vie. Feb 26th, 2021

Iridodonesis es una condición en la cual el iris (parte coloreada del aro) vibra durante los movimientos de los ojos. Sobre la mudanza del aro rápidamente, el iris puede aparecer a la danza del `’, o el ` tiembla’ (tremulousness). Esto ocurre cuando la lente llega a ser parcialmente separada (subluxation de la lente) de sus ligamentos suspensorios. Este sí mismo es a menudo asintomático y llega a ser solamente evidente sobre el examen físico del aro.

¿Qué causa iridodonesis?

La causa primaria del iridodonesis es el subluxation de la lente. Esto puede ocurrir como resultado de glaucoma, de la formación de la catarata, de complicaciones postquirúrgicas, o de trauma al aro. El subluxation de la lente ocurre raramente naturalmente; sin embargo, se denuncia los casos del iridodonesis que ocurren debido a las mutaciones genéticas que afectan a la fuerza de tejidos conectivos.  

En un parte del caso, una mujer de 65 años que era evaluada para el síndrome de Marfan, un desorden genético que afecta a los tejidos conectivos de la carrocería, también tenía iridodonesis. Fue encontrado que el paciente tenía una mutación en el gen FBN1, que codifica fibrillin, un componente importante de las fibras elásticos que son parte del tejido conectivo de la carrocería.

Los pacientes con el síndrome de Marfan tienden a tener tejido elástico anormalmente flojo. Dentro del aro, esto aparece como zonules ciliares flojos.

Anatomía básica de la carrocería ciliar

La carrocería ciliar es una estructura integrada por dos porciones: un anillo del músculo circular que es una extensión del iris, y el epitelio ciliar que produce el humor acuoso en la cámara anterior del aro. Las piezas insertas ciliares del músculo en los zonules ciliares, y contratan o se relajan para producir una lente más fina o más gruesa, con una potencia refractiva más inferior o más alta respectivamente.

El zonule ciliar o el zonule de Zinn es un anillo o una banda de fibras 1-2 micrones de ancho, sujetando la carrocería ciliar a la lente. Tiene dos capas: una capa delgada, que forra la fosa hialoide, y una capa más gruesa que comprende las fibras zonulares. Componen el ligamento suspensorio de la lente. Cuando estas fibras aflojan, lleva a la dislocación parcial de la lente (llamada los lentis de la ectopia), dando por resultado iridodonesis.

Los zonules ciliares debilitados en el síndrome de Marfan llevan así al subluxation de la lente. Por lo tanto, el iridodonesis es un sello del síndrome de Marfan.

Otro parte del caso registró los episodios periódicos del vértigo debido al tremulousness del iris con el movimiento de los ojos. Estos episodios pueden ser poco más que segundo largos. En este caso determinado, los investigadores concluyeron que el tremulousness del iris causó un temblor de la retina, llevando a la irritación de caminos de los nervios asociados.

Sin embargo, en la mayoría de los casos del iridodonesis, la vibración de la lente no da lugar a ninguna síntomas.

¿Cómo se maneja el iridodonesis?

Puesto que el iridodonesis es una consecuencia directa del subluxation de la lente, tratar la causa del destacamento por aproximaciones quirúrgicas puede ayudar a reducir el tremulousness del iris. Sin embargo, en pacientes con una causa genética para el iridodonesis, no hay a menudo vulcanización. Pues el iridodonesis no da lugar generalmente a ninguna síntomas evidente, aparte del caso raro del vértigo, puede a menudo ser dejado solo a menos que se presenten las complicaciones.

Por notiregio

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