Retinopathy is not a very well-known disease, but this does not make it any less dangerous. This is a very complex eye lesion. As a result, there is a violation of the blood supply to the retina and the destruction of retinal vessels. This leads to dystrophy of the optic nerve and its subsequent atrophy. As a result, complete blindness may develop. What kind of disease is retinopathy? Why does the disease arise and how to treat it? We will discuss this later in the article.
The causes of the onset of the disease. Photo
Retinopathy - what is it? By medical definition, retinopathy is a non-inflammatory retinal lesion. It occurs as a result of vascular disorders, the main cause is a pathological change in blood circulation in the eye vessels. In addition, reviews of retinopathy write that it has a number of complications in the form of hypertension or diabetes mellitus. If you do not deal with the treatment, the eye may lose some of its functions, and in the worst case, completely lose them. In order to prevent irreversible processes in the development of the disease, it is necessary to identify this pathology at an early stage and seriously engage in its treatment.
To have an idea about the possibility of this disease, you should know what are the causes of retinopathy and what mechanisms are involved in starting the disease. Everyone knows that the retina is the inner ocular membrane that has an extensive network of vessels. These small vessels are very thin and fragile, they get damaged even at high pressure, therefore, hypertensive patients with experience are at risk. In addition, microcirculation disorders can provoke retinopathy. They arise due to a diabetic shift in metabolism. This is not uncommon in early birth, when abnormal extensive growth of blood vessels occurs - retinopathy of premature babies.
The causes of primary retinopathy are unknown to today's medicine, but secondary are well known. These include complications of some serious illnesses:
- hypertonic disease;
- renal failure;
- systemic atherosclerosis;
- pathology of the circulatory system;
- diabetes;
- injuries of the chest, as well as the eyeball;
- toxicosis during pregnancy.
And retinopathy occurs as a result of the fact that retinal maldevelopment is diagnosed in deeply premature babies due to premature birth. Depending on what disease was the reason for the development of the disease, there are several types of this disease. Each of the species has its own stages of retinopathy. We will talk about them below, in the application to certain types of disease. Let us dwell in more detail on the features of the development of the disease in each of the species. But first, a few words should be said about what are the symptoms of retinopathy. About it further.
Common symptoms of the disease
Symptoms, with all the variety of forms of retinopathy for all, are one - a violation of the visual functions of the eye. This is manifested by a decrease in visual acuity or a reduction in the field of view, and also by the appearance of dark dots or spots before the eyes, and in some cases, the onset of blindness occurs. These main symptoms of retinopathy can also be accompanied by hemorrhages in the eyeball, as a result of which the eye protein turns red. If the violations are severe enough, the color of the pupil may change, as well as its reaction. In this case, the patient may feel pain of different localization, dizziness, nausea. More specific signs of retinopathy already depend on the type of disease.
We proceed to consider the existing types of this ailment. We will also tell you what treatment retinopathy will require for each of them.
Diabetic retinopathy: features
The main cause of this pathology is diabetes. An increased blood sugar level, as well as a lack of proper diet, a violation of the timing of taking sugar-lowering drugs and their dosage can trigger the development of retinopathy. This complication is considered one of the most severe. It occurs for hereditary reasons and with a shift in metabolic processes. During diabetes, various undesirable substances penetrate the eye retina, which upset the metabolism and increase blood flow.
This leads to damage to the inner surfaces of the vessels and clogging of the capillaries. In this case, the formation of microaneurysms occurs, in which the walls of the vessels and capillaries bulge and grow in those directions where they should not be. The started hemorrhages destroy part of the capillaries and the degeneration of the vessels of the eye occurs. All these processes are divided into certain stages of retinopathy; for a diabetic species, three such stages are characteristic:
- 1 - hemorrhages and edema of the retina;
- 2 - venous and capillary abnormalities, accumulation of blood in the retina;
- 3 - vascular proliferation, hemorrhage and pathological changes in the vitreous body.
The mechanism itself occurs in this way: tiny newly formed vessels with extremely fragile walls cannot withstand much pressure with increased blood flow, they rupture with further retinal detachment. In the initial stages of the process, any symptoms are completely absent and the eye has not yet noticed any visible changes. If visual impairment has become noticeable, then the disease is at a deeper stage. Typically, the initial stages are characterized by signs of retinopathy, such as appearing and disappearing dots or spots, as well as difficulties with reading texts and performing minor tasks that require eye strain. In the later stages of the development of the disease, complete retinal detachment occurs, resulting in loss of vision.
Diabetic retinopathy. Examination and treatment
In order to avoid such a sad ending, it is necessary to conduct a diagnosis. Retinopathy sometimes in the initial stages can be almost asymptomatic. Therefore, it is necessary to carry out diagnostics, not waiting for the appearance of signs, but simply because of being at risk. Eye examination is performed using ultrasound, electroretinography, retinal angiography or scanning laser diagnostics. Timely diagnosis will help make the treatment of retinopathy more successful and most effective. The treatment process itself must necessarily take place under the full control of the endocrinologist and ophthalmologist. In the process of treatment, it is necessary to clearly follow the recommendations of doctors and take medicine according to the scheme, observing the time of administration and dosage. In addition, some more vitamins are needed to activate the body's defenses, as well as regular checks of blood glucose levels.
Atherosclerotic retinopathy: features and treatment
A similar form occurs against the background of atherosclerosis, in which plaques appear in the vessels, blocking the normal blood flow through the vessels and provoking an increase in pressure. To accurately diagnose retinopathy, an ophthalmoscopy should be performed - fundus examination. This will enable the specialist to see both the retina and the blood vessels that feed it. An ophthalmologist will also be able to see pathological changes in the structure of blood vessels and in the vitreous body. During the study, it is possible to detect lipid deposits and small capillary hemorrhages.
With an atherosclerotic form, vasodilator and atherosclerotic drugs are prescribed, as well as such drugs that improve the microcirculation of the vessels of the eyeball. A treatment such as surgery is not required for atherosclerotic retinopathy.
Hypertensive retinopathy: features
Hypertensive retinopathy occurs against the background of serious hypertensive problems. At high eye pressure, micro arteries and eye veins are damaged - they are regularly compressed at the intersection. In this case, pathological changes are observed not only in the eye vessels, but also in the vessels of the brain. In order for retinopathy treatment to be successful, the features of hypertension and the degree of their depth, as well as the duration of the disease, should be considered. With the appearance of retinopathy, hemorrhage in the vessels, microaneurysms is observed, but at the initial stage, too, no special symptoms are manifested, except for headaches and less clarity in the visibility of objects.
This type of disease has the following stages:
- Hypertensive angiosclerosis, in which changes in the retinal vessels begin, compaction of their walls and a decrease in transparency, and the ability to reflect light rays significantly increases - this is the first stage. In the second one you can already observe functional changes in the vessels of the retina, straightening of the arterioles and an increase in the angle of their branching closer to blunt. Both one and the other stage are characterized by reversibility of the processes, but provided that the treatment was started in a timely manner. For this reason, one should not wait until the symptoms of retinopathy become apparent. Treatment only brings positive results when it starts as early as possible. The last stage is accompanied by severe swelling of the optic nerve.
- The stage of neuroretinopathy is more serious and can lead to optic atrophy and loss of vision. Against this background, there are often focal detachments of the retina. At this stage, retina changes are very persistent and irreversible. However, properly prescribed and timely treatment of retinopathy gives a chance to stop the progress of the pathology and preserve the patient’s vision.
Retinopathy of premature infants: features and consequences
The most at risk for retinopathy are very premature babies whose body weight does not exceed 2 kg, or those born before 32 weeks. The reason for this is the underdevelopment of the retina, the formation and maturation of which requires complete rest for vision and local oxygen-free breathing of tissues. Since most babies born prematurely have underdeveloped lungs, in order to provide babies with comfortable conditions, they are placed in special incubators where they maintain a constant temperature and humidity. In addition, the air there is enriched with oxygen, which makes it easier for kids to breathe. But this same oxygen during an increase in concentration becomes the cause that affects the development of retinopathy.
The causes of premature babies are:
- inflammatory diseases of the mother through gynecology;
- cases of bleeding during childbirth;
- congenital pathology of the fetus;
- small baby weight;
- long stay in the oxygen chamber.
In a premature newborn, retinopathy is very active - up to six months. This is manifested by a change in the shape of arteries and veins, vitreous hemorrhage, and retinal detachment. After six months, a period of reverse development begins, and after a year you can see the effects of retinopathy. Then there is myopia in the child, tears and detachment of the retina, decreased eyeballs and increased eye pressure.
Disease treatment
Depending on the factors influencing the formation of favorable conditions for the development of retinopathy, treatment methods are also used. Depending on the type and stage of the disease, both conservative and surgical treatment can be prescribed. The main focus of treatment is to reduce the permeability of blood vessels and the destruction of new ones by focusing a superthin and accurate laser beam on the affected retina. The so-called retinal pancoagulation is performed with massive burns of the fundus - from 2000 to 4000. Such treatment is carried out on an outpatient basis, but after that you may need to repeat it. Laser treatment can not be used to improve the patient’s vision, but only to preserve it.
With timely treatment, the chance to avoid complete blindness is quite high - in 80-90% of cases it is possible to delay the progression of the disease and maintain vision at an acceptable level. Laser equipment is used in cases where the doctor has detected neovascularization of the retina or there is a real threat of its appearance after a short time. As a rule, this happens in diabetics with a long experience of 10-12 years. There is another indication for the use of laser treatment - strong capillary permeability in the macula or in the surrounding area.
In conservative methods of treatment, you can include drops in the eyes with drugs - vitamin or hormonal. Of the methods of surgical treatment, laser and cryosurgical retinal coagulation, as well as vitrectomy (removal of the vitreous body), are suggested. Will the operation improve the patient's condition and restore his vision? Vitrectomy is a micro operation that is performed using miniature instruments under a microscope. In its course, the vitreous is removed and the fundus is cleansed.
At the same time, the affected turbid vitreous body is replaced with a transparent one, through which light freely penetrates and reaches the retina. This helps to partially restore the visual function of the eye and allows you to use your vision to a certain extent. After the operation, a lot of time can pass until the vision improves - the bill can go for weeks or months. With late intervention, the restoration of vision is no longer discussed, because the changes that have occurred are so great that it’s a great success to simply save what is left.
With conservative treatment of hypertensive retinopathy, doctors are faced with the task of rapidly reducing pressure. In this case, patients are prescribed medications that reduce eye strain. At the same time, these drugs also reduce the pressure on other vessels located in organs vital to the life of the body. The heart, for example, can work in extreme mode for a not very long time, therefore, overcoming hypertensive manifestations directly leads to salvation from mortal danger.
Diabetic retinopathy needs to be treated by several doctors together, usually an optometrist and an endocrinologist. The correct diet plays an important role here, which consists in eliminating harmful harmful digestible carbohydrates such as sweets, chocolates, and more from the daily diet. In addition, vitamins are recommended that have a firming effect on the walls of blood vessels, as well as substances that normalize fat metabolism in the body. If the disease is already at stage 2 or 3, treatment with pulsed light is applied - photocoagulation. During this treatment, the walls of the vessels heat up, and blood coagulation remains normal.
With retinopathy of premature babies, examinations of an ophthalmologist are indicated. Usually, several types of treatment are prescribed simultaneously. These are drops in the eyes, laser correction of the eye retina, correction with liquid nitrogen, removal of the vitreous body. In the early stages, a cure of the disease is spontaneous.
Consequences of the disease
In case of hypertensive retinopathy , recurrent hemophthalmus and also retinal vein thrombosis are possible. In addition, decreased vision and the development of blindness. With atherosclerotic consequences, arterial retinal occlusion, optic atrophy are observed. Diabetic retinopathy can lead to cataracts, hemophthalmus, clouding of the vitreous body and its cicatricial changes. As a result of retinopathy of premature babies, glaucoma, strabismus, amblyopia, myopia, low vision, and also retinal detachment develop.
Conclusion
In this article, we tried to convey to the reader that retinopathy can be a very dangerous disease if it is not detected in time and treated. This is especially true for patients with a hypertensive type of disease, which in the last stage can result in a fatal case.