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Moramarco gharbya

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Moramarco gharbya

  1. 1. Coinvolgimento oculare nella Joint Hypermobility Sindrome/EhlersDanlos Syndrome Hypermobility Type Francesco Parisi
  2. 2. …cosa già si conosceva Fragilità sclerale Microcornea EDS di tipo cifoscoliotico Sclera blu Strabismo Cornea plana Cheratocono Cheratoglobo Cataratta Ectopia lentis Distacco di retina Strie angioidi. Miopia Rima palpebrale antimongoloide Ptosi palpebrale JHS/EDS-HT.
  3. 3. cosa abbiamo evidenziato nel nostro studio… Maggior frequenza nei pz JHS/EDS-HT •Sindrome da Disfunzione Lacrimale (occhio secco) •Opacità del cristallino asintomatiche •Miopia patologica •Cornee più curve Nessuna differenza tra i gruppi: •Acuità visiva •Pressione intraoculare •Spessore corneale •Lunghezza assiale •Profondità camera anteriore
  4. 4. Sindrome da Disfunzione Lacrimale "La sindrome da disfunzione lacrimale è una patologia multifattoriale del film lacrimale e della superficie oculare che causa sintomi di discomfort oculare, disturbi visivi ed instabilità del film lacrimale con potenziali danni alla superficie oculare. E' accompagnata da aumentata osmolarità del film lacrimale e da infiammazione della superficie oculare."
  5. 5. Sintomi: •bruciore •sensazione di C.E. •fotofobia •sensazione di secchezza •sensazione di peso e dolore oculare •distrubi del visus •difficoltà ad aprire gli occhi al mattino •dolore notturno Segni: •iperemia congiuntivale •segni di sofferenza epiteliale (disepitelizzazione grave o moderata, ulcera corneale) •alterazioni biomicroscopiche del film lacrimale(diminuzione del lago lacrimale,accumulo di materiale etc.)
  6. 6. DIAGNOSI Storia clinica Visita oculistica Valutazione del film lacrimale test di Schirmer I TBUT
  7. 7. Terapia •ripristinare il film lacrimale con lubrificanti oculari •correzione delle patologie di base (oculistiche e non)
  8. 8. Opacità del cristallino asintomatiche
  9. 9. E’ caratterizzata da:  errore refrattivo di almeno -6D  lunghezza assiale del bulbo oculare maggiore di 26.5 mm Interessa il 27-33% degli occhi con miopia, con una prevalenza variabile dal 1.7 al 2% nella popolazione generale
  10. 10. Conclusioni Fenotipo oculare della JHS/EDS-HT è caratterizzato da: SDL, aumento della curvatura corneale senza fragilità del globo oculare, opacità del cristallino asintomatiche, alta incidenza di miopia patologica e alterazioni specifiche della struttura microscopica corneale. Revisione futura degli esistenti criteri diagnostici nella JHS/EDS-HT. Una visita oculistica potrebbe essere utile per porre diagnosi di JHS/EDS-HT nei casi dubbi. Ruolo dell’oculista nella diagnosi e cura della SDL e nella diagnosi e gestione delle complicanze della miopia patologica è di fondamentale importanza per cercare di migliorare la qualità di vita dei pz affetti da JHS/EDS-HT.

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