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UVEITELE ANTERIOARE
Inflamatia irisului=IRITA iar inflamatia
corpului ciliar = CICLITA. De obicei lele
evolueaza concomitentIRIDOCICLITE.
Simptome subiective:
1. DURERI OCULARE2.FOTOFOBIE, LACRIMARE,
BLEFAROSPASM
3.VEDERE INCETOSATA
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SEMNE OBIECTIVE
1.CONGESTIE CONJUNCTIVALAPERIKERATICA
2.EDEM CORNEEAN ENDOTELIAL
3.MIOZA sau IREGULARITATE
PUPILARA
4.PRECIPITATELE RETROCORNEENE-celule inflamatorii localizate pe fata
posterioara a corneei.
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5.EXUDATE IN CAMERA ANT cu
aspect de fulgi de nea.
PurulenteHemoragice
Fibrinoase
6.TULBURAREA UMORII
APOASE
in functie de tipul exudatelorprezente.
7.ALTERAREA RELIEFULUI SI
CULORII IRIENE
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DIAGNOSTIC DIFERENTIAL
-CONJUNCTIVITE
-GLAUCOM ACUT
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ETIOPATOGENIE
Uveitele anterioare endogene apar
in cadrul unei boli manifeste sau latentece afecteaza organismul respectiv
1. Boli infectioase cronice (tbc.lues)
2. Infectii de focar
3. Boli de colagen (les,pr)
4. Boli SN5. Boli de piele (acnee rozacee,eritem
nodos)
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6. Boli reumatismale degenerative
7. Sarcoidoza
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FORME CLINICE
-d.p.d.v evolutiv *acute
*subacute
*cronice-d.p.d.v anatomo-patolgic:
*difuze-negranulomatoase
*nodulare-granulomatoase
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COMPLICATII-propagarea lor in intreaga uvee
-panuveite/ panoftalmie
-sinechiile iriene
-glaucomul secundar
- cataracta complicata-atrofia progresiva a G.O.
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TRATAMENT
Local- midriatice
- antibioticeinstilatii sau inj.subconjunctivale sau parabulbare
- cortizoninstilatii sau inj.subconjunctivale sau parabulbare
General - Antiinflamator
- Antibiotic
- Acetazolamida in
uveitele hipertensive
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Iridociclita acuta
http://images.google.ro/imgres?imgurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/toxoplasma_chorioretinitis.jpg&imgrefurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/clinical_symptoms.htm&h=158&w=193&sz=7&hl=ro&start=10&tbnid=cDl8wCIr-XnWqM:&tbnh=84&tbnw=103&prev=8/13/2019 x Patologie Uvee
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Uveita anterioara cu sinechii
cronice posterioare
http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/Chorioretinitis.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=178&w=248&sz=62&hl=ro&start=4&tbnid=WMibR3O7B-e20M:&tbnh=80&tbnw=111&prev=8/13/2019 x Patologie Uvee
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Precipitate
http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/toxobilat.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=198&w=482&sz=130&hl=ro&start=34&tbnid=HgDSgVcPWXjD9M:&tbnh=53&tbnw=129&prev=8/13/2019 x Patologie Uvee
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UVEITELE POSTERIOAREcand procesul inflamator afecteaza
coroida vorbim despre uveita posterioara
sau coroidita.
COROIDITELE EXOGENEse datoreaza patrunderii agentului
patogen in interiorul ochiului printr-o
plaga perforanta accidentala sauchirurgicala.
- stafilococ, streptococ,
pseudomonas, pneumococ, escherichia
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Tablou clinic
SEMNE SUBIECTIVE
- durere ocularaaccentuata la palpare sila miscarile globului ocular
SEMNE FUNCTIONALE
- scaderea acuitatii vizualeSEMNE OBIECTIVE
- edem si spasm palpebral
-congestie ciliara accentuata-plaga (daca exista) cu buze infiltrate
-hipopion
-sinechii posterioare, exudat pupilar
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Evolutie:
a) spre vindecare sub tratament
b) subacut complicandu-se cu secluzie- ocluzie
pupilara
c) spre panoftalmie dureri vii
chemozis ce herniaza
printre pleoapecornee tulbure
hipopion abundent
exudat galbui in pupilavitros cu reflex galbui, nu
se vizualizeaza fundul de ochi
glob ocular dur, exoftalm
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Tratament:
Local: -antibioatice cu spectru larg-midriatice
General: -antibiotice in doze mari
-antalgice, sedative, AINS
Chirurgical in cazul panoftalmiei in care
ochiul e pierdut functional si dezorganizat
anatomic. Se recomanda evisceratia.
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COROIDITELE ENDOGENE
I. COROIDITE EXOGENE
NESUPURATIVE
Etiopatogenia:
apar prin mecanism autoimun, alergic.
Cea mai frecventa cauza-TOXOPLASMOZA
Tablou clinic:
- senzatia de muste zburatoare
- metamorfopsii
- scaderea AV
- scotoame
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- Ochiul este alb fara congestie
conjunctivala- flocoane in vitros = exudate inflamatorii
FO: noduli albi galbui cu contur sterszone alb galbui marginite sau
presarate cu pigment negru peste care
vasele retiniene trec nemodificate. Acestaspect indica o leziune cicatricealasi se
datoreaza atrofiei coroidiene
http://images.google.ro/imgres?imgurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/toxoplasma_chorioretinitis.jpg&imgrefurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/clinical_symptoms.htm&h=158&w=193&sz=7&hl=ro&start=10&tbnid=cDl8wCIr-XnWqM:&tbnh=84&tbnw=103&prev=http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/Chorioretinitis.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=178&w=248&sz=62&hl=ro&start=4&tbnid=WMibR3O7B-e20M:&tbnh=80&tbnw=111&prev=8/13/2019 x Patologie Uvee
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http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/toxobilat.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=198&w=482&sz=130&hl=ro&start=34&tbnid=HgDSgVcPWXjD9M:&tbnh=53&tbnw=129&prev=http://images.google.ro/imgres?imgurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/toxoplasma_chorioretinitis.jpg&imgrefurl=http://www.foodsafety.no/Skjerve/Platform_Toxoplasma_Risk_Assessment/clinical_symptoms.htm&h=158&w=193&sz=7&hl=ro&start=10&tbnid=cDl8wCIr-XnWqM:&tbnh=84&tbnw=103&prev=http://images.google.ro/imgres?imgurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/Chorioretinitis.jpg&imgrefurl=http://medweb.bham.ac.uk/easdec/eyetextbook/Uveitis/uveitis.htm&h=178&w=248&sz=62&hl=ro&start=4&tbnid=WMibR3O7B-e20M:&tbnh=80&tbnw=111&prev=8/13/2019 x Patologie Uvee
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Tratament:
- antiinfectios local si general- antiiflamator
- antialergic
Complicatii:
- cataracta complicata subcapsulara
posterioara- pierderea nervului optic realizan o
neurocorioretinita
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