Środkowa siateczkowa dystrofia naczyniówki i zespół antyfosfolipidowy
Central Reticular Choroid Dystrophy and Antiphospholipid Syndrome
Monika Modrzejewska, Ewelina Lachowicz, Danuta Karczewicz
Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej w Szczecinie
Samodzielny Publiczny Szpital Kliniczny nr 2 w Szczecinie
Kierownik: prof. dr hab. n. med. Danuta Karczewicz
Summary: Purpose: To present the patient with retinal and choroid dystrophy in macula (CRCD) of both eyes and coexisting antiphospholipid syndrome (APS).
Material and Methods: Standard ophthalmological examination, Amsler test, fluorescein angiography (AF), electrophysiological tests (multifocal electroretinography – Mf ERG, electrooculography – EOG), static perimetry (Zeiss Humphrey test 24.2), campimetry and retrobulbar blood flow measurement using color Doppler ultrasonography (CDU) were performed. Chorioretinal changes were recorded using Ret - Cam II - photography. Serological laboratory diagnostic tests for rheumatologic diseases, including antiphospholipid syndrome, were performed concerning characteristic anamnesis of existing embolic and thrombotic changes in peripheral blood vessels.
Results: The ophthalmological examination revealed visual acuity reduction in both eyes (Snellen charts). Funduscopy showed characteristic features for CRCD chorioretinal degeneration in macular region in both eyes. A relative scotoma in ophthalmological tests was present. AF showed retinal pigment epithelium (RPE) atrophy. Mf ERG revealed bioelectrical function dysfunction in the central retina, corresponding to scotoma in static perimetry. Changes in the blood flow parameters of retrobulbar arteries in CDU were present. Increased serum levels of aCL and anti β2 – GP1 were confirmed in laboratory tests. Local medicines improving blood flow in chorioretinal vessels and antithrombotic agents were used. In the period of visual acuity reduction with serum level antibodies increase in serological tests, antithrombotic agents were used. Antithrombotic and blood flow improvement treatment was used.
Conclusions: The antiphospholipid syndrome could coexist with the central reticular choroid dystrophy. Proper treatment procedure lead to retinal function stabilization.
Słowa kluczowe: środkowa siateczkowa dystrofia naczyniówki, zespół antyfosfolipidowy.
Keywords: central reticular choroid dystrophy, antiphospholipid syndrome.