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Œdème maculaire d’origine choroïdienne

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Œdèmes maculaires

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Résumé

L’œdème maculaire est le plus souvent défini cliniquement comme une accumulation de fluide séreux à l’intérieur de la rétine sensorielle avec augmentation d’épaisseur de la rétine centrale. Au cours de la dégénérescence maculaire liée à l’age, exsudative, les diffusions des fluides à partir des néovaisseaux choroïdiens peuvent être à l’origine d’un œdème maculaire. La perméabilité anormale des néovaisseaux et la réaction inflammatoire sont les mécanismes essentiels qui interviennent dans l’accumulation de fluides qui se produit et s’étend à toutes les couches rétiniennes.

L’œdème maculaire cystoïde est plus souvent associé à la présence de néovaisseaux choroïdiens sousépithéliaux de type occulte plutôt qu’à des néovaisseaux pré-épithéliaux de type classique (« classic »).

La présence simultanée de néovaisseaux choroïdiens et d’œdème maculaire implique l’existence de nombreux dysfonctionnements cellulaires et d’altérations métaboliques. Les diffusions, à partir de néovaisseaux choroïdiens, sont essentiellement liées au VEGF et peuvent entraîner une importante accumulation de fluides sous la rétine neurosensorielle. Il est vraisemblable que les étapes essentielles surviennent avant l’augmentation d’expression du VEGF et sont soit initiées, soit facilitées par les cytokines qui agissent normalement pour contrebalancer l’ensemble des effets des VEGF et qui, dans des circonstances pathologiques peuvent, soit contredire, soit servir à amplifier le processus.

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  1. Service d’ophtalmologie, Hôital intercommunal de Créteil, Créteil, France

    Gisèle Soubrane

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  1. Gisèle Soubrane
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Soubrane, G. (2011). Œdème maculaire d’origine choroïdienne. In: Œdèmes maculaires. Springer, Paris. https://doi.org/10.1007/978-2-8178-0118-6_11

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  • DOI: https://doi.org/10.1007/978-2-8178-0118-6_11

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0117-9

  • Online ISBN: 978-2-8178-0118-6

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