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