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Quản lý bệnh giãn mạch võng mạc ẩn nguyên phát loại 2
Tóm tắt
Bệnh giãn mạch võng mạc ẩn nguyên phát loại 2 (MacTel) là một bệnh tương đối hiếm gặp và chưa có phương pháp điều trị được xác lập. Mặc dù trước đây MacTel được coi là một bệnh lý chủ yếu có nguồn gốc từ mạch máu, nhưng tư duy về sinh bệnh học của nó đã chuyển sang xem xét nó chủ yếu là một bệnh thoái hóa thần kinh. Điều này đã dẫn đến sự thay đổi trong cách tiếp cận điều trị theo hướng bảo vệ thần kinh cho giai đoạn không tăng sinh của bệnh này. Việc bổ sung carotenoid đã cho kết quả mixed. Yếu tố thần kinh có nguồn gốc từ cili (CNTF) đã cho thấy một số kết quả khả quan ban đầu, nhưng cần có thêm nghiên cứu để xác định tác động thực sự của nó. Một số cải thiện cấu trúc đã được quan sát thấy trong giai đoạn không tăng sinh với acetazolamide đường uống nhưng không có cải thiện chức năng đi kèm. Các thuốc chống nội mô mạch máu đã được nghiên cứu và không có lợi ích trong giai đoạn không tăng sinh của bệnh nhưng đã thể hiện giá trị cấu trúc và chức năng đáng kể trong điều trị sự tái tạo mạch máu thứ phát. Hiện chưa có bằng chứng mức độ I cho các phương pháp điều trị MacTel khác nhau được đề xuất và cần nỗ lực để tiến hành các thử nghiệm ngẫu nhiên đa trung tâm nhằm hiểu rõ hơn về các phương pháp điều trị khả thi cho bệnh này.
Từ khóa
#MacTel #giãn mạch võng mạc #bảo vệ thần kinh #acetazolamide #CNTF #thuốc chống nội mô mạch máu #phương pháp điều trị bệnh thoái hóa thần kinhTài liệu tham khảo
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