Hypertensive retinopathy is considered a very serious complication that occurs as a result of the development of hypertension. In the presence of such a pathology, a complex lesion of the retina, as well as the vessels of the eye, occurs. If treatment is not started in time, serious circulatory disorders in the optic nerve and retina can occur.
As a rule, retinopathy with hypertension is more common in people who have problems with high blood pressure, suffer from adrenal gland diseases, and renal hypertension. This disease is also characteristic of the elderly. When the disease is just beginning to develop, a person does not have any symptoms. Already at later stages of development, the disease begins to make itself felt by a sharp and severe deterioration in vision.
Stages of the development of the disease
Specialists distinguish only four stages of hypertensive retinopathy:
- Hypertensive angiopathy. During the development of this stage, there are changes that can still be reversed. Only small vessels located in the retina are affected exclusively .
- Hypertensive angiosclerosis. At this stage, modifications of the organic type occur, which affect the retinal vessels.
- Hypertensive retinopathy. A characteristic feature is a change in the vessels of the retina. Around them, lesions that develop in the retinal tissue itself gradually begin to appear. Focal clouding also occurs, hemorrhages, a variety of degenerative abnormalities that are localized in the central part of the retina begin to manifest clearly.
- Hypertensive neuroretinopathy. According to its characteristics, this stage may resemble angiopathy or angiosclerosis. In addition, the clouding of the upper part of the retina, located directly above the optic nerve disc, is clearly visible, swelling appears. It is at this stage that a sharp deterioration in vision occurs.
Causes of Hypertensive Retinopathy
The main reason for the appearance of pathology is considered to be a very high blood pressure, which worries a person for a long time. A particularly high risk of developing hypertensive retinopathy is in those people who have incorrectly or not fully treated hypertension. Other causes of pathology include diabetes mellitus, atherosclerosis, or excessive smoking.
Signs of the disease
It is not a secret for specialists that hypertension has an extremely negative effect on the state of vessels located in the retina. Most people with hypertensive retinopathy have almost no symptoms at the initial stages. At the last stage of the development of the disease, a sharp deterioration in vision occurs. Complete loss of vision is observed only in isolated cases.
Symptoms that few pay attention to include the appearance of floating spots or “flies” in front of the eyes. Over time, images become blurry, dark streaks appear, and in the dark, vision deteriorates significantly.
The main danger of hypertensive retinopathy is that it can cause retinal detachment. Such a problem will manifest itself in the form of spots or stripes floating in front of the eyes, sometimes sharp flashes of light, shadows appear on a certain interval of the field of view. Sometimes the images blur or the spots turn black.
Diagnosis of eye pathology
The main diagnostic method in this situation is a thorough examination of the fundus. A procedure such as ophthalmoscopy is used. Also, a similar procedure allows you to examine the optic disc, to determine the condition of the vessels located in the retina. Sometimes ophthalmoscopy allows you to determine other deviations from the norm, in addition to hypertensive retinopathy. For example, hemorrhages uncharacteristic of fundus deposition of fat and so on.
An ophthalmoscope is used for the procedure. The device looks like a concave mirror with a round shape. There is a small hole in the middle of the device. Today, they are increasingly starting to use a similar device, but of an electric type. With it, you can easily view the fundus in detail and even take a picture. In order to study in more detail the changes in the fundus with hypertensive retinopathy, the maximum pupil expansion is performed. For this, a special tool is instilled into the eyes.
What can the doctor see during the diagnosis
During the diagnosis of the disease, an ophthalmologist can detect the following:
- The presence of a spasm of the retinal arterioles of the patient’s eye.
- Hemorrhages in the affected area.
- The vitreous body of the human eye.
- The presence of body fat directly on the retina.
- Puffiness of the optic disc (especially often seen in advanced situations).
- The walls of the vessels may become too dense and opaque.
- Sometimes even full or partial retinal detachment is detected.
Fluorescence angiography as a diagnostic method
If necessary, an ophthalmologist may prescribe fluorescence angiography to the patient. A similar procedure will detect possible abnormalities that have appeared in the vessels of the retina. To do this, a special dye is injected intravenously to a person and after that ophthalmoscopy is repeated.
Coherent Tomography
Another method of diagnosis is considered to be coherent tomography. Using this technique, you can get very detailed information about each of the layers of the affected retina. You can also identify possible thickenings and fat deposits, hemorrhages.
Pathology treatment
The treatment of hypertensive retinopathy depends very much on what stage of development the disease is at. In almost all cases, first a variety of medicines are used for treatment. It is imperative to use funds to expand the vessels, take vitamin complexes and anticoagulants.
If there is no result from such treatment, or if hypertensive retinopathy is at the last stage of development, then surgical intervention cannot be dispensed with. Today, surgery is performed using a laser and is called laser coagulation.
The main principle of the treatment of the disease is the elimination of the main causes that provoked its development. In no case should you postpone treatment until later. After all, such actions can lead to serious consequences and completely deprive you of vision.
As preventive measures, it is necessary to regularly conduct an examination with an ophthalmologist, because only a doctor can determine the presence of deviations at the earliest possible stage of development and prevent the occurrence of complications in the future. Therefore, even if you do not notice the symptoms of hypertensive retinopathy, consultation with an ophthalmologist will not be superfluous. As experience shows, in the diagnosis often reveals diseases that the person did not even suspect. Better safe than sorry in the future.