An inflammation of the choroid is also called choroiditis and describes an inflammation of the choroid, which is located between the retina and the sclera. The choroid is responsible for supplying nutrients and regulating the temperature of the retina. Often the inflammation affects the retina at the same time, so in most cases it is called chorioretinitis.
It often occurs in the context of other diseases or infections with pathogens such as toxoplasmosis, tuberculosis or candida fungi. During the ophthalmological examination, white spots often appear on the back of the eye. Due to the lack of nerves in the choroid, the choroidal inflammation does not cause pain and is particularly noticeable in the form of deterioration of vision.
The causes of a choroidal inflammation are many and varied and can have very different origins. Often the exact cause is not fully understood. Other diseases in which there is an increased incidence of choroidal inflammation are Herpes simplex, chickenpox, rubella, syphilis, Lyme disease, AIDS and histoplasmosis.
Often the choroidal inflammation occurs in immunocompromised patients. In most cases there is no isolated choroiditis, but an inflammation of the entire posterior vascular layer (uveitis posterior). – Choroiditis often occurs in the context of other diseases, such as inflammatory bowel diseases (Crohn’s disease, ulcerative colitis).
- They also occur frequently in rheumatic diseases, such as Behcet’s disease or scleroderma. – In most cases, however, the cause is an infection caused by bacteria, viruses, parasites or fungi. – If there is inflammation of the teeth or tonsils, pathogens can spread to the eye via the bloodstream. Important pathogens of a choroidal inflammation are toxoplasmosis pathogens, cytomegalovirus, tuberculosis bacteria or candida fungi.
Inflammation of the choroidal membrane is primarily noticeable in the form of a deterioration in vision. Patients often complain of distorted vision and black spots in front of the eyes. In the course of the disease, visual field failures can occur in the area of the focus of inflammation.
Increased sensitivity to glare or redness of the eye can also be symptoms. Frequently there is an increased internal pressure in the context of the choroidal inflammation. In contrast to the other layers of the retina, the choroid contains no sensitive nerve fibres.
This means that the retina cannot perceive pain. Accordingly, affected patients do not feel any pain when the choroidal inflammation is isolated. As a rule, however, not the choroid alone is affected, but several layers simultaneously. In the case of chorioretinitis, for example, in which the retina is also affected, pain can also occur.
The diagnosis of a choroidal inflammation is made by the ophthalmologist by means of an ophthalmoscopy or funduscopy. With this examination the posterior segment of the eye can be assessed. During this ophthalmoscopy, the doctor can in most cases detect white or yellow, blurred round spots that represent focal points of inflammation on the choroid.
Depending on the degree of activity of the inflammation, they can be of varying degrees of severity. For further diagnosis and to exclude other diseases, a slit-lamp examination and a measurement of the intraocular pressure (tonometry) can also be performed. In some cases, optical coherence tomography (OCT) may also be helpful, which allows detailed imaging of the retinal layers.