Etiopatogeneza i liječenje keratokonusa

master's thesis

• Title (english): Etiopathogenesis and treatment of keratoconus
• Author: Marin Miljak
• Mentor: Miro Kalauz (mentor)
• Committee member: Damir Katušić (predsjednik povjerenstva)
• Committee member: Tomislav Jukić (član povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Keratokonus je bolest koja zahvaća rožnicu. Naziv nosi prema stožastom obliku kojega poprima bolešću oštećena, stanjena rožnica. Incidencija keratokonusa je oko 1 na 2000, a treba napomenuti kako bolest zahvaća mlađu populaciju. Pacijenti s keratokonusom gube vidnu oštrinu, ali srećom nikada potpune ne izgube vid zbog svoje osnovne bolesti. Keratokonus ima najprije progresivni tijek, dok u zrelijoj dobi ublažava kliničku sliku. Etiopatogeneza keratokonusa nije posve razjašnjena. Pojedine studije daju naslutiti postojanje jače ili manje izražene genetske podloge kod pacijenata, dok autori u drugim radovima vide degenerativne promjene kao uzroke nastanka bolesti. S obzirom na različit klinički stadij bolesti pacijente možemo liječiti primjenom naočala i leća kako bismo oboljelima povratili vidnu oštrinu. Kod uznapredovalih stupnjeva keratokonusa nudi nam se više kirurških tehnika (penetrirajuća keratoplastika, prednja lamelarna keratoplastika, fototerapeutska keratoplastika), a u novije vrijeme napori idu prema sprječavanju etiopatogenetske podloge za nastanak keratokonusa (kolagen cross linking CXL, insercije intrakornealnih ringova ICRS), te selektivne Mini-SARK i SACL kirurške tehnike. S obzirom na povezanost nastanka keratokonusa i smanjenja endotelnih
stanica rožnice koja je zamjetna kod ljudi koji nose kontaktne leće, svakako se preporuča upotreba mekanih ili plinopropusnih leća, izbjegavanje tvrdih kontaktnih leća, te učestali kontrolni pregledi kod ljudi koji nose leće.

Abstract (english)

Keratoconus is a corneal disease. Affected cornea becomes thinner and protrudes in conical shape, hence the name. Prevalence for keratoconus is about 1 in 2000 people. It should be stressed that the disease affects people at a young age.
Patients have progresive deterioration of their vision because of changed corneal curve, but luckily never completely loose their sight for their primary disease. In a mature age (40s) it usually decreases by itself. Etiopathogenesis of keratoconus remains unclear. Some studies show influence of the genetic basis, others emphasize the degenerative part of the disease
as the main cause. Depending of the condition patients present themselves in, we should find suitable spectacles or lenses in order to provide a good level of visual correction. In progressive states we can choose between several surgical keratoplasty techniques (penetrating, lamelar, phototerapeutic), and recently we try to stop progression of the disease by collagen crosslinking or by inserting intracorneal ring segments. Also there are selective Mini-SARK i SACL surgical techniques.
Considering a connection between keratoconus presentation and decrease in number of the corneal endothelial cells spotted in people that wear contact lenses, it is advised to use soft or rigid gas-permeable lenses. Also, more frequent controls are
advised.

• Keywords: keratokonus; leće; keratoplastika; CXL; ICRS; Mini-SARK; SACL
• Keywords (english): keratoconus; lenses; keratoplasty; CXL; ICRS; Mini-SARK; SACL
• Language: croatian
• URN:NBN: urn:nbn:hr:105:406144
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-03-14 13:27:20