic path of development of chorioretinitis is due to the formation of defects in the basal plate, as well as vasomotor disorders. This leads to a pathological increase in the permeability of the capillary bed and vascular membranes, as well as some areas of the basal lamina.

Symptoms

Central serous chorioretinitis in the early stages usually presents with blurred vision. In the future, the formation of a dark spot occurs. Quite often, metamorphopsia and photopsia join. There may also be a decrease in visual acuity, the severity of which ranges from tenths to hundredths. Some patients develop central scotoma, transient hypermetropia, and impaired color vision.

Diagnosis and stages of the disease

During ophthalmoscopy in the early stages of the disease, retinal opacity in the macula area can be detected. Opacification has a round or oval shape, and the diameter ranges from 0.5 to 2 diameters of the optic nerve head. The pathological focus usually protrudes slightly forward, and at the border of its vessels make a slight bend. Also, a light reflex can be detected along the border. The severity of macula opacity varies from subtle to pronounced gray. In some cases, not a foveal, but an eccentric paramacular arrangement is detected.

After some time (from several days to several months), central serous chorioretinitis passes to the second stage. It is also called the stage of precipitates. At the same time, there is an increase in visual acuity, but there is still a spot in front of the eye. With ophthalmoscopy, it is possible to reveal only gray-white small-dotted foci, called precipitates, and the area of opacification practically resolves.

In the third stage of the disease, central scotoma and metamorphopsia no longer bother the patient. Visual acuity usually returns to baseline. Ophthalmoscopy often fails to detect precipitates and edema, but an area of dyspigmentation is usually present. The macula becomes mottled in color, which is associated with the presence of small clumps of pigment, small areas of discoloration of the pigment epithelium, as well as yellow flat lesions.

Central serous chorioretinitis can affect one or both eyes. This process is prone to recurrence, so the prognosis is usually unfavorable. Due to the absence of vivid symptoms, it is rather difficult to diagnose pathology during an outpatient examination. To do this, it is necessary to conduct a comprehensive examination, which includes ophthalmochromoscopy, biomicroscopy, and fluorescein angiography. These techniques help to detect additional manifestations of chorioretinitis, which is important for differential diagnosis with other pathologies (retrobulbar neuritis, juvenile spot dystrophy).

Among the characteristic signs of central serous chorioretinitis, there is an expansion of the optical section of the retina, which is accompanied by the accumulation of transudate between the retina and the pigment epithelium, microprecipitates. Fluorescein angiography can also detect small defects in the basal lamina that look like dye leak points (fluorescent flags).

Treatment

In this disease, complex treatment is usually prescribed, which should take into account the etiology of chorioretinitis. Pathogenetic methods include laser coagulation of defects in the basal lamina. Approximately 4-10 days after the operation, signs of retinal edema disappear. In this case, you should additionally use drugs that restore vascular permeability (aevit, ascorutin), dehydration drugs (sodium chloride 10%, glucose solution 40%, glycerin, phonurite), vasodilator drugs (nicotinamide, no-shpa). Cocarboxylase, vitamins, heparin and ATP can be used to improve metabolism in retinal cells. With symptoms of edema of the retinal substance, glucocorticosteroids are prescribed (for retrobulbar administration).