Causes, symptoms and treatment of angiopathy of retinal vessels
The content of the article:
Angiopathy of retinal vessels – what is it?
The retina requires a large consumption of nutrients and oxygen because it is responsible for trapping light waves, they are converted to nerve impulse and transmission in the brain, where the image formation. Insufficiency of blood supply choroid causes serious visual disturbances. Angiopathy of retinal vessels – not separately incurred a disease, the pathology that develops as a result of destruction of cells of the blood vessels and the violation of their functions in diseases of different Genesis.
Angiopathy of retinal vessels is a pathological disturbance of the tone of blood vessels and capillaries of the fundus. As a result, their tortuosity, narrowing and extension. Changes of blood flow velocity and failure of the nervous regulation. Vascular defects give the opportunity to suspect and diagnose the underlying disease before its clinical manifestations.
The pathology of this form signals the presence in the body of the disease, which hinders normal blood circulation, affect the tone of small and large blood vessels, causing necrotizing lesions in a certain area of the retina is threatened by the complete or partial loss of vision or decline in its quality. Angiopathy more common in older patients (older than 35 years) on the background of chronic diseases, but occasionally is diagnosed in children and even newborns.
Causes of angiopathy of the retinaThe most important structure of the eye – retina – responsive to the slightest disturbances in the blood supply. Angiopathy is not an independent disease, it serves as a signal about the disease, which is a negative impact on ocular vessels. Pathological processes in the body cause damage to the walls of eye blood vessels, their modification and disruption to the structure.
The main reasons that lead to angiopathy:
Hypertension. High blood pressure has a detrimental effect on the walls of eye blood vessels, destroying the inner layer. Vascular wallthickens, it takes its fibromyalia. Disturbance of blood circulation, blood clots and hemorrhages. Due to the constantly increased pressure , some blood vessels burst. A characteristic feature of hypertensive angiopathy – crimped, constricted blood vessels fundus. At the first degree GB there are changes in the blood vessels of the eyes third of the patients, while second – half of the cases, and in the third stage of hypertension the blood vessels of the ocular fundus is mutated in all patients;
- Diabetes. The disease causes damage to the vascular walls, not only in the retina but also throughout the body. Pathology develops on the background of continuously high levels of glucose in the blood. This causes the development of an occlusion, the blood leaks into the tissue of the retina, thickening and proliferation of the capillary walls, reducing vessel diameter and the deterioration of blood microcirculation in the eyes. Pathogenesis often leads to the gradual loss of vision;
Injuries to the skull, eyes and spinal (cervical), severe and prolonged squeezing of the chest. The condition causes a sharp increase to high numbers in intracranial pressure, to rupture the walls of blood vessels and bleeding into the retina of the eye;
- Hypotension. The decrease in vascular tone entails branching vessels, their strong expansion, palpable pulsation, reducing the speed of blood flow, and promotes formation of clots in the blood vessels of the retina, increases the permeability of the vessel walls.
Factors that contribute to threat angiopathy:
- Increased intracranial pressure;
- Bad habits (Smoking, alcohol);
- Poisoning (acute or chronic);
- Advanced age;
- Congenital anomalies of the vessel wall;
There are several varieties of this disease, which is also sometimes found:
Youth angiopathy. Inflammation in the blood vessels of the retina develops for an unknown reason. It is accompanied by small hemorrhages into the vitreous body of the eye and the retina. The most severe type of the disease, which contributes to detachment of the retina, also provokes the appearance of cataracts and glaucomaoften leads to blindness;
- Angiopathy in preterm infants. The disease occurs infrequently, the cause isa complication of childbirth or birth trauma. The defeat of the retina is characterized by proliferative changes in blood vessels, narrowing and impaired blood flow;
- Angiopathy during pregnancy. In the early stages of the disease bears no alarming consequences, but if it is not treated can lead to irreversible complications (retinal detachment). To develop this pathology can in the second half of pregnancy on the background of hypertensive disease or other diseases that are characterized by weakness of the vascular walls.
To angiopathy may cause any pathology or disease that negatively (directly or indirectly) affect the condition of vessels.
Common causes of angiopathy include:
- Arterial hypertension of various etiology;
- Congenital abnormalities of the vascular walls;
- Increased intracranial pressure;
- Traumatic lesions of the eye;
- Some diseases of the blood;
Additional risk factors:
- Older age and presbyopia (senile vision);
- Work in hazardous industry;
- Smoking and abuse of alcohol;
- The effects of radiation.
Symptoms of angiopathy of the retinaAngiopathy of the vessels is divided into types depending on the underlying disease:
- Diabetic angiopathy. The most common. Patients with type 1 diabetes, she noted in 40% of cases, patients with type 2 – 20%. Typically, the disorder begins to develop in 7-10 years from onset of the disease. There are two variants of development: microangiopathy and macroangiopathy. When microangiopathy affects the thinning of the capillaries that leads to disruption of the microcirculation and bleeding. In macroangiopathy affects the larger vessels are occluded(obstruction), leading to hypoxia of the retina;
- Hypertensive angiopathy. On the background of chronically elevated pressure there is a narrowing of the arteries and retinal veins. Gradually formed sclerosis of the vessels of the venous bed is branchy, exudates are formed due to seepage of blood through the capillary walls;
Hypotonic angiopathy. On the background of arterial hypotension, on the contrary, the arteries expand, the blood flow slows down, marked pulsation of the veins, the vessels become tortuous, which increases the likelihood of blood clots. The characteristic symptoms in this case are feeling of pulsation in eyes and dizziness;
- Traumatic angiopathy. In injuries of the head or the chest, squeezing the abdomen, osteochondrosis can dramatically increase intraocular pressure. If the vessels cannot withstand the load, be their ruptures with subsequent bleeding;
- Angiopathy during pregnancy. In this case, the disorder is functional in nature and goes away by itself after 2-3 months after birth. The reason is that the increase in blood volume causes passive expansion of blood vessels of the retina. Another question, if a diabetic or hypertensive angiopathy were before pregnancy. In this case, it likely will begin to progress quickly.
Risk of angiopathy is that in the early stages and for quite a long time, she was asymptomatic. At the stage of noticeable deterioration of view, the process usually is irreversible.
Common symptoms of angiopathy:
- The decrease in visual acuity.
- The appearance of fog and spots before the eyes;
- The narrowing of the field of view;
- Sense of pulsation in the eyeball;
The presence of ruptured blood vessels and yellow spots on the conjunctiva.
- Bleeding from the nose.
- Pain in the legs;
- Blood in the urine.
Treatment of angiopathy of the retinaTreatment of angiopathy is strictly individually for each patient taking into account the nature of the disease and severity. Drug therapy is aimed at the complete elimination of factors causing this pathology: in case of hypertensive disease are assignedantihypertensive drugs, diabetes medicines, reduces the level of sugar in the blood. Treatment of angiopathy of retinal vessels is complex conservative and surgical methods in the interaction of many doctors, ophthalmologist, surgeon, ophthalmologist, General practitioner, endocrinologist, cardiologist, rheumatologist, neurologist.
Therapy the pathological process includes the actions of the conservative character:
- Taking medications that improve blood circulation and strengthen the vascular wall: Trental, Pentoxifylline, Actovegin, Vasonit, Solkoseril, Arriflex, Cavinton;
- The appointment of drugs that reduce vascular permeability: Dobezilat, Parmidin, Ginkgo biloba extract;
- Vitamin preparations of group b (B6, B1, B12, B15), C, d, E;
- Medications that prevent blood clots: Trombone, Aspirin, Dipyridamole, Magnecor, Ticlodipine;
- Drops to improve blood circulation in eyes: Emoxipin, Taufon;
- Medications for the treatment of primary disease that triggered the angiopathy of retinal vessels (hypotensive, hypoglycemic);
- Physiotherapy treatments: laser irradiation, magnetic resonance therapy, acupuncture;
If the treatment does not give the expected results, as the disease progresses, to eliminate the appointed surgery. Use the methods of laser coagulation of the retina, vitrectomy, photocoagulation. In severe cases, apply treatment angiopathy by cleansing the blood with hemodialysis.
However, the capabilities of modern ophthalmic techniques do not guarantee the recovery of vision in angiopathy of retinal vessels. Timely access to specialist, high-quality diagnosis of disease, elimination of its root cause, a permanent and proper treatment of the underlying disease – the key to a favorable prognosis and full recovery.