Corpi mobili (miodesopsie)

Date
Apr, 01, 2020

Se si verifica la comparsa improvvisa di mosche volanti o di una ragnatela, e soprattutto se questa è accompagnata da flash (fotopsie), si dovrebbe contattare con URGENZA un oculista per la valutazione della parte posteriore dell’occhio per escludere la presenza di fori retinici, distacco di retina o altro.

La visione di mosche volanti o corpi mobili (miodesopsie è il termine medico) è dovuta ad un deterioramento progressivo del corpo vitreo, il gel che riempie l’occhio, che perde parte della sua integrità liquefacendosi progressivamente nel tempo.

Nella maggior parte dei casi le miodesopsie sembrano essere associate ad un normale processo di invecchiamento del corpo vitreo. Esistono dei fattori predisponenti o concause che ne determinano la comparsa: miopia al di sopra delle 5 diottrie e a qualsiasi età, traumi violenti alla testa, uso di colliri particolari per lunghi periodi di tempo,…Raramente sono associate ad alcune patologie oculari quali uveite, distacco di retina regmatogeno, linfomi oculari, retinopatia diabetica, emorragie retiniche,vitropatia steroide,…Spesso accade che i corpi mobili appaiano bruscamente in seguito a un distacco posteriore di vitreo con conseguente prolificazione dei corpi mobili e possibili lesioni retiniche.

Il paziente descrive questo fenomeno come visione di oggetti di varia forma e tipo che fluttuano dentro l’occhio e che fuggono quando si cerca di fissarli. Si notano prevalentemente quando c’è molta luce, quando si guarda uno sfondo bianco o un cielo sereno.

Quando i lampi di luce, della durata di qualche minuto sono preceduti o accompagnati da emicrania, si parla di emicrania oftalmica.  La percezione dei lampi può essere anche associato all’assunzione protratta di “digitale” nei pazienti cardiopatici.

COSA FARE

Rivolgersi sempre al medico oculista per sottoporsi ad una visita approfondita per escludere le malattie che possono portare alla formazione dei corpi mobili vitreali.

Esistono in commercio diversi prodotti a base di integratori utili per il trofismo del corpo vitreo e per rallentarne i processi degenerativi. Un ‘alimentazione sana a base di frutta e verdure, bevendo molta acqua sembra rallentare il processo di degradazione e contrazione vitreale.

Alcuni autori hanno proposto la frammentazione (vitreolisi) dei grossi corpi mobili mediante YAG laser ma non esistono studi che ne provano la reale efficacia e sicurezza.

La vitrectomia (la rimozione del gel vitreale)  potrebbe rappresentare l’unico vera  e definitiva soluzione per questo problema ma con rischi molto elevati (rotture retiniche, distacco di retina, comparsa di cataratta).

In definitiva non esiste una terapia realmente efficace che possa eliminare questo disturbo ed è meglio convivere con i corpi mobili piuttosto che azzardare operazioni rischiose. Col tempo questi fastidiosi puntini neri tendono a diminuire ma è difficile che scompaiano del tutto.

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