Uloga kortikosteroida u liječenju makularnih bolesti

master's thesis

• Title (english): The corticosteroid's function in treating macular diseases
• Author: Tatjana Topalović
• Mentor: Tomislav Jukić (mentor)
• Committee member: Damir Katušić (predsjednik povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Committee member: Tomislav Jukić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Mrežnica je funkcionalno najvažniji dio oka. Osigurava vidnu oštrinu, širinu vidnog polja, osjet svjetla, boje, kontrasta i sjajnosti. Makula je ovalno područje u središtu mrežnice, veličine oko 5,5 mm i odgovorna je za detaljni, centralni vid. Njen središnji dio, foveola, mjesto je najjasnijeg vida. Stoga patološki procesi koji zahvaćaju makulu dovode do smanjenja centralne vidne oštrine uz često iskrivljenu sliku i poremećen kolorni vid.
Senilna makularna degeneracija i dijabetička retinopatija među najčešćim su makularnim bolestima i najčešćim uzrocima slabljenja vidne oštrine. Nešto rjeđi uzroci su cistoidni makularni edem i okluzija mrežničnih vena.
Patofiziološki, glavni uzrok smanjenja vidne oštrine je edem makule. Mehanizmi koji do toga dovode vrlo su složeni i još uvijek nisu u potpunosti poznati. Ključnu ulogu imaju vaskularni endotelni faktor rasta (VEGF) i upalni citokini koji zajedničkim djelovanjem povećavaju vaskularnu propusnost.
Sprječavanje ovakvog razvoja bolesti, smanjujući upalu i blokirajući angiogenezu, nalazi se u podlozi liječenja makularnih bolesti.
Kortikosteroidi, kao protuupalni lijekovi, u novije vrijeme pokazali su se učinkoviti u liječenju makularnih bolesti. Primjena kortikosteroidnih intravitrealnih implantata osigurava kontinuirano otpuštanje lijeka te stalni nadzor nad upalnim zbivanjima. S druge strane, smanjuje potrebu primjene intravitrealnih injekcija anti-VEGF lijekova te prateće komplikacije i troškove. U budućnosti, kortikosteroidni implantati bi mogli biti osnovna terapija na koju se dodaje liječenje laserom ili anti-VEGF lijekovima, kao kombinirana terapija makularnih bolesti.

Abstract (english)

Retina is functionally the most important part of the eye. It provides visual acuity, field of vision, the sense of light, colour, contrast and brightness. The macula is an oval area in the centre of retina, the size of about 5.5 mm and is responsible for the detailed, central vision. Its central part, foveola, represents the place of the clearest vision. Therefore, pathological processes that affect the macula lead to a reduction in central visual acuity with the often distorted image and disrupted colour vision.
Age-related macular degeneration and diabetic retinopathy are among the most common macular diseases and the most common causes of the observed visual acuity. Some less common causes of cystoid macular include oedema and retinal vein occlusion.
Pathophysiologically, the main cause of reduced visual acuity is macular oedema. The mechanisms that lead to it are very complex and still not fully understood. Key role is played by the vascular endothelial growth factor (VEGF) and inflammatory cytokines, whose joint action increases vascular permeability.
Prevention of such a disease development, by reducing the inflammation and blocking angiogenesis, is located in the substrate of the macular diseases' treatment.
Corticosteroids, as anti-inflammatory drugs, have recently been turned out to be effective in the treatment of macular diseases. The use of corticosteroid intravitreal implants provides continuous release of the drug and the constant monitoring of inflammatory developments. On the other hand, it reduces the need for application of intravitreal injections of anti-VEGF drugs and associated complications and costs. In the future, corticosteroid implants could become the basic therapy, to which is added the treatment by laser or anti-VEGF drugs, as a combined therapy of macular diseases.

• Keywords: makula; vidna oštrina; upala; kortikosteroidi; intravitrealni implantati
• Keywords (english): macula; visual acuity; inflammation; corticosteroids; intravitreal implants
• Language: croatian
• URN:NBN: urn:nbn:hr:105:051848
• 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: 2016-03-29 11:31:46