Okluzija centralne vene retine kod bolesnice sa sistemskom sklerozom

  • Jelena Karadžić Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
  • Aleksandra Radosavljević Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Igor Kovačević Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP141028073K
Ključne reči: scleroderma, systemic||, ||sklerodermija, sistemska, retinal vein occlusion||, ||okluzija retinalne vene, diagnosis||, ||dijagnoza, angiogenesis inhibitors||, ||angiogeneza, inhibitori, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Skleroderma (sistemska skleroza) je ozbiljna hronična bolest vezivnog tkiva, koja zahvata brojne unutrašnje organe. Promene u oku mogu da budu posledica organ-specifičnih manifestacija skleroderme ili se mogu javiti usled neželjenih efekata imunosupresivne terapije koja se koristi u lečenju. Prikaz bolesnika. U radu je prikazana 42-godišnja bolesnica sa dijagnozom sistemske skleroze i naglim pogoršanjem vida na levo oku (sa vidnom oštrinom 0,9). Nakon detaljnog kliničkog pregleda, uključujući fluoresceinsku angiografiju i optičku koherentnu tomografiju, postavljena je dijagnoza neishemične forme okluzije centralne vene retine. Dalja biohemijska, reumatološka i imunološka ispitivanja, osim inaktivne sistemske skleroze, pokazala su normalan nalaz. Stoga je utvrđeno da je jedini uzrok venske okluzije predstavljaju mikrovaskularne promene u sklopu sistemske skleroze. Nakon tri meseca, vidna oštrina levog oka se pogoršala na 0,6 usled razvoja cistoidnog makularnog edema. Bolesnica je primila intravitrealnu injekciju bevacizumaba i nakon samo jedne doze vidna oština se popravila na 0,9. Nakon šest meseci praćenja, makularni edem se povukao, a vidna oština je ostala nepromenjena. Zaključak. Prema našim saznanjima i uvidom u literaturu, okluzija centralne vene retine je retka manifestacija skleroderme, koja može da ugrozi funkciju vida. Postoji svega nekoliko objavljenih radova u kojima je prikazana centralna venska okluzija kod ovih bolesnika. Kod bolesnika sa sistemskom sklerozom preporučuje se pregled zadnjeg segmenta oka radi procene mogućih vaskularnih promena.

Biografije autora

Jelena Karadžić, Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
Medical retina department, ophthalmology specialist
Aleksandra Radosavljević, Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Uveitis department, ophthalmology specialist, clinical assistant
Igor Kovačević, Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Vitreoretinal surgery and trauma department, ophthalmology specialist, clinical assistant

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Objavljeno
2017/03/10
Broj časopisa
Vol. 73 Br. 9 (2016)
Rubrika
Prikaz bolesnika