| Abstract | Keratokonus je najčešća ektatička degenerativna bolest rožnice, koja uzrokuje progresivne strukturne promjene i dovodi do postupne pojave stožastog, nepravilnog, centralnog izbočenja te progresivnog stanjenja same rožnice.
Bolest zahvaća osobe oba spola i svih etniciteta, s najvećom pojavnošću u osoba između 20. i 30. godine života, a prevalencija i incidencija bolesti pokazuju značajne varijacije diljem svijeta.
Keratokonus je bolest čija točna etiologija i mehanizam nastanka nisu u potpunosti poznati te se trenutno razumijevanje etiopatogeneze keratokonusa temelji na interakciji multifaktorijalnih procesa, odnosno, kombinaciji utjecaja genetske komponente, promijenjene stanične biokemije te biomehaničkih čimbenika i različitih faktora rizika.
Klinička slika bolesti ovisi o njenom stadiju, tako da u početku simptomi mogu biti vrlo blagi, primjerice blagi pad vidne oštrine ili povećana osjetljivost na odsjaje, a klinički znakovi vrlo diskretni. Međutim, progresijom bolesti simptomi postaju intenzivni, a dolazi do manifestacije mnogih kliničkih znakova, od kojih je vjerojatno najprepoznatljivije karakteristično stožasto izbočenje rožnice.
Rano dijagnosticiranje keratokonusa povezuje se s boljim ishodima bolesti, ali izazov predstavlja dijagnosticiranje ranijih, subkliničkih stadija bolesti. Dijagnoza keratokonusa zasniva se na anamnezi te kliničkom pregledu, koji uključuje ispitivanje vidne oštrine, pregled na biomikroskopu, pahimetriju te metode kornealne topografije i tomografije.
Temeljne metode liječenja keratokonusa obuhvaćaju: korekciju naočalama ili kontaktnim lećama, fotorefraktivnu keratektomiju, terapiju intrakornealnim prstenovima ili intraokularnim lećama, križno umrežavanje kolagena rožnice te keratoplastiku. |
| Abstract (english) | Keratoconus is the most common ectatic degenerative disease of the cornea, which causes progressive structural changes and leads to the gradual appearance of a conical, irregular, central protrusion and progressive thinning of the cornea itself.
The disease affects people of both genders and all ethnicities, with the highest incidence in people between 20 and 30 years of age, and the prevalence and incidence of the disease show significant variations around the world.
Keratoconus is a disease whose exact etiology and mechanism of occurrence are not fully known, and the current understanding of the etiopathogenesis of keratoconus is based on the interaction of multifactorial processes, i.e., a combination of the influence of the genetic component, altered cellular biochemistry, and biomechanical factors and various risk factors.
The clinical picture of the disease depends on its stage, so initially the symptoms can be very mild, for example a slight decrease in visual acuity or increased sensitivity to glare, and the clinical signs are very discrete, however, with the progression of the disease, the symptoms become intense, and there is a manifestation of many clinical signs, the most recognizable of which is probably the characteristic conical protrusion of the cornea.
Early diagnosis of keratoconus is associated with better disease outcomes, but the diagnosis of earlier, subclinical stages of the disease poses challenge. The diagnosis of keratoconus is based on taking patient's history and performing a clinical examination, which includes a visual acuity test, a biomicroscope examination, pachymetry, and performing corneal topography and tomography.
The basic methods of treating keratoconus include: correction with glasses or contact lenses, photorefractive keratectomy, therapy with intracorneal rings or intraocular lenses, cross-linking of corneal collagen, and keratoplasty. |
