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NR. 4/2004
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Idiopatyczne
nowotwórstwo podsiatkówkowe u młodych dorosłych – współczesne
poglądy na etiologię, diagnostykę i leczenie
Idiopatic choroidal neovascularization of young adults –
contemporary view at etiology, diagnosis and treatment
Anna Otto, Aneta Paćkowska
Katedra i Klinika Okulistyki I Wydziału Lekarskiego Akademii
Medycznej
w Warszawie
Kierownik: prof. nadzw. dr hab. med. Dariusz Kęcik |
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| Summary: |
Age-related macular
degeneration is the most popular reason of choroidal
neovascularization (CNV) appearance and treatment.
However CNV may occur in population of young people (younger
than 50 yrs) without relation to any, well known
ophtalmological disease. This type of choroidal
neovascularization is called an idiopatic CNV (ICNV).
Patobiology of CNV is a very complicated process related
with many factors. The best known one is VEGF (vascular
endothelial growth factor), but there are also some
mediators produced by macrophages taking part in this
process. These are for example: MCP (monocyt
colonization protein), MMPS (matrix metaloproteinazy),
aTNF (tumor necrosis factor).
Dynamic stages between pro and antyangiogenic factors
plays the most important role in prevention of CNV
appearance. Following methods have the most important
meaning in CNV diagnosis: fluoroscein and indocianin
angiography as well as optical coherent tomography
examination. As far as treatment of ICNV is concerned we
should consider methods like: photodynamic therapy (PDT),
laser photocoagulation, vitreorethinal surgery – macular
translocation or removal of the subfoveal choroidal
neovascular membranes. Comparison outcomes have shown
that PDT is the most efficient kind of CNV treatment.
Experiments on animals proved that it is possible to
change CNV activity by factors like Anecortev and
synthetic VEGF. The most important for the right
prognosis as to final vision acuity is extensiveness of
the neovascular membranes during the first AF
examination, so when planning right treatment the
natural history of disease must be always considered. As
it was proven by many authors ICNV doesn’t lead to a
serious lost of vision. |
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| Key words: |
idiopatic choroidal
neovascularization, VEGF, PDT. |
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