Retinal angiopathy: types, diagnosis, treatment and prevention

Blood vessels are an important structural component of the visual apparatus. They nourish cells, ensuring the full functioning of all structures. When the blood flow is disrupted, a decrease in visual acuity and other ophthalmological manifestations develop. One of the most common ailments of the circulatory system is retinal angiopathy, in which vascular tone decreases due to impaired nervous regulation. Today there are effective treatment methods, but the prognosis for recovery depends entirely on timely consultation with a doctor.

Definition of disease

Retinal angiopathy is usually understood not as an independent disease, but as a similar symptom characteristic of a number of systemic diseases. The disease is characterized by changes in large and small vessels of the visual apparatus, which occur due to a violation of nervous regulation. Over time, the blood becomes too thick, which leads to poor circulation. If treatment is not started in time, pathological changes in the retina of the eye occur, visual acuity deteriorates, up to complete blindness. Plus, the risk of hemophthalmos increases. At the same time, diagnosing angiopathy in the early stages is very difficult, since in the early stages there are no external manifestations of the disease.

Angiopathy is a reversible pathology that occurs mainly in people after 30 years of age, but there are cases of the disease being diagnosed in childhood.

Over time, the disease develops into a more complex and severe form - retinopathy, in which irreversible processes occur in the visual structures.

Retinal angiopathy: treatment

As a rule, angiopathy of both eyes develops. Treatment is based on the type of disease and stage of progression. The medications used must completely eliminate the causes of angiopathy. For example:

Hypertension is treated with antihypertensive pharmaceuticals that effectively stabilize blood pressure and reduce low-density lipoprotein levels. For chronic hypertension, hemodialysis is prescribed, which should cleanse the blood of cholesterol and reduce blood pressure.
For diabetes, medications are prescribed to lower blood sugar levels. Additionally, a special diet is prescribed. It involves removing carbohydrates and fats. Light physical exercise is prescribed: it promotes the absorption of sugar into the muscles, improves overall well-being and normalizes heart function. If traumatic capillary fragility is diagnosed, calcium dobesilate is prescribed. With its use, blood circulation improves significantly, serum viscosity is normalized, and blood vessels become more permeable.

Therapeutic measures against pathology are mixed, since they are based on conservative and surgical methods, and also involve many specialists.

Therapeutic measures for angiopathy

The use of medications that stabilize blood microcirculation and improve the walls of blood vessels. These include Cavinton, Trental, Vazonit and Pentoxifylline.
The use of pharmaceuticals aimed at reducing vascular permeability: Parmidine and Dobesilate.
Taking B vitamins.
Treatment of retinal angiopathy involves the use of Taufon and Emoxipin drops.
"Sidorenko's glasses." An effective physiotherapy device that is suitable for home use. The glasses are a combination of pneumomassage, phonophoresis, infrasound and color therapy. Thanks to this complex, the patient feels the therapeutic effect already in the second week of use. The device has undergone the most stringent clinical studies and has virtually no contraindications.

Important! When treating with beta-carotene, taurine and lutein, the patient should minimize the intake of sugary foods.

You can also use folk remedies. Chamomile, yarrow, St. John's wort and hawthorn have healing properties for the eyes. Experts recommend taking more dairy products and drinking freshly squeezed parsley juice in the morning. It is very beneficial for the eyes to drink tea from black currant leaves and rowan berries; you can add lemon balm, ginger, cinnamon and licorice.

Good results are shown by systematically taking tinctures of fenugreek, cumin and rose radiola.

If a month's drug treatment does not bring the desired results and the ophthalmologist diagnoses the progression of the disease, this can only mean one thing - surgery.

Types and classification

Due to the fact that angiopathy is a secondary symptom, all types of this disease are usually divided depending on the etiology.

Hypotonic or primary angiopathy. Occurs when the disease directly affects the blood vessels of the eye. For example, in a child, pathology can be triggered by hypoxia or individual characteristics of the structure of blood vessels. In adults, angiopathy of this type appears against the background of neurocirculatory dystonia - the main problem in diseases of the vegetative-vascular system;
Background or secondary angiopathy. It develops due to a systemic primary disease, for which vascular damage is only an indirect manifestation. There are several types of pathology in this group:
Dysoric (Morel's angiopathy). It can only occur in patients with Alzheimer's disease (senile dementia). The pathology develops due to the accumulation of amyloid substances on the walls of blood vessels;
Hypertensive. The disease develops due to chronic high blood pressure. A number of manifestations occur in all types of vessels. With the development of angiopathy, pathological processes affect the retina, as well as the eyeball;
Traumatic. Associated with injuries to the cervical spine or traumatic brain injury, as a result of which the innervation of blood vessels is disrupted, which leads to their pathology. Angiopathy is often accompanied by increased cranial pressure;
Juvenile (Iles disease). The causes of this type of angiopathy are still unclear. There is an opinion that changes in the functioning of the circulatory system of the visual apparatus arise due to the restructuring of all body systems and unstable hormonal levels. The disease is accompanied by small hemorrhages in the retinal tissue, and inflammatory processes occur in the vessels.

In rare cases, angiopathy is caused by several factors at once. This leads to the rapid development of the disease and significantly complicates treatment.

Types of angiopathy

Retinal angiopathy occurs as a result of pathological conditions of the body, accompanied by deterioration of blood supply to the fundus of the eye. Such changes in the capillaries of the visual apparatus can appear at any age, but are most often diagnosed in older people. Depending on the nature of the origin, the following types of retinal angiopathy are distinguished:

Hypertensive. Elevated blood pressure is one of the most common causes of hypertensive angioneuropathy. Arterial hypertension leads to damage to the central artery, narrowing of blood vessels, dilation of veins and damage to retinal tissue. As a result of this, the venous bed branches, pinpoint hemorrhages occur, and the risk of rupture and the development of atherosclerosis increases. With timely treatment of hypertension, the structure of the eye returns to normal.
Hypotonic. Low blood pressure provokes a slowdown in blood flow and a decrease in the tone of small capillaries, as a result of which the blood thickens and the risk of thrombosis increases. During the diagnostic process, expansion of the arterial network and pulsation of the veins are observed.
Diabetic. In diabetes mellitus, blood vessels are damaged throughout the body, as a result of which blood circulation is impaired, blood vessels become clogged, the capillary wall swells and vision deteriorates. Due to high levels of glucose in the blood, blood clots form, tissue atrophy begins, and multiple hemorrhages are observed.

Diabetic retinal angiopathy develops in several stages:

Non-proliferative. Gradual damage to the vessels of the fundus is observed, microscopic aneurysms are formed, and minor hemorrhages develop. This stage is accompanied by swelling of the retina and redness of the iris.
Preproliferative. Damage occurs to the retinal veins, which become tortuous and dilated. When blood vessels rupture, hemorrhages are observed and venous infiltrates are formed, causing a significant deterioration in vision.
Proliferative. The most severe degree of diabetic angiopathy, in which new capillaries are formed, characterized by increased fragility. This leads to the appearance of a large number of hemorrhages, causing retinal detachment.
Traumatic. Due to injuries to the head, neck or eyes, blood vessels are compressed and intracranial pressure increases significantly, which can lead to the formation of leukocyte emboli.
Youthful. A rare and dangerous form of retinal angiopathy, the nature of which is not precisely known. The pathology develops up to 30 years of age. Juvenile vascular angiodystonia manifests itself through inflammatory processes, hemorrhages and proliferation of connective tissue, which ultimately leads to various complications.
Congenital. Develops in premature babies due to underdevelopment of the vascular system.

Determining the type of retinal angiopathy is an important point in making a diagnosis, on which the specifics of treatment depend.

Treatment of retinal angiopathy is best started at the initial stage, when changes are minimal. Lack of treatment threatens the development of blindness.

Causes

Angiopathy occurs only against the background of any systemic disease or injury. There are several most common diseases that are accompanied by problems with blood flow:

Hypertension and hypotension of any origin. Most often they are caused by diseases of the cardiovascular system;
Diabetes;
Angiopathy during puberty;
Oncological circulatory diseases;
Scoliosis and mechanical damage to the spine, traumatic brain injury;
Atherosclerotic processes.

In addition, there are a number of factors that can trigger the development of the disease:

Alcohol abuse and smoking;
Harmful working conditions in production;
Intoxication of any type, exposure to radiation;
Congenital pathologies of the structure of blood vessels;
Senile age.

According to statistics, the disease is diagnosed much more often in older people, which is associated not only with the development of systemic diseases at this age, but also with degenerative processes in the visual apparatus.

Causes of angiopathy

The development of angiopathy can be caused by any disease associated with pathological changes in blood vessels. The causes of retinal angiopathy, in most cases, are as follows:

diabetes;
increased blood pressure;
atherosclerosis;
increased radioactive background;
poisoning with toxic substances;
congenital and acquired retinal diseases;
age over 50 years;
intracranial pressure;
diseases of the circulatory system.

Whatever disease leads to the appearance of retinopathy, they all, slowly but surely, lead to vision loss . That is why it is necessary to identify the disease at the initial stage, when changes in the blood vessels of the eye can still be stopped, thereby preventing the occurrence of blindness.

Examination, diagnosis and treatment must be carried out by a highly qualified ophthalmologist.

Symptoms

Regardless of the form and etiology of angiopathy, there are a number of characteristic signs that intensify as the primary disease or syndrome develops.

Decreased visual acuity, as well as ophthalmological disorders - blurred vision, temporary blindness, flickering scotoma;
Development of myopia, especially with angiopathy during puberty;
The appearance of flies and lightning before the eyes;
Sensation of pulsation in the eyes;
Increased intraocular pressure, pain during movement of the eyeball;
Hemorrhages in various structures of the eye, the appearance of hemophthalmos;
In severe cases of the disease, blood clots are found in the urine and stool.

When examining the eyes, you may notice distinct yellow spots, branched small vessels, as well as broken capillaries on the eyeball or sclera.

Possible complications

With a long course of angiopathy, reversible and irreversible ophthalmological disorders occur. The risk of developing optic nerve atrophy increases significantly, and visual acuity decreases, up to complete blindness of one or both eyes. Due to regular disruption of blood flow, severe visual diseases such as cataracts or glaucoma can occur. In complex forms of angiopathy, bleeding often occurs in the vitreous body or retina of the eye, which causes complete or partial dysfunction of these visual structures.

Retinal diseases: retinoschisis, detachment, macular degeneration.

Treatment of retinopathy

To treat retinopathy of any kind, it is necessary to identify and eliminate the primary disease. For example, if angiopathy is caused by hypertension, the doctor prescribes antihypertensive therapy; for diabetes mellitus, insulin treatment is prescribed. If the signs of the disease do not go away, then specialized treatment for retinal angiopathy is carried out: medication or surgery.

Drug treatment is aimed at improving blood circulation in the retina, eliminating hypoxia and thrombosis. Drugs used:

helping to strengthen the walls of blood vessels;
blood thinners (usually aspirin based);
vitamins;
corticosteroid eye drops;
physiotherapy.

If conservative treatment is not able to stop the progression of the disease, then laser coagulation is used to prevent retinal detachment. It is mandatory to maintain a healthy lifestyle, reduce physical activity, and follow a diet.

Elimination of the primary disease is the key to successful treatment of angiopathy.

Despite the fact that modern medicine has enormous capabilities for treating this disease, there are cases when it is not possible to preserve vision.
Timely diagnosis is a guarantee of successful treatment of a disease such as retinal angiopathy. Now you know what it is and why it is dangerous, and if the first alarming symptoms appear, immediately contact a specialist. Facebook

Diagnostics

Pathology is most often discovered during a routine visit to an ophthalmologist during an examination of the fundus. In this case, a characteristic narrowing or expansion of the walls of blood vessels is observed, as well as the position of the corpus luteum. To make an accurate diagnosis, additional research methods are used:

Ultrasound of the vessels of the visual apparatus using Doppler or duplex scanning of the retina. This allows not only to determine anatomical changes, but also to evaluate physiological characteristics;
X-ray using a contrast agent. Necessary for assessing the patency of blood vessels and determining the speed of blood flow;
MRI and CT are prescribed only in severe cases of angiopathy. With their help, you can comprehensively assess the condition of the soft tissues of the eye and identify pathological changes.
Carrying out MRI
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Often, tests common to all ophthalmological syndromes are prescribed - general blood and urine tests, ophthalmoscopy and visometry.

Treatment

Diagnostic methods make it possible to detect the appearance of a dangerous symptom at the earliest stages and prevent the development of the disease. First, the doctor listens to the patient’s complaints and performs a visual examination, after which he performs ophthalmoscopy - examination of the fundus of the eye using a special device.

In addition, the following can be carried out:

Ultrasound scanning of blood vessels;
X-ray examination;
Magnetic resonance topography.
Carrying out an ultrasound examination of the eyes

Elimination of angiopathy symptoms begins with treatment of the underlying disease. In each individual case, this may be a completely different therapeutic tactic. To develop it, highly specialized specialists can be involved: ophthalmologist, cardiologist, rheumatologist, endocrinologist, neurologist, therapist, ophthalmologist surgeon.

Drug therapy

Conservative methods are effective in the early stages of diagnosing the disease and can be used using the following drugs:

Vascular strengtheners: Trental, Actovegin, Solcoseryl, Cavinton. The action of drugs from this group improves blood microcirculation;
Reducing vascular permeability: Parmidine, Dobesilate, ginkgo biloba extract. At the same time, the drugs increase the elasticity of the vascular walls and restore microcirculation;
Anti-thrombosis agents: Trombonet, Dipyridamole, Ticlodipine. The drugs inhibit the binding of ADP to platelet receptors, thereby reducing blood clotting;

Trombonet is used in the treatment of retinal angiopathy

Vitamin complexes: with a predominant content of B vitamins, vitamins C, E, P;
Eye drops: Taufon, Quinax, Emoxipin, etc. Help restore metabolism in the eye tissues and have a general strengthening effect;
Hypotensive, hypoglycemic. The drugs are used to eliminate the symptoms of the underlying disease.

Trombonet is used in the treatment of retinal angiopathy

Physiotherapeutic procedures can be prescribed as additional means: magnetic resonance therapy, acupuncture, laser irradiation.

Surgically

In advanced forms of the disease, when conservative therapy does not produce the expected effect, surgical treatment of angiopathy is possible.

In most cases, this is laser photocoagulation - cauterization of blood vessels. This method provides successful treatment in 70% of cases and is usually prescribed for diabetic retinopathy.

In some cases, vitrectomy is performed - an operation to remove blood, scars or pathologically modified tissues from the vitreous body.

In the most complicated conditions, hemodialysis may be recommended - a procedure for forced blood purification.

Performing vitrectomy

Folk remedies

Treatment of angiopathy is mainly conservative. Therefore, as an additional therapy for long-term treatment, it is possible to use folk remedies:

Grind mistletoe to the consistency of flour, 1 tsp. Brew the resulting powder with 200 ml of boiling water in a thermos and leave overnight. Take the strained infusion 2 tbsp. l. morning and evening for 3-4 months. ;
As a vessel cleanser, use tea made from currant leaves or rowan fruits, parsley juice, infusion of dill seeds;
Increase the consumption of dairy products in your diet;
Make a mixture of hawthorn flowers (50 g), knotweed grass (30 g) and horsetail (20 g). Pour 2 tsp of boiling water over a glass. collection, insist, strain and take 2 tbsp. l. three times a day shortly before meals for a month;
Make a tincture from the roots of Rhodiola rosea (20 g of crushed raw materials per 0.5 liter of vodka), leave for 2 weeks in a dark place. After this, strain the tincture, pour another 0.5 liter of vodka into the roots and leave for 3 weeks. Take 5 drops three times a day an hour after meals for 2 weeks, then a 7-day break and again 2 weeks of treatment. Repeat the regimen until the medicine runs out, then take a second tincture of 10 drops, following the same regimen.

If you take only plant-based drugs, the effect will be negligible, because to restore blood vessels, the diet must contain vitamins: carotene, taurine, lutein, ascorbic acid. They can be taken as medications or obtained from food.

Prevention

Due to the fact that angiopathy is a side symptom of many systemic diseases, the development of pathology can be prevented at all stages of the disease. To do this, it is necessary to treat systemic diseases in a timely manner, as well as promptly consult a doctor if ophthalmological manifestations are detected.

Quitting smoking and alcohol, following a work schedule, adequate sleep and nutrition are not reliable preventive methods, but they help reduce the risk of developing angiopathy, as well as prevent complications of the disease.

conclusions

In ophthalmological practice, angiopathy is a common pathology, since it can be caused by many systemic diseases, as well as diseases of the retina. Modern methods of medicine and pharmacology make it possible to treat disorders of the blood vessels of almost any severity, but timely treatment is the most important condition for the effectiveness of therapy. Due to the fact that the disease occurs more often in older people, regular consultation with a doctor at this age is a mandatory requirement to maintain overall health and vision.

Diabetic angiopathy

Diabetic angiopathy affects people diagnosed with diabetes. With this type of angiopathy, small and large vessels are affected. Damage to the walls of blood vessels occurs, and hemostasis is disrupted. Most often, such processes occur in the vessels of the retina, glomerular blood capillaries of the kidneys, in the vessels of the heart, and in the arteries of the lower extremities.

In these cases, thickening of the basement membranes is observed, mucopolysaccharides begin to be deposited on the walls of the vessels, this leads to the narrowing of the lumen of the vessel and ultimately its blockage may occur. These changes lead to deterioration of microcirculation, which, in turn, leads to tissue hypoxia.

Diabetic angiopathy of the lower extremities has its own characteristics. Sensitivity may be lost, polyneuritis of varying degrees may be expressed (burning, numbness of the foot, pain), ulcers may appear, and in the most severe cases, with diabetic angiopathy, gangrene of the toes is possible. But if a person seeks medical help in time, such an outcome is practically excluded.