UTICAJ TOPIKALNIH HIPOTENZIVNIH LEKOVA NA REDUKCIJU PADA SENZITIVNOSTI VIDNOG POLJA USLED DRUZA GLAVE VIDNOG ŽIVCA - PRIKAZ SLUČAJA

PRIKAZ SLUCAJA

  • Marija Radenkovic dr, oftalmolog
Ključne reči: Ključne reči: druze glave vidnog živca, vidno polje, skotomi, hipotenzivni lek

Sažetak


SAŽETAK

Druze glave vidnog živca predstavljaju kongenitalnu anomaliju, formu kalcijumske degeneracije aksona glave optičkog nerva. Inicijalno su asimptomatske ali mogu biti i jedan od uzroka progresivne optičke neuropatije. Prezentuju se kao acelularni, hijalini depoziti globularnog izgleda u prelaminarnom segmentu glave vidnog živca. Nastaju usled: izmenjenog aksonalnog transporta, malog dijametra skleralnog kanala, direktne kompresije i ishemije. Komplikuju se progresivnim ispadima u vidnom polju, ishemičnom optičkom neuropatijom, okluzijom centralne retinalne arterije ili vene, peripapilarnom neovaskularizacijom. Dijagnostikuju se oftalmoskopijom, angiografijom, kompjuterizovanom perimetrijom, B-scan ultrasonografijom, CT, OCT, HRT, GDx, elektrofiziološkim ispitivanjem. Terapija je medikamentozna, laser, hirurška. Većina pilot studija potvrđuje benefit topikalnih hipotenzivnih lekova i kada druze nisu asocirane sa glaukomom. Sniženjem intraokularnog pritiska se smanjuje kompresija aksona vidnog živca i poboljšava reperfuzija. Rad prezentuje mladu pacijentkinju sa obostranim druzama vidnog živca, progresivnim skotomima, zbog čega je uključena topikalna hipotenzivna terapija. Nakon šest meseci redukovani su skotomi i gubitak senzitivnosti vidnog polja. Efekat neuroprotektivnih lekova se istražuje radi smanjenja potencijalnog morbiditeta.     

Ključne reči: druze glave vidnog živca, vidno polje, skotomi, hipotenzivni lek

Reference

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2022/11/09
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