Angiopathy of retinal vessels: types, causes, treatment
Probably, many people after visiting the ophthalmologist was returning home with a new and confusing diagnosis of “angiopathy of retinal vessels”. What it is, what threat this disease poses to vision and overall health, how to treat it – this will be discussed in this article.
What is angiopathy of the retina?
Angiopathy of retinal vessels is the pathological changes of arteries and veins, which cut across the fundus, yet this condition is called retinopathy. Such changes may be caused by impaired regulation of vascular tone (spasm or atony), and organic changes of blood vessels.
It should be noted that angiopathy is not an independent disease, it is always a symptom of the primary pathology.
Eye doctors compared to the mirror of our body. That is, all diseases that affect blood vessels, are displayed in the arteries and veins of the retina. Very often, the pathological changes in the first place be amazed by the vessels of the retina. This gives you the opportunity to suspect and diagnose as early as the preclinical stage of the underlying disease, when symptoms yet, but the retinal vessels have already responded.
Angiopathy in the early stages is completely reversible condition. If you eliminate the cause of the vascular changes, retinopathy will be on their own. But, if the disease is not recognized or treatment is not appointed, the disorder has a tendency to progression. Eventually this phenomenon leads to gradual loss of vision up to complete blindness. Also characteristic symptom of is that the disorder is always bilateral.
Examination of the fundus
Angiopathy is diagnosed very simply, it is much harder to find its cause. To see the retinal vessels, applied ophthalmoscopy (fundus examination). There are two types of ophthalmoscopy:
- Video – is performed using a special instrument with a light source and lens that allows you to zoom in 15 times.
- Indirect – it uses a special lens and a distant light source, it has more diagnostic capabilities than video.
No special preparation for ophthalmoscopy do not need. In some cases, the eye fluid drops that expand the pupil for a better view of the structure of the eye.
Normal Ophthalmoscope picture:
- the retina is red color;
- the optic disc has clear boundaries, rounded shape and pink color;
- in the fundus there is no infiltration and hemorrhage;
- vessels clearly visible, veins are wider than arteries (the ratio of their diameters 2 to 3), they are not crimped;
- clearly shows blind spot– macula.
Changes begin with a angiopathy of the arteries and veins become tortuous, changing their diameter and the ratio of progression appear to exudates and hemorrhages.
Causes of angiopathy of the retina
The angiopathy can cause any diseases and pathological conditions that affect the condition of blood vessels in the body. The nature of changes in the blood vessels in the eyes to judge the rest of the blood stream.
The most frequent causes of angiopathy:
- diabetes mellitus;
Principal angiopathy of the retina
The angiopathy of retinal vessels are divided into separate types depending on the primary disease which caused changes of the arteries and veins of the eye. Consider the most common options.
This is the most common form of angiopathy. In the first type of diabetes retinopathy develops in 40% of patients, while the second – 20%. This complication of diabetes is the number one cause of blindness in people aged 20 to 65 years.
Increase risk of development of angiopathy in diabetic patients, the following factors:
- duration of diabetes, as a rule, retinopathy developing after 7-10 years from the onset of the disease, but may occur earlier;
- lack of control over hyperglycemia (patient's refusal of treatment, incorrect treatment program, not diagnosed with diabetes);
- pregnancy (giving a boost to the rapid progression of the angiopathy in women with diabetes);
- high blood pressure;
- kidney disease;
- Smoking, obesity, elevated levels of atherogenic fats in the body.
The basis for the development of diabetic retinopathy has a high content of glucose in the blood, which leads to pathological structural changes in the vessels of the whole body of small caliber (microangiopathy). In the capillaries of the retina are developing occlusion and the blood leaks into the tissue of the retina with the formation of hemorrhage and infiltrates. Each component reduces the area of healthy retina, leading to gradual loss of vision.
Allocate 3 stages of diabetic angiopathy of the retina:
- Nonproliferative – developed vascular occlusion, microaneurysms and small hemorrhages, retinal edema in the region of the blind spot. As a rule, serious violations of view, at this stage no, but its severity gradually decreases.
- Preproliferative – retinal vein becomes tortuous, beaded, the diameters of the vessels increase, lost the normal ratio of arteries and veins (2 to 3), in the retina develop infiltrates and cotton wool exudates, the amount of hemorrhage is greatly increased. Usually at this stage suffers visionperson.
- Proliferative at this stage, the neovascularization (ingrowth of new blood vessels). But these capillaries are very fragile, which leads to an even greater number of hemorrhages in the retina, to its gradual detachment, in the field of developing infiltrates the coarse connective tissue, formed hemorrhage into the vitreous and there is complete and irreversible blindness.
Special treatment of non-proliferative angiopathy is not required. It is sufficient to observe the changes in the fundus in dynamics, adequate treatment of diabetes to compensate for hyperglycemia, and to correct the known risk factors of progression of angiopathy.
In preproliferative angiopathy control should be held more often. In some cases, when no opportunity to visit an ophthalmologist, at this stage, use the specific ophthalmological treatment – photocoagulation.
Already at the first signs of neovascularization (retinopathy of transition 3-stage) ophthalmologists recommend laser coagulation of the retina.
Video about diabetic retinopathy:
Symptoms of angiopathy of the retina
For a long period of time, angiopathy of retinal vessels hidden flows and absolutely no symptoms. This is the main danger and insidiousness of this disease. As a rule, man turns to the ophthalmologist in case of problems with vision, and this is the last stage retinopathy, when, at times, to save the vision is impossible.
The symptoms by which one can suspect the disorder:
- decrease visual acuity;
- the emergence of “flies” when you look;
- fog when you look;
- changing boundaries (reduction) of the visual field;
- the development of cattle (blind black spots when looking);
- pain in the eyeballs;
- feeling of pulsation and pressure in the eyeball;
- the appearance of broken eye blood vessels;
- the primary symptoms of the pathology.
Principles of treatment of angiopathy of the retina
The main treatment of any kind of angiopathy is adequate therapy for primary disease, for example, control of blood pressure for hypertension, effective glucose-lowering therapy in diabetes.
If the treatment of the underlying pathology angiopathy is maintained or progressing, then prescribe specific eye care treatment that can be conservative and operative.
Conservative therapy of angiopathy includes the following activities:
- the use of drugs, which make the process of microcirculation and strengthen the vascular wall – pentoksifillin, trental, nicotinic acid, Actovegin, solkoseril, vasonit, etc.;
- medications that prevent blood clots – aspirin,trombone, dipyridamole, aspirin, magnecor;
- vitamin therapy;
- corticosteroid eye drops;
Video transmission of surgery of retinal detachment
If you do not take measures to stop the progression of angiopathy (treatment of the underlying disease), then conservative treatment is not successful, and retinopathy will progress, which leads to the need of surgical correct the problem (various types of photo - and laser coagulation of the retina, * vitrectomy).
Despite all the possibilities of modern ophthalmology, it is not always possible to save the vision in patients with angiopathy of the retina. The key to successful treatment acts timely diagnosis of the disease and address its root causes. Only in this case it is possible to get rid of the retinopathy of retinal vessels even without the use of surgery.