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Choroiditis - Treatment
Medical expert of the article
Last reviewed: 06.07.2025
Treatment of choroiditis should be individual, its intensity and duration are determined by the infectious agent, the severity and localization of the process, the severity of immunological reactions. In this regard, drugs used to treat choroiditis are divided into etiotropic, anti-inflammatory (non-specific), immunocorrective, symptomatic, affecting complex regenerative and biochemical processes in the structures of the eye, membrane protectors, etc. Systemic use of drugs is combined with local (parabulbar and retrobulbar injections), if necessary, surgical treatment is performed.
Etiotropic treatment of choroiditis involves the use of antiviral, antibacterial and antiparasitic drugs, but broad-spectrum antibiotics are used in the treatment of choroiditis only after determining the sensitivity of infectious agents to them. In the active phase of the disease, broad-spectrum antibiotics from the aminoglycoside group, cephalosporins and others are used in the form of parabulbar, intravenous and intramuscular injections and taken orally. Specific antibacterial drugs are used for choroiditis that occurs against the background of tuberculosis, syphilis, toxoplasmosis, brucellosis, etc. Antiviral drugs are recommended for choroiditis of viral origin.
Immunotropic therapy is often the main method of treating endogenous choroiditis. Depending on the patient's immunological status and the clinical picture of the disease, either immunosuppressants or immunostimulants are used.
Passive immunotherapy is no less important. In this regard, it is possible to use globulins. Vaccines can also be used, but with great caution, taking into account the individual status of the patient, in order to avoid exacerbations of the pathological process. Interferon inducers (interferonogens) and interferons are used as immunocorrective therapy.
Against the background of the use of etiotropic drugs, corticosteroids occupy a leading place in the treatment of inflammatory processes, despite the possibility of their side effects. In the acute stage of the process, inflammation is suppressed by local or systemic use of corticosteroids. In some cases, their early use improves the prognosis.
Hyposensitization is carried out to reduce the sensitivity of sensitized eye tissues in tuberculous, toxoplasmic, viral, staphylococcal and streptococcal choroiditis. Antihistamines (tavegil, suprastin, claritin, telfast, etc.) are used as non-specific and hyposensitizing therapy. In case of active inflammation, immunosuppressants (mercaptopurine, fluorouracil, cyclophosphamide, etc.) are used, sometimes in combination with corticosteroids.
In the treatment of choroiditis, cyclosporine A and thymus gland preparations are also used, which play an important role in the development of the immune system.
Physiotherapeutic and physical methods of influence (electrophoresis of medicinal preparations, laser coagulation, cryocoagulation) are also used at different stages of the disease. For resorption of exudates and hemorrhages in the choroid, retina and vitreous body, enzymes are used (trypsin, fibrinolysin, lidase, papain, lekozyme, phlogenzyme, wobenzyme, etc.), which are administered intramuscularly, retrobulbarly, by electrophoresis and taken orally. Transscleral cryocoagulation of the choroid and laser coagulation of the retina are possible. Vitamin therapy (vitamins C, B 1, B 6, B 12 ) is indicated at all stages.
The prognosis depends on the etiology of choroiditis, prevalence and localization of the process. Complete blindness is rare, mainly with the development of complications, optic nerve atrophy, exudative retinal detachment, in which, in case of ineffectiveness of drug therapy, surgical treatment is indicated.
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