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Choroiditis: treatment
Last reviewed: 23.04.2024
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Treatment of choroiditis should be individual, its intensity and duration are determined by the infectious agent, severity and localization of the process, the severity of immunological reactions. In this regard, the drugs used to treat choroiditis are divided into etiotropic, anti-inflammatory (nonspecific), immunocorrecting, symptomatic, affecting complex regenerative and biochemical processes in the structures of the eye, membrane protectors, etc. Systemic use of the drugs is combined with local (parabulbar and retrobulbar injections ), if necessary, perform surgical treatment.
Etiotropic treatment of choroiditis involves the use of antiviral, antibacterial and antiparasitic drugs, but broad-spectrum antibiotics are used in the treatment of choroiditis only after determining the sensitivity of infectious agents to them. In the active phase of the disease, broad-spectrum antibiotics from the aminoglycoside group, cephalosporins and others are used as parabulbar, intravenous and intramuscular injections and taken internally. Antibacterial specific drugs are used for choroiditis that occur against the background of tuberculosis, syphilis, toxoplasmosis, brucellosis, etc. In choroiditis of viral nature, antiviral drugs are recommended.
Immunotropic therapy is often the main treatment for endogenous choroiditis. At the same time, depending on the immunological status of the patient and the clinical picture of the disease, either immunosuppressors or immunostimulants are used.
No less important is passive immunotherapy. In this regard, the use of globulins. Vaccines can also be used, but with great care, taking into account the individual status of the patient, in order to avoid exacerbations of the pathological process. As immunocorrecting therapy, interferon inducers (interferons) and interferons are used.
Against the background of the use of etiotropic drugs, the leading place in the treatment of inflammatory processes is occupied by corticosteroids, despite the possibility of their side effects. In the acute stage of the process, inflammation is suppressed by the local or systemic use of corticosteroids. In some cases, their early use improves the prognosis.
Hyposensitisation is carried out in order to reduce the sensitivity of sensitized eye tissues in tuberculosis, toxoplasmosis, viral, staphylococcal and streptococcal choroiditis. As a nonspecific and hyposensitizing therapy, antihistamines (tavegil, suprastin, claritin, telfast, etc.) are used. With active inflammation, immunosuppressors (mercaptopurine, fluorouracil, cyclophosphamide, etc.) are used, sometimes in combination with corticosteroids.
In the treatment of choroiditis, cyclosporine A and thymus preparations that play an important role in the formation of the immune system are also used.
Physiotherapeutic and physical methods of action (electrophoresis of medicinal products, laser coagulation, cryocoagulation) are also used in various stages of the disease. For the absorption of exudates and hemorrhages in the choroid, retina and vitreous body, enzymes (trypsin, fibrinolysin, lidazum, papain, lekosim, phlogenzyme, vobenzim, etc.) are used, which are injected intramuscularly, retrobulbarno, by electrophoresis and taken internally. Transscleral cryocoagulation of the choroid and laser coagulation of the retina are possible. At all stages, vitamin therapy is indicated (vitamins C, B 1, B 6, B 12 ).
The prognosis depends on the etiology of the choroiditis, the prevalence and localization of the process. Complete blindness is rarely observed, mainly in the development of complications, atrophy of the optic nerve, exudative retinal detachment, in which surgical treatment is indicated in the case of ineffective drug therapy.
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