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Centrální serózní chorioretinopatie. Přehled

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Authors: Manethová Myslík;  Kateřina 1,2
Authors‘ workplace: Oční oddělení, Fakultní Thomayerova nemocnice, Praha 1;  Fakultní nemocnice Královské Vinohrady a 3. lékařská fakulta Univerzity Karlovy, Praha 2
Published in: Čes. a slov. Oftal., 80, 2024, No. 2, p. 59-75
Category: Review Article
doi: https://doi.org/10.31348/2023/27

Overview

Centrální serózní chorioretinopatie (CSC) je onemocnění charakterizované serózním odchlípením neuroretiny zejména v zadním pólu oka. Často je doprovázené serózním odloučením retinálního pigmentového epitelu (RPE) a sdružené s prosakováním tekutiny do subretinálního prostoru skrze defektní RPE. CSC nejčastěji postihuje muže v produktivním věku. Přesná patofyziologie onemocnění není zcela známa. Na základě angiografického vyšetření s indocyaninovou zelení (ICG), která odhalila zvýšenou permeabilitu choroidálních cév, a optické koherenční tomografie (OCT) ukazující zvýšenou tloušťku choroidey se předpokládá choroidální vaskulopatie jako primární příčina vzniku CSC. Ve většině případů má CSC dobrou prognózu se spontánní resorpcí subretinální tekutiny (SRT) a úpravou zrakových funkcí. U malého procenta pacientů však onemocnění přechází do chronického či rekurentního průběhu a může vést k nevratným funkčním i anatomickým změnám sítnice s konečným klinickým obrazem difuzní retinální pigmentové epitelopatie (DRPE). Optimální léčebný přístup k pacientům s CSC zůstává kontroverzní. V posledních dekádách se v léčbě chronických forem CSC (cCSC) používalo nespočet léčebných přístupů; tyto zahrnovaly například laserovou fotokoagulaci, medikamentózní léčbu, standardní fotodynamickou terapii (PDT) či anti-VEGF. V posledních letech se v léčbě cCSC preferuje méně destruktivní metoda, kterou je PDT v redukovaných dávkovacích schématech, ať už s redukovanou dávkou verteporfinu nebo použité energie laserového paprsku. Je prokázána srovnatelná účinnost a bezpečnost při použití redukovaných schémat PDT u pacientů s cCSC, u kterých došlo ke zlepšení nejlépe korigované zrakové ostrosti i redukci SRT. 

Klíčová slova:

Choroidální neovaskularizace – centrální serózní chorioretinopatie – retinální degenerace – multimodální zobrazení – fotodynamická terapie

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Labels
Ophthalmology
Multimodálne zobrazovanie choroidálnych nodulov pri neurofibromatóze typu I
Problematika diagnostiky oční formy rosacey
Porovnání kvality časného vidění segmentované refrakční čočky SBL-2 a SBL-3
Vliv pandemie COVID-19 na kvalitu vyšetření v očních ambulancích v České republice – dotazníková studie
Kaposiho sarkom. Kazuistika
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