2023-11-25 22:01:00
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The retina is a part of our eyes that plays an important role in vision, and if there is an abnormality, vision is also affected. In particular, even healthy young adults in their 30s to 50s may suddenly experience symptoms in which straight lines appear bent, objects appear distorted, or objects appear smaller or further away than they originally were.
‘Central retinitis’ may be suspected, where water accumulates in the macula, the center of the retina, due to abnormal blood flow to the choroid, which supplies nutrients, causing the retina to fall. Most cases recover naturally within 1 to 3 months without special treatment, but the recurrence rate is quite high at 50 to 75%, so follow-up is important.
According to ophthalmologists on the 26th, central retinitis mainly occurs in young people in their 30s to 50s, and there are 3 to 8 times more male patients than female patients. It is known to be related to systemic steroid treatment, Helicobacter infection, pregnancy, smoking, drinking, high blood pressure, and sleep apnea.
Unlike other retinal diseases that require immediate treatment, acute central retinitis is first observed without special treatment. Within 3 to 4 months, the water accumulated in the macula will disappear and the condition will naturally improve. Vision recovers slowly over about a year, but in most cases, the original vision is eventually regained. Fluorescein angiography photo showing leakage points due to central serous chorioretinopathy (left), fundus photo showing water accumulating under the retina due to macular inflammation/(provided by Kim Eye Hospital)
However, the possibility of recurrence is high at 50-75%, so regular follow-up is important. If symptoms persist for more than 6 months or occur and improve frequently, it may be difficult to restore vision due to damage to visual cells or accompanying diseases such as macular degeneration.
In particular, if central retinitis recurs as the patient ages, it is highly likely to lead to macular degeneration. Macular degeneration is an age-related disease and has a poor prognosis. Because it is progressive, vision may decline and lead to blindness.
Yoo Young-joo, a specialist at the Retina Hospital (ophthalmology department) at Kim Eye Hospital, said, “It is easy to feel relieved because central retinitis occurs in relatively young people and is mostly cured naturally,” and warned, “However, when it develops into a chronic disease, it can lead to serious eye disease.” .
As he warned, if you are diagnosed with central retinitis, it is best to visit an ophthalmologist regularly to check the condition of your eyes. Avoid overwork as much as possible and improve your living environment and habits, such as quitting smoking and drinking. If you are receiving steroid medication, have a Helicobacter pylori infection, or have high blood pressure, you should inform your doctor.
This is because the duration of central retinitis can be reduced through drug discontinuation and treatment. If symptoms persist, local laser light coagulation and photodynamic therapy, which coagulate the leakage points revealed in fluorescein angiography with a laser beam, are performed. Drug injection treatment may also be used as an auxiliary measure.
It is a disease that can affect daily life when it becomes chronic, but the exact pathogenesis of central retinitis has not yet been revealed. Recently, researchers at Asan Medical Center in Seoul discovered a biomarker that can predict disease prognosis or treatment response as well as identify the pathogenesis.
The research team, led by Professor Lee Jun-yeop of the Department of Ophthalmology at Asan Medical Center in Seoul, compared and analyzed the eyes of patients with central retinal disease and the control group and found that a specific microRNA (miR-184) was significantly increased in the patients. The research results were published in the international academic journal ‘Nanobiotechnology’.
The research team explained, “It can be cured naturally, but if it progresses chronically or recurs, symptoms can be improved with anti-vascular endothelial growth factor antibody injection treatment, but it is not effective in some patients, so an indicator that can predict treatment response is needed.” did.
To identify biomarkers related to central retinitis, the research team collected and analyzed the aqueous humor contents of the eyes of 42 subacute (between acute and chronic) patients and 20 normal controls. Aqueous humor refers to the clear liquid that fills the space between the cornea and the lens.
Previous studies mainly analyzed waterproof proteins to selectively identify only factors secreted into body fluids among biomarkers, but the research team focused on waterproof exosomes that would reflect both tissue and cell characteristics, including factors not secreted into body fluids.
As a result of examining aqueous humor exosomes using next-generation sequencing (NGC), the patient’s specific microRNA called miR-184 was significantly increased compared to the general control group. In particular, the expression level increased further in patients who had little response to anti-vascular endothelial growth factor antibody injection treatment.
The research team found that miR-184 acts to inhibit the creation of new blood vessels by regulating the expression of the STC2 gene, which is involved in vascular endothelial cell proliferation and migration. The explanation is that there was a compensatory increase in miR-184 as a defense system that suppresses the creation of new blood vessels to prevent macular degeneration from progressing.
Professor Lee said, “Expensive injection treatments are being used to treat various retinal diseases. If we can predict the therapeutic responsiveness of drugs, we will be able to select the optimal treatment early and quickly improve symptoms and reduce the burden on patients.”
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