Angiopathy of retinal vessels: what is it?
Vascular lesions of the retina occurs in many diseases, e.g., diabetes or hypertension. Unlike the vascular network of the retina from the plexus of other sites is that it can be closely examined by an ophthalmologist in the study of the fundus and is a mirror of the brain vessels. Therefore, the study of various disorders of this phenomenon has a long history. What is angiopathy of retinal vessels, and how it can be caused by?
The mesh membrane of the eye called the retina, or a retina, a vascular disease of the retina retinopathy. As follows from the anatomy, the retina is a peripheral area of the visual analyzer. So what is it? In the retina overlie the dendrites of neurons, which are cells that perceive light (sticks) and color (cones). They form the primary visual image, which is then sent for analysis, first – subcortical sections of the visual analyzers and then in the cortex of occipital lobes of the brain.
Given that almost 90% of the information about the outside world man perceives through vision, the blood supply of the retina of both eyes should be very good. Therefore, the retinal vessels form a well-developed network, which is accessible to direct study by the ophthalmologist in a dark room.
What is angiopathy?
Angiopathy of retinal vessels is a symmetrical change in the vasculature in the fundus. The doctor sees excessive pathological tortuosity, congestion, increased vascular pattern and additional reactions of small arteries and veins of the retina in various diseases. We must remember that the disorder is a symptom that is characteristic of many diseases, but a separate diagnosis of «disorder» does not exist. If changes in the retinal vessels exist only in one eye, then most likely we are talking about any surround education, located in close proximity to the retina (often behind the eye socket, retro-orbital). Only in the case of symmetric lesions of the retinal vessels of both eyes can be a question about angiopathy.
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Causes of angiopathy
Most often, angiopathy of the vessels (not only of the retina) occurs due to age-related changes found in patients older than 30 – 35 years, even if they don’t make any complaints. However, the symptoms can occur a newborn baby, for example, if the blood-filled veins mistaken for spasm of the arteries because the veins look quite wide.
But in this case, you need to look for signs of disease, such as congenital systemic vasculitis, as angiopathy necessarily indicate any disease. An isolated diagnosis of «disorder» carries no information and is therefore devoid of diagnostic and practical value. Diseases and conditions that lead to angiopathy, and alteration of the vascular bed of the retina:
- Diabetes. Diabetic microangiopathy is an indirect confirmation of the activity of the process. The result is blurred vision with the development of diabetic cataracts and blindness. A more aggressive process proceeds in the case of insulin-dependent diabetes type 1 diabetes.
- Hypertension. Vascular lesions of the kidney, retina and myocardium hypertrophy the basis for clinical diagnosis of various degrees of hypertension.
- Arterial and cerebral hypotension. The situation is reversed hypertensive angiopathy there is the extension of small venules, which may clinically manifest migrenozopodobnykh pulsating pains in the eyeballs during pressure reduction.
- The effects of the severe traumatic brain injury, e.g. brain injury. While there is a strong functional dysregulation of autonomic vascular tone, which may lead to angiopathy.
- Impaired venous outflow of blood from the cranial cavity and increased intracranial pressure. The most common cause of severe angiopathy, combined with a «stagnation» in the fundus, is obstructive hydrocephalus. This will increase arching of persistent headache, nausea and vomiting, may develop reduced vision.
- Hereditary blood disease. These include various types of anemia, polycythemia (a Disease Wekesa), tendency to thrombosis and clotting disorder.
- Bad habits. This may sound strange, but Smoking and alcohol can cause persistent changes of blood vessels in the fundus.
- Different occupational diseases, chronic intoxication production.
- Elderly and senile age. In old age, angiopathy of retinal vessels is usually mixed. Cause is arterial hypertension, chronic spasm, and atherosclerotic disease of the small blood vessels.
- Autoimmune disease in which there are antibodies to self components of the vascular wall, including the endothelium. These diseases called vasculitis.
- Congenital vascular diseases (e.g., ataxia – telangiectasia, a syndrome or Louis-Bar).
This is not a complete list of diseases that can signal the presence in the human body that is angiopathy of retinal vessels. This suggests that a competent ophthalmologist, seeing vascular changes in the fundus should start searching for the above diseases, if not yourself, then sending the patient to consult a physician and neurologist.
What is angiopathy?
The above listed diseases causing vascular disease of the retina and brain in General. Are there any complaints characteristic of angiopathy? It turns out there, but they are not specific. These include transient loss of vision, occasional headaches, and flashing «flies» before the eyes. A well-studied disorder that is associated with such vascular diseases as migraine. The headache coincides with rapid and excessive expansion of vessels, including vessels of the retina. The treatment consists in prescribing drugs, which again increases the tone of cerebral vessels.
In addition to simple fundus examination can be applied the following studies:
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- Ultrasound of blood vessels of the retina;
- Eyeball MRI with contrast (Mr angiography). Typically, this method of research is used in neurosurgical and neuro-oncological practice, with detection close to the eyeball tumor. In this case, changes of retinal vessels are not angiopathy, and accompany tumor growth.
Therapeutic tactics in identifying angiopathy and observation with treatment of the underlying disease. As a rule, begin with the search for manifestations of diabetes, and if not found, then begin to treat hypertension, fortunately, in adulthood it is found in almost all.