Introduction:

Choroidal neovascularization (CNV) is the abnormal growth of new blood vessels in the choroid, a vascular layer of the eye. In some cases, CNV can occur as a complication of chorioretinitis or posterior uveitis, inflammatory conditions affecting the retina and choroid. This comprehensive article aims to provide valuable insights into CNV secondary to chorioretinitis/posterior uveitis, including its causes, symptoms, diagnosis, and treatment options.

Understanding Choroidal Neovascularization Secondary to Chorioretinitis/Posterior Uveitis:

Chorioretinitis and posterior uveitis are inflammatory conditions affecting the retina and choroid, respectively. They can be caused by infections, autoimmune diseases, or other inflammatory disorders. When these conditions are not adequately controlled or managed, they can lead to the development of CNV, a sight-threatening complication.

Causes of Choroidal Neovascularization Secondary to Chorioretinitis/Posterior Uveitis:

The exact mechanism leading to CNV in patients with chorioretinitis/posterior uveitis is not fully understood. However, several factors may contribute to its development, including:

• Chronic Inflammation: Prolonged inflammation in the retina and choroid can trigger the release of growth factors that promote the formation of abnormal blood vessels.
• Vascular Endothelial Growth Factor (VEGF): Elevated levels of VEGF, a protein that stimulates the growth of blood vessels, can contribute to the development of CNV.
• Immune-Mediated Mechanisms: Dysregulation of the immune system in inflammatory conditions can disrupt the delicate balance of blood vessel growth and regression in the choroid.

Symptoms of Choroidal Neovascularization Secondary to Chorioretinitis/Posterior Uveitis:

The symptoms of CNV secondary to chorioretinitis/posterior uveitis may include:

• Blurred Vision: Abnormal blood vessel growth in the choroid can affect the clarity of central vision.
• Metamorphopsia: Straight lines may appear wavy or distorted.
• Central Scotoma: Patients may experience a dark or empty spot in the center of their visual field.
• Decreased Contrast Sensitivity: The ability to perceive differences in shades of gray may be reduced.

Diagnosis of Choroidal Neovascularization Secondary to Chorioretinitis/Posterior Uveitis:

Diagnosing CNV secondary to chorioretinitis/posterior uveitis involves a comprehensive eye examination and specialized tests, including:

• Fundus Examination: Dilated eye examination allows the ophthalmologist to visualize the retina and choroid for any signs of CNV.
• Optical Coherence Tomography (OCT): OCT provides detailed cross-sectional images of the retina and can detect the presence of abnormal blood vessels.
• Fluorescein Angiography: This test involves injecting a dye into the bloodstream to visualize blood flow in the retina and choroid and detect any leaking blood vessels.

Treatment of Choroidal Neovascularization Secondary to Chorioretinitis/Posterior Uveitis:

The management of CNV secondary to chorioretinitis/posterior uveitis aims to control inflammation, reduce abnormal blood vessel growth, and preserve vision. Treatment options may include:

• Intravitreal Anti-VEGF Injections: Medications that block VEGF, such as ranibizumab or aflibercept, can be injected into the eye to reduce CNV activity and leakage.
• Corticosteroids: Intravitreal or periocular corticosteroid injections may be used to control inflammation and reduce VEGF production.
• Photodynamic Therapy: In some cases, photodynamic therapy may be considered to selectively target and close abnormal blood vessels.
• Immunosuppressive Therapy: In cases of autoimmune-related chorioretinitis/posterior uveitis, immunosuppressive medications may be prescribed to control inflammation.

Conclusion:

Choroidal neovascularization secondary to chorioretinitis/posterior uveitis is a serious complication that can lead to vision loss if left untreated. Early detection, timely intervention, and a multidisciplinary approach involving ophthalmologists and uveitis specialists are essential in managing CNV and preserving visual function.

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