Retinal vascular angiopathy. Angiopathy: causes, types and treatment of vascular pathology

Typically, this condition is more common in older people. Retinal vascular angiopathy - what is it, how does it occur and in what diseases does it occur? Let's talk about this in more detail.

The essence of pathology and its danger

It should be noted that retinal angiopathy is not an independent diagnosis. This is the name given to the process that occurs in the vessels and leads to insufficient blood flow. Most often, this angiopathy is systemic in nature and occurs in many diseases, which will be discussed below. In almost 100% of cases, we are talking about retinal angiopathy of both eyes.

In rare cases, when signs of angiopathy appear on only one side, a person needs to consult an ophthalmologist or a vascular neurosurgeon, since an asymmetric process indicates local problems: thrombotic damage to the retinal vessels, a tumor process and other disorders.

Types of eye angiopathy

This condition can be classified in many different ways. The two most understandable classification options are: by gradient blood pressure and by damage to individual parts of the vascular bed.

So, based on the pressure difference they distinguish:

• Retinal angiopathy of the hypertensive type. As a rule, this option is accompanied by hypertension. The second reason is symptomatic cerebral arterial hypertension, in which the pressure in the cerebral vessels increases. A characteristic sign of this disorder is the appearance of pinpoint hemorrhages (hemorrhages) in the retinal tissue. As a compensatory mechanism, blood pressure can rise in pregnant women in the 2nd and 3rd trimesters, which contributes to the development of functional hypertensive retinal angiopathy. After childbirth it goes away on its own. Retinal angiopathy due to hypertension occurs most often in old age.
• Retinal angiopathy of the hypotonic type. This type of vascular tone disorder is much less common and is manifested by significant overflow of blood vessels, especially small ones, with blood, decreased tone of the vascular wall, and the presence of congestion in the fundus. A complication may be a thrombotic process occurring in the vessels, as well as their pronounced pulsation. This type often accompanies the course of arterial hypotension, that is, it develops in people with a tendency to low blood pressure.

Retinal angiopathy is also distinguished by venous type and arterial type. This division is largely arbitrary. The division into arterial and venous angiopathy appeared on the basis of examination data, in which damage to one or another department is immediately visible. But this classification does not affect treatment and prognosis.

Finally, you can come across the term retinal neuroangiopathy - what is it? The retina itself, despite its complex structure, consists mostly of nervous tissue: after all, peripheral section The visual analyzer consists of rods, which perceive light, and cones, which are responsible for color vision. Therefore, all vessels supplying the retina provide nerve tissue. For this reason, the diagnosis of neuroangiopathy implies angiopathy, in which there may be certain visual disturbances, for example, spots in front of the eyes or colored spots.

Causes of angiopathy

Most often, hypertensive retinal angiopathy develops.

Its source can be many conditions and diseases, for example:

• arterial hypertension ( hypertonic disease);
• intracranial hypertension syndrome (increased intracranial pressure);
• functional disorders responsible for changes in vascular tone (for example, vegetative-vascular dystonia);
• smoking and alcohol abuse;
• consequences of traumatic brain injuries.

Old age is also a non-modifiable factor; it automatically indicates an increased risk of angiopathy.

A special type of pathology is diabetic retinangiopathy. It appears in cases where the patient has diabetes. The damaging factor is the increased glucose content, which harms blood vessels.

Diabetic retinal angiopathy develops most rapidly in insulin-dependent diabetes mellitus, or type 1 diabetes. In this case, damage is possible at a young age; there are cases of diabetic cataracts followed by blindness before the age of 20 years.

In type 2 diabetes, this condition develops in old age. Often, by this time, the patient already has background retinal angiopathy, which is superimposed by new symptoms characteristic of diabetic vascular disorders.

Other causes of angiopathy may be systemic lesions blood vessels and blood diseases: periarteritis nodosa, thrombocytopenic purpura, Vaquez disease or erythremia. Sickle cell anemia or autoimmune disorders can also cause this condition.

Symptoms and diagnosis

Signs of retinal angiopathy are nonspecific, that is, they can exist in different diseases. So, when it is identified and subsequently diagnosed as diabetes, the underlying disease begins to be treated. As a result of correct tactics, the symptoms of angiopathy also decrease and disappear altogether.

These include the following complaints:

• blurred vision, appearance of fog, spots before the eyes;
• the occurrence of headaches;
• regular nosebleeds;
• transient ischemic attacks with the development of neurological symptoms and their complete disappearance within 24 hours.

Symptoms such as: severe pain in the joints of the legs or periodic hematuria (blood in the urine) and swelling, bruises and hemorrhages, and even trophic ulcers. It would seem that all this is far from the eyes. In fact, retinal angiopathy, the symptoms of which we have examined, is just the tip of the iceberg. All vessels in the body are affected, which simply cannot be seen.

Treatment

First of all, a thorough diagnosis must be carried out and the main diagnosis made, since without knowing the true cause, the condition can only be slightly improved. Treatment of retinal angiopathy without taking into account the etiology is doomed to failure. Thus, in diabetes mellitus, the main condition is to stop the increase in blood sugar levels and reduce them to normal, since it is the high concentration of glucose that affects the blood vessels.

The basic principles of therapy are as follows:

• improvement of microcirculation in capillaries. For this they use Trental, Pentoxifylline;
• multivitamins and mineral complexes, prescription of B vitamins - thiamine, pyridoxine;
• the use of alpha-lipoic acid (berlithione) as an antioxidant;
• low-carbohydrate diet and glucose-lowering therapy for diabetes;
• weight loss;
• rejection of bad habits;
• normalization of blood pressure levels;
• fight against peripheral edema;
• reducing blood cholesterol levels, normalizing the atherogenic index.

Important factors are the selection of glasses, visual gymnastics and preventive observation by an ophthalmologist.

Treatment of retinal angiopathy initial stage folk remedies may bring some improvement. It must be remembered that there are no local remedies that act only on the blood vessels of the eyes. The treatment affects the blood vessels of the entire body. When treating angiopathy they take herbal teas to lower blood pressure, soothing decoctions.

In conclusion, I would like to note that hypertensive retinal angiopathy is a marker of diseases that carry a risk of sudden death. It is known that heart attack and stroke are directly related to the course of arterial hypertension and atherothrombosis. Therefore, timely detection of angiopathy and the fight against atherosclerosis can not only prolong life, but also make its course full and joyful.

Useful video about retinal angiopathy

Initial retinal angiopathy is the first stage of the disease. In many cases, angiopathy during this time period occurs without any symptoms noticeable to the patient. But soon, as the disease progresses, the appearance of peculiar “floaters”, dark spots before the eyes, light flashes, and so on is observed. But visual acuity still remains normal, and when examining the fundus, changes in the eye tissues are not yet noticeable.

We can say that at the first stage of the disease, all processes can be reversed, that is, the blood vessels in the eyes can be restored. In this case, there will be no damage to the structure of the eye tissue, and visual acuity will remain normal, the same as before the disease.

For this purpose, it is necessary to begin timely treatment of both the vascular problems themselves and the underlying disease that caused this serious complication. Only in this case, at the initial stage of the process, can the progression of negative changes in the eyes be stopped.

All of the above applies to cases of disease caused by hypertension. With diabetic angiopathy, which is provoked by diabetes mellitus, even at the initial stage, the processes of destruction of blood vessels in the eyes become irreversible.

There are three degrees of retinal vascular angiopathy.

Retinal angiopathy of both eyes

Since angiopathy is a consequence of other systemic diseases body and affects blood vessels throughout the human body, it is almost always observed in both eyes of a person.

Angiopathy of the retina of both eyes is a disorder of the structure and functioning of blood vessels, which leads to various problems with the eyes and vision, depending on the degree of the disease itself. Progressive myopia or blindness, as well as glaucoma and eye cataracts, may occur.

The causes and symptoms of the disease for which the disease can be diagnosed were described in the previous sections. Also, vascular problems in both eyes are characterized by a division into diabetic, hypertensive, traumatic, hypotonic and juvenile, which are also found in the case of retinal vascular disease in one eye. At the same time, treatment of this problem is also associated, first of all, with improvement general condition person and getting rid of the underlying disease. Of course, symptomatic is also important local treatment, which will maintain the state of the eye vessels in some stability, preventing irreversible changes from occurring.

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Retinal angiopathy 1st degree

In hypertension, there are several stages of angiopathy, which were caused by problems with high blood pressure. This classification arose due to the degrees of damage to the blood vessels of the eyes that are observed with this complication. There are three stages of the disease – first, second and third. It is possible to find out at what stage the disease is only through an ophthalmological examination of the patient’s fundus.

The process of vascular changes in hypertension is characterized by dilation of the veins of the fundus, as they become overfilled with blood. The veins begin to wriggle, and the surface eyeball covered with small pinpoint hemorrhages. Over time, hemorrhages become more frequent, and the retina begins to become cloudy.

The first degree of angiopathy is characterized by the following changes in the eyes, which are called physiological:

• the arteries located in the retina begin to narrow,
• retinal veins begin to dilate,
• the size and width of the vessels becomes uneven,
• There is an increase in vascular tortuosity.

Retinal angiopathy of the 1st degree is a stage of the disease in which the processes are still reversible. If the cause of the complication itself—hypertension—is eliminated, then the blood vessels in the eyes gradually return to normal, and the disease recedes.

Moderate retinal angiopathy

Moderate retinal angiopathy is the second stage of the disease, which occurs after the first stage.

With retinal angiopathy of the second degree, the appearance of organic changes in the eyes is characteristic:

• vessels begin to vary more and more in width and size,
• vascular tortuosity also continues to increase,
• in color and structure, the vessels begin to resemble light copper wire, because the central light strips located along the vessels become so narrow,
• with further progression of the narrowing of the light strip, the vessels resemble a kind of silver wire,
• the appearance of thrombosis in the retinal vessels is observed,
• hemorrhages appear,
• characterized by the appearance of microaneurysms and newly formed vessels located in the disc area optic nerve,
• when examined, the fundus is pale, in some cases even a waxy tint is observed,
• it is possible to change the field of view,
• in some cases there are disturbances in light sensitivity,
• blurred vision occurs
• Visual acuity begins to be lost, myopia appears.

The first two have already been discussed in previous sections. Now let's touch on the third and most severe stage of the disease.

Grade 3 retinal angiopathy

Hypertensive retinal angiopathy

Hypertension is a disease characterized by periodic or constant promotions blood pressure. One of the main causes of the disease is the narrowing of small vessels and capillaries throughout the vascular system, which leads to difficulty in blood flow. And therefore, the blood begins to put pressure on the walls of the blood vessels, which leads to an increase in blood pressure, since the heart puts more effort into pushing the blood through the vascular bed.

Hypertension causes various complications in the human body, such as heart disease, brain disease, kidney disease, and so on. No exception vascular diseases eyes, namely the retina, one of which is angiopia.

With this disease, the veins begin to branch and expand, and frequent pinpoint hemorrhages appear, which are directed into the eyeball. Cloudiness of the eyeballs of one or both eyes may also occur.

If you take actions aimed at treating the underlying problem and achieve good results and a stable condition, hypertensive retinal angiopathy will go away on its own. If the disease is neglected, it can result in serious visual impairment and other eye problems.

Retinal angiopathy of the hypertensive type

This type of disease is characterized by deterioration of visual acuity, expressed in blurred vision in one or both eyes. Myopia may also develop, which progresses as the patient’s condition worsens with hypertension.

Retinal angiopathy of the hypertensive type occurs as a complication from a person’s existing hypertension. With this disease, the pressure on the walls of blood vessels increases so much that it leads to problems in various organs of the human body.

The eyes, which begin to experience difficulties in functioning, are no exception. This is especially true for the retina, in the vessels and tissues of which degenerative changes begin to occur.

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Hypotonic retinal angiopathy

Hypotension, that is, a strong decrease in blood pressure, is observed in a disease called arterial hypertension. In this case, the pressure drops so much that this process becomes noticeable to the person and leads to a deterioration in well-being.

There are two types of arterial hypertension – acute and chronic. In an acute condition, manifestations of collapse can be observed, in which vascular tone drops sharply. Shock may occur, which is characterized by paralytic vasodilation. All these processes are accompanied by a decrease in oxygen supply to the brain, which reduces the quality of functioning of vital human organs. In some cases, hypoxia occurs, which requires immediate medical attention. And in this case, the determining factor is not the pressure in the vessels, but the rate of its decrease.

Hypotonic retinal angiopathy is a consequence of arterial hypertension and manifests itself in reduced vascular tone in the retina. As a result, the vessels begin to overflow with blood, which reduces the speed of its flow. Subsequently, blood clots begin to form in the vessels due to stagnation of blood. This process is characterized by a sensation of pulsation, which is observed in the vessels of the eyes.

Retinal angiopathy of hypotonic type

Typically, this type of complication disappears with proper treatment of the underlying disease. The tone of blood vessels throughout the body improves, which also affects the condition of the eye vessels. Blood begins to move faster, blood clots stop forming, which affects the improvement of blood supply to the retina, eyeball, and so on.

Retinal angiopathy of the hypotonic type is caused by the main human disease - hypotension. In this case, there is a decrease in vascular tone throughout the body, and also, in particular, in the eyes. Therefore, blood begins to stagnate in the vessels, which leads to the appearance of blood clots in these vessels. Thrombosis of capillaries and venous vessels causes various hemorrhages in the retina and eyeball. Which leads to visual impairment and other eye problems.

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Retinal angiopathy of mixed type

With this type of disease, diseases begin to appear pathological changes in the vessels of the eyes, which are caused by dysfunctions in the regulation of their activity from the autonomic side nervous system.

Mixed type retinal angiopathy is an eye disease that is caused by general systemic diseases affecting the vessels of the whole body. In this case, capillaries and other vessels located in the fundus are the first to be damaged.

This type of vascular dysfunction can lead to very serious consequences for a person’s vision, for example, its deterioration, as well as loss.

This form of complication occurs in everyone age categories patients, since systemic diseases are characteristic of any age. But there has been an increase in cases of angiopathy in people who have passed the age of thirty.

Typically, the condition of the retinal vessels begins to return to normal when the underlying disease is treated. This applies not only vascular system in the eyes, but also in blood circulation throughout the body. In this case, treatment should be carried out comprehensively, taking into account therapeutic and ophthalmological diagnoses.

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Dystonic retinal angiopathy

This type of complication is characterized by serious visual impairment, which can manifest itself in active development myopia. In some cases, there is even complete loss of vision. Problems with eye vessels and blurred vision usually affect people after thirty years of age.

Dystonic retinal angiopathy is a complication of another pathology that occurs in the human body. Moreover, this dysfunction affects all vessels of the circulatory system, while the eye vessels suffer no less, and sometimes even more.

The patient's condition is characterized by symptoms such as the appearance of a veil before the eyes, the presence of pain or discomfort in the eyes, the occurrence of light flashes in the eyes, deterioration of visual acuity, the appearance of local hemorrhages that occur in the eyeball.

When observing such symptoms, a person should definitely consult an ophthalmologist to find out the cause of vision problems, as well as select the appropriate treatment package.

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Diabetic retinal angiopathy

Diabetes mellitus is a group of diseases that is caused by disorders in endocrine system. In this case, there is a deficiency of the insulin hormone, which takes an important part in regulating metabolic processes in the body, for example, in the metabolism of glucose and so on. But these are not the only dysfunctions caused by this disease. Not only glucose metabolism is disrupted, but all types of metabolic processes suffer - fat, protein, carbohydrate, mineral and water-salt.

Diabetic retinal angiopathy occurs as a complication of diabetes mellitus. Blood vessels are affected due to the advanced stage of the disease and its effect on all tissues of the body. Not only small capillaries located in the eyes suffer, but also larger vessels throughout the human body. As a result, all blood vessels narrow, and blood begins to flow much more slowly. As a result, the vessels become clogged, leading to problems in the tissues they are supposed to supply with nutrients and oxygen. All this causes metabolic disorders in the eyes, namely in the retina, which is most sensitive to vascular dysfunctions. In this situation, visual impairment, myopia and even blindness are possible.

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Background retinal angiopathy got its name because it occurs against the background of the appearance of various diseases. In this case, changes occur in the walls of blood vessels, which affect their normal functioning. There is a violation of blood circulation in the eyes, which becomes chronic dysfunction. Such changes in the vessels become the causes of persistent visual impairment, which in many cases are irreversible. Some patients experience complete loss of vision.

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Retinal venous angiopathy

Blood begins to flow more slowly and sometimes stagnates, which leads to blockage of blood vessels, the appearance of blood clots, and the occurrence of hemorrhages in the eyeball. The veins also begin to change their shape, expanding and twisting along their entire length. Subsequently, changes in the tissue structure begin to occur in the retina.

Retinal venous angiopathy is a complication of systemic diseases of the body, which manifests itself in disruption of venous blood flow.

With such problems with the eye veins, the patient may experience various visual impairments. For example, blurred vision occurs, weak or constantly progressive myopia. To eliminate problems with the eye veins, it is necessary to treat the underlying disease in combination with the treatment of the vascular disorders themselves.

Symptoms of this type of angiopathy are observed in hypertension, which caused a similar complication in the vessels of the eyes.

Traumatic retinal angiopathy

Any injuries, even seemingly minor ones, can lead to serious complications and health problems. For example, injuries to the cervical spine, brain injuries, and sudden compression in the chest often lead to complications in the eye organs.

Traumatic retinal angiopathy is characterized by narrowing of blood vessels in the eyes due to compression of the vessels of the cervical spine. Also, the consequences of injuries are an increase in intracranial pressure, which can become permanent and affect the tone of the retinal vessels. Subsequently, the patient develops visual impairments, which are expressed in its constant and steady deterioration, called progressive myopia.

The mechanism of occurrence of this complication is as follows: sharp and sudden compression of the vessels of the body leads to spasm of arterioles, which causes hypoxia of the retina, during which transudate is released. Some time after the injury, organic changes appear in the retina, which accompany frequent hemorrhages.

With this disease, there are frequent lesions not only in the retina, but also atrophic changes in the optic nerve.

Contusions cause changes in the eyes, which are called Berlin retinal opacities. In this case, edema appears that affects the deep retinal layers. There are also signs of subchoroidal hemorrhage, in which transudate is released.

To summarize, we can say that in the traumatic form of angiopathy, retinal shock occurs. This was caused by damage to the optic nerve, namely its thin cribriform plate. Damage to the plate occurs because sharp impacts provoke it to move back, which causes hemorrhages in the retina and the appearance of edema in the optic nerve head.

Vascular diseases can manifest themselves in the form of various angiopathies, which cause irreversible changes in the body. In some cases, they are quite dangerous, as they lead to disability or even death for the patient. Therefore, in such cases, correct diagnosis and effective treatment are necessary.

Angiopathy (AP) is characterized by damage to blood vessels, most often small and medium-sized, resulting in the development of a corresponding clinical picture. It occurs against the background of various diseases (diabetes mellitus, hypertension, due to injury), and is therefore considered a complication of them.

The long course of angiopathy threatens the occurrence of chronic disorders in the blood supply system, which leads to disruption of the functioning of various organs and parts of the body.

Examination of patients with angiopathy plays an important role in making the correct diagnosis, since it is important to determine the main cause of the development of the pathology. The course of AP may be more or less pronounced, but appropriate treatment must be carried out. Otherwise, the tissues that supplied blood to the affected vessels begin to die.

Video Hypertensive retinal angiopathy. What is it and why is it dangerous?

What is angiopathy?

In normal condition, small-caliber vessels are elastic and free for blood flow. With angiopathy, their structure is disrupted, as a result of which they become brittle, with thick walls, and in some cases the lumen of the vessel is partially or completely blocked. All this contributes to a change in normal blood circulation, which disrupts the blood supply to tissues and organs.

Angiopathy most often affects:

1. Lower limbs
2. Retina
3. Brain
4. Kidneys.

It is in these organs and parts of the body that small-caliber vessels are most concentrated. If the structure of a small part is broken capillary mesh, mild symptoms of the disease develop quite quickly at first, and over time they become more pronounced and clinically unfavorable.

Predisposing factors leading to angiopathy:

• A disorder of nervous regulation, expressed in changes in vascular tone (persistent expansion, that is, dilatation, or excessive narrowing, that is, spasm).
• The presence of abnormal proteins in the blood that permeate the vascular walls, thereby changing their structure.
• High blood pressure in blood vessels, which has a negative effect on the vascular wall.
• Inflammation that lasts for a long time.

Angiopathy is more often diagnosed in diabetes mellitus, since this disease is very common today. Other forms of the disease are no less complex and dangerous in their development, so there is this opinion:

“Angiopathy develops suddenly and leads to serious consequences”

Some statistics:

• Damage to the kidney vessels in 60% of cases develops against the background of diabetes mellitus, and in 40% - arterial hypertension.
• 80% of patients with angiopathy have bad habits, are over 50 years old, or have other risk factors.
• In patients with diabetes, angiopathy occurs after 10-15 years of development of the underlying disease.
• In 35-40% of patients of working age, angiopathy is found in the vessels of the heart.
• Depending on the clinical form of AP, a complication in the form of cerebral angiopathy occurs in 5-75% of cases.

Causes

Angiopathy in 90% of cases is a secondary pathology, as it develops against the background of other diseases. The remaining 10% are defined as primary angiopathy, which is an independent pathological condition.

The main causes of AP:

• Atherosclerosis.
• Hypotonic angiopathy. Associated with a decrease in peripheral vascular tone.
• Hypertensive angiopathy. Develops due to increased pressure in the peripheral vascular bed of the blood.
• Traumatic angiopathy. Occurs due to compressive injuries to various parts of the body and other injuries.
• Diabetes. Causes damage to capillaries in various organs due to the deposition of sorbitol and fructose in the vessels.
• Amyloidosis. Associated with abnormal proteins circulating in the blood, which cause chronic intoxication to organs and tissues.
• Diseases connective tissue (lupus, rheumatoid arthritis).
• Autoimmune diseases. Angiopathy can be complicated by scleroderma, sclerotic vasopathy, and polyarthritis.
• Blood diseases. In diseases such as thrombocytosis, leukemia, and polycythemia, an increased number of blood cells is observed, which also has an adverse effect on the walls of blood vessels.

In addition, angiopathy may be associated with disorders of the spinal cord, brain, autonomic and peripheral nervous systems. This also often affects the structure and performance of the capillary system.

Risk factors contributing to the development of angiopathy:

• Having bad habits (smoking, drinking alcohol).
• Metabolic disorder.
• Unfavorable working conditions.
• Hereditary diseases.
• Age 50 years and above.

The more risk factors a patient has, the more severe and pronounced the underlying disease and its complication in the form of vascular damage.

Kinds

Angiopathy is divided into clinical forms taking into account the causes of the disease, the size of the lesion and its location.

The following types of angiopathic lesions are distinguished:

• because of:
  • diabetic;
  • hypertensive;
  • hypotensive;
  • traumatic;
  • toxic;
  • neurogenic;
  • amyloid.
• by localization:
  • retinopathy (the retina of the eye is affected);
  • nephropathy (pathological process affects the kidneys);
  • angiopathy of the extremities, most often the lower ones;
  • angiopathy of cerebral vessels;
  • angiopathy of other organs (intestines, heart, lungs).
• according to the size of the affected area:
  • microangiopathies (affect small-caliber vessels, that is, capillaries);
  • macroangiopathy (medium and large vessels are involved in the pathological process, in such cases their atherosclerosis is additionally observed).

One patient may experience several clinical forms of angiopathy (for example, damage to the vessels of the retina, kidneys and lower limbs, which is typical for the diabetic form of angiopathy). Such multiple vascular lesions are observed in 65% of patients with AP.

In some cases, temporary vascular lesions are identified, which, with proper observation, may not require specific treatment. In particular, careful attention to capillaries is required in the following cases:

1. The patient was exposed oxygen starvation.
2. The birth of the child was accompanied by complicated or difficult labor, after which angiopathy was discovered.
3. During pregnancy, angiopathy caused by increased vascular load is determined.

Diabetic angiopathy

Typical angiopathy develops against the background of diabetes mellitus, when the capillary bed changes against the background of an increased amount of sugar in the blood. After the capillaries, the damage affects larger vessels, which, with a long course of the disease, leads the patient to severe disability.

In diabetes mellitus, the glucose level often rises above 6 mmol/l, which contributes to the deposition of its various derivatives on the walls of blood vessels. As a result, the vascular walls thicken, the lumen of the vessel narrows, and their fragility increases, which subsequently leads to the death of soft tissues.

Diabetic angiopathy is most often expressed in:

• angiopathy of the lower extremities (diabetic foot);
• retinal angiopathy;
• nephropathy.

The disease is dangerous because of its consequences, since in diabetic foot the affected limb is often subject to amputation. Involvement of larger vessels in the pathological process leads to heart attacks, strokes, and heart failure.

Video Diabetic angiopathy: symptoms, diagnosis, treatment

Hypertensive angiopathy

High pressure in the circulatory system leads to consequences no less severe than diabetes mellitus. During the development of hypertension, the vascular endothelium is damaged because it is constantly exposed to high pressure. Consequently muscle layer begins to hypertrophy, which subsequently leads to fibrosis.

Blood circulation becomes more complicated, multiple places of narrowing and even blockage of blood vessels appear. At the same time, blood pressure remains high, which in severe cases leads to more or less hemorrhages.

Hypertensive angiopathy most often affects:

• retina;
• cerebral vessels;
• renal arteries;
• coronary vessels of the heart.

Hypotonic angiopathy

The disease mainly affects the peripheral bloodstream, which, due to decreased vascular tone, begins to overflow with blood. This leads to an increase in the permeability of the walls of blood vessels, due to which formed blood elements accumulate in the lumen of the capillaries. These are predisposing conditions for the formation of blood clots and edema. Such changes are more often observed in the lower extremities, although as the disease progresses, the vessels of other parts of the body undergo changes.

Hypotonic angiopathy can develop into hypertension, since prolonged stretching of blood vessels leads to backlash- vascular tone increases, but due to the resulting rigidity of blood vessels and calcium deposits in their walls, prerequisites are created for the development of hypertension.

The appearance of hypotensive angiopathy is most often accompanied by:

• damage to retinal vessels;
• cerebral vessels;
• change in skin color.

For example, a patient may have a cyanotic tint to the skin of the nose, ears, cheeks, and chin. If blood circulation in the brain is impaired, autonomic disorders may develop, as well as dizziness, combined with headaches. Damage to arterioles and venules is also often observed on the retina at this time.

Traumatic angiopathy

Compression injuries chest, skulls lead to a very sharp increase in blood pressure. As a result of such a lesion, light spots form on the retina, in addition, some blood vessels become clogged. All this leads to deterioration of vision. Upon provision of timely medical care the condition can be improved, but most often it is not possible to completely restore vision.

Clinic

Angiopathy of the first degree can be asymptomatic and in such cases small changes in the retina of the eyes can be detected, which should necessarily lead to elucidation of the cause of the development of the pathological condition.

Typical complaints with angiopathy:

• Vision has deteriorated (the patient sees blurry pictures).
• Stars may begin to flash before your eyes.
• Color perception is also impaired.

Other symptoms are associated with vascular damage internal organs and lower extremities:

• You may feel pain in your legs.
• Convulsive conditions develop.
• At physical activity Intermittent claudication often occurs.
• There is a tingling sensation or abnormal sensations in the feet and hands.
• Minor nosebleeds may develop, and blood is often detected in the stool and urine.

Thrombotic microangiopathy - characteristic feature tissue dystrophy and microthrombosis, which manifests itself as cutaneous erosions and ulcers.

The clinical determination of blood flow disorders must necessarily be supplemented by laboratory and instrumental studies, which will make it possible to make a more accurate diagnosis and prescribe effective treatment.

Diagnostics

After defining clinical manifestations must be carried out comprehensive examination sick. For this purpose they are used various methods studies assessing the functioning of internal organs, the nervous system, and the state of the vascular bed.

The main way to determine signs of arterial microangiopathy is performing ophthalmoscopy. To do this, visit an ophthalmologist who examines the fundus of the eye and determines the following disorders:

• capillaries are narrowed;
• vessels often intersect, there is tortuosity of arteries and veins;
• compensatory expansion of the capillary network;
• foci of hemorrhage are most often point-like;
• formation of small blood clots.

Additionally, the following studies can be carried out:

• angiography;
• Dopplerometry;
• duplex scanning;
• Magnetic resonance imaging.

Determining vascular lesions with the maximum likelihood of developing complications is considered an indication for specific therapy, which is selected on an individual basis.

Treatment

Much depends on the clinical form of the disease, so various specialists are involved in the treatment of angiopathy:

1. An ophthalmologist deals with retinal angiopathy.
2. Vascular surgeon or general surgeon - angiopathy of the lower extremities.
3. Neurologist - cerebral angiopathy.
4. Therapist or nephrologist - damage to the blood vessels of internal organs, such as the kidneys.
5. Cardiologist - diseases of the cardiovascular system.

The direction of drug therapy largely depends on the clinical form of angiopathy and the underlying disease against which it developed.

• In diabetes mellitus, it is important to keep glucose levels within acceptable limits so that vascular damage does not develop.
• The presence of hypertension requires controlled use of antihypertensive drugs.
• The definition of atherosclerosis forces adherence dietary nutrition, acceptable physical activity, treatment/prevention of impaired metabolic processes.

In most cases, drugs from the following pharmacological groups are used:

• Anticoagulants. They help treat and prevent thrombosis.
• Angioprotectors. The action of the drugs is aimed at protecting the walls of blood vessels.
• Metabolic substances. Improve exchange processes.

Additionally, all measures must be taken to eliminate unmodified risk factors, that is, those that are subject to change.

Prognosis and prevention

In the majority of patients (about 85% of cases) who adhere to medical recommendations, the disease progresses poorly and does not contribute to the development of severe complications.

In the case of a malignant course of the underlying disease (hypertension, diabetes mellitus), in 99% of cases angiopathy also develops unfavorably. In such cases, blindness, kidney failure or tissue death develop. Therefore, the earlier treatment is started, the greater the chances of maintaining health.

Discomfort in the eyeballs

Behavior change

Lightning before my eyes

Impaired concentration

Peeling of the skin on the extremities

Interruptions in heart function

Loss of vision

Decreased vision

Dry skin on the extremities

Lameness

Angiopathy is damage to blood vessels due to various ailments, as a result of which their full functioning is disrupted and the walls are destroyed. The pathological process can affect different parts of the body and vessels of various sizes - from small capillaries to large vessels. If angiopathy progresses over a long period of time, this is fraught with the development of irreversible changes in organs in the human body (due to chronic disruption of their blood supply).

The pathogenesis of the effect on blood vessels is different for each form of pathology, but the result of this effect is always the same - necrosis of the tissue that fed the affected blood vessel. In the international system of classification of diseases (ICD 10), angiopathy has its own code and list of diseases that can cause it.

Etiology

The main causes of angiopathy of any type include:

• elderly age;
• severe form;
• peculiarities anatomical structure vessels;
• autoimmune diseases;
• hazardous work conditions, toxins and radiation;
• metabolic disease;
• smoking and alcohol;
• excess body weight;
• lack of moderate physical activity in the patient’s daily life;
• eating over-salted food;
• various injuries;
• lack of certain nutrients or minerals in the body;
• intoxication of the body.

Varieties

There are several types of this disease (depending on the cause of progression and location of the lesion):

• diabetic;
• hypertensive;
• angiopathy of the lower and upper extremities;
• retina;
• hypotonic;
• cerebral (brain);
• arterial (heart);
• traumatic;
• youthful.

Medical statistics are such that most often patients are diagnosed with the diabetic form of the disease (this is due to the prevalence of diabetes mellitus). Angiopathy of the lower extremities also often develops against the background of diabetes. With this type of disease, thickening of the walls of blood vessels and narrowing of the lumen of the arteries in the legs are observed. These processes together constitute favorable conditions for progression. Diabetic angiopathy can affect not only the vessels of the lower extremities. It negatively affects the functioning of the kidneys, retina, and heart. If this type of disease is not treated for a long time, it can lead to serious consequences, the saddest of which is disability.

The causes of hypertensive angiopathy include: genetic predisposition, excessive consumption of alcoholic beverages, as well as. High blood pressure adversely affects blood circulation, as well as the functioning of internal organs and systems in general.

Symptoms

The symptoms of angiopathy directly depend on its type, and the severity of the symptoms depends on the degree of damage to the blood vessels and on the localization of the pathological process.

Main symptoms:

• decreased visual acuity;
• feeling of itching and burning in the legs;
• lameness while walking (after a short rest - disappears, but reappears during long walks);
• bleeding in the gastrointestinal tract;
• disorientation (only with cerebral angiopathy);
• memory and attention impairment;
• changes in human behavior;
• dryness and peeling of the skin on the hands and feet;
• complete loss of vision;
• hallucinations.

Symptoms of hypertensive angiopathy do not always appear in the initial stages of the disease. The patient rather feels discomfort in the form of a slight deterioration in vision and apparent glare in front of the eyes. But if the disease is not detected at this time, then the symptoms will become more acute not only in relation to the patient’s vision. Signs of impaired blood circulation will appear. In the early stages of progression, the disease can still be cured, but in the later stages this will be very difficult to achieve, to the point that it remains incurable.

Symptoms of diabetic angiopathy, in particular of the lower extremities, depend on the volume of vessels that have been affected and on the degree of development of the pathological process. Microangiopathy is divided into six degrees - from initial, in which there are no complaints from the patient, to the degree when it is no longer possible to avoid amputation of the leg. With macroangiopathy, the patient first feels a slight pain in the legs, but gradually pain syndrome intensifies and the clinic is supplemented by other symptoms. If treatment is not carried out, angiopathy will become severe, which will lead to the death of the toes.

Almost always, any disturbances in vision or a feeling of discomfort in the eyeballs are symptoms of the appearance and development of optic nerve angiopathy. Cerebral angiopathy is localized in the brain and can often lead to the penetration of blood into its tissues. Due to the thinning of the walls of blood vessels and their inability to hold back blood, they rupture, causing hemorrhage in the brain.

Arterial angiopathy disrupts the functioning of the heart. Can lead to blood clots and heart attacks. This happens because the walls of blood vessels (normally elastic) become denser and narrower during illness.

Diagnostics

Diagnosis of each type of angiopathy should be carried out by highly qualified specialists. First, the doctor conducts a detailed examination and interview of the patient, listens to his complaints. After the initial examination, the person is prescribed the following instrumental diagnostic techniques:

• radiography (both with and without contrast);
• Whole body MRI;
• ophthalmochromoscopy;
• angiography;
• examination by an ophthalmologist.

Treatment

Treatment is primarily aimed at eliminating symptoms, as well as associated diseases. Therapy for vascular angiopathy consists of:

• drug treatment;
• physiotherapy;
• surgical intervention.

Drug treatment can be varied, since different types of angiopathy require taking completely different drugs. For example, if you have diabetes, you should take medications that stabilize blood sugar levels. For hypertension - vasodilators, lowering heart rate and diuretics. Angiopathy of the lower extremities is treated with medications to thin the blood and accelerate microcirculation. Often, with this disease, the doctor may prescribe a special diet.

Physiotherapeutic treatment for angiopathy includes:

• laser vision restoration;
• acupuncture;
• therapeutic mud procedures;
• electrotherapy.

Surgical intervention is applicable only in severe cases, when it is necessary to urgently reduce the pressure on the artery and eliminate the source of the disease. For diabetic angiopathy, operations are performed to amputate limbs prone to gangrene.

Special attention should be paid to the treatment of pregnant women and young children. In such cases, treatment of any nature is prescribed strictly individually.

Prevention

Some simple rules will help protect against the progression of angiopathy and the diseases that can cause it:

• lead healthy image life;
• maintain hygiene;
• stick to a diet;
• If possible, avoid heavy physical activity;
• try to limit yourself from stressful situations;
• Have a scheduled check-up with your doctor several times a year.

Is everything correct in the article? medical point vision?

Answer only if you have proven medical knowledge

Angiopathy is a symptom that occurs due to other diseases that affect the blood vessels in the retina. This pathology should be treated at the first manifestations, as it can lead to blindness.

Angiopathy occurs together with diseases such as diabetes mellitus or hypertension, and usually develops in both eyes at the same time. The disease is diagnosed in people after 30 years of age, and they need to undergo vision diagnostics once or twice a year. In general, if you notice a decrease in vision, you should immediately go to an ophthalmologist for a consultation.

In this article we will talk about retinal angiopathy, its manifestations, causes, classification and treatment methods.

Retinal angiopathy

Retinal angiopathy
Source: nara-glaz.ru Retinal angiopathy is not an independent disease, but only a manifestation of diseases that affect the blood vessels of the whole body, including the blood vessels of the retina. Angiopathy manifests itself in pathological changes in blood vessels due to a violation of nervous regulation.

This disorder is receiving a lot of attention today, as it can lead to extremely sad consequences for the body, including loss of vision. Angiopathy of the vessels of the eye tissue occurs in both children and adults, but most often it manifests itself at the age of over 30 years.

The human body is a single whole and pathological processes, occurring in one organ or system, often have manifestations in a completely different place. For example, retinal angiopathy is a secondary manifestation or consequence of certain diseases.

Retinal angiopathy is a lesion of the blood vessels, most often caused by general diseases(vegetative-vascular dystonia, hypertension, diabetes mellitus, etc.)

Angiopathy is the result of diseases that affect blood vessels throughout the body, and usually develops in both eyes at once.

Target

The retina is a unique formation consisting, on the one hand, of photoreceptor cells, and on the other, of nerve cells.

The photosensitive part of the retina occupies the inner surface of the eye from the dentate line to the place where the optic nerve (disc) originates. Here there are no photosensitive cells at all, and long processes of ganglion cells intertwine and give rise to the optic nerve.

In contrast, this area of ​​the retina contains the area with the highest concentration of color-sensitive cells—cones. This is the macula (macula) and its central depression. This ensures the clearest perception and visual acuity.

As we move away from the center to the periphery, photosensitive cone cells begin to mix with cells of another type - rods, which almost completely occupy the periphery.

These cells are highly sensitive to light and provide us with vision at dusk, but they do not perceive color. Thanks to this arrangement of perceptive cells, a person develops central and peripheral vision.

Retinal diseases are mainly manifested by decreased visual acuity, field defects, and adaptation disorders. Since this membrane has no innervation, the diseases are painless.

Also, the retina itself does not have blood vessels, and its nutrition is provided by the choroid. However, functionally there is no point in separating these structures.

So, what is retinal angiopathy? This is the name for a disorder of the mechanisms for regulating contraction and expansion in its vessels. As a consequence, neuroangiopathy leads to a disorder in the nutrition of the retina, degenerative processes occur in it, possible consequences which are detachment and loss of vision.

How does the disease manifest itself?

Source: okardio.com Symptoms of narrowing mainly concern the quality of vision. A person can see “lightning”, “sparks”, vision deteriorates, the picture becomes cloudy and blurry, myopia progresses.

Usually this disease is typical for the older age group. Here it is important to undergo an examination to clarify the diagnosis, since presbyopia – age-related visual impairment – ​​gives similar symptoms. Arteriospasm of retinal vessels can occur against the background of headaches, nosebleeds, and attacks of hypertension.

Symptoms of retinal angiopathy:

1. Deterioration or blurred vision;
2. Loss of vision;
3. Nosebleeds;
4. Progression of myopia;
5. Retinal dystrophy;
6. Lightning in the eyes.

The disease manifests itself as a deterioration in the functioning of the vessels of the fundus. This occurs against the background of thinning of the walls of blood vessels. Next comes gradual necrosis of these cells. More often, only one eye is affected; retinal angiopathy of both eyes is less common, which in later stages can manifest as complete loss of vision.

In any case, it is important first of all to know what contributes to the development of the pathology, as well as what its main manifestations are, in order to be able to consult a doctor for help as quickly as possible in order to prevent the development of a late stage of the disease.

The sooner you start treatment, the higher the probability. If therapy is not started as soon as possible, then retinopathy may develop - a serious disease that leads to complete blindness.

Loss of vision occurs due to the fact that the retina simply detaches, ruptures, or severe necrotic changes occur in the vessels.

Often, patients at the initial stage of the disease may not even pay attention to it, explaining the symptoms as simple overwork. They think that if the retina is damaged, it will go away on its own soon.

In the modern rhythm, many people work on computers and therefore are forced to subject their eyes to increased stress. In this case, it is precisely necessary to check the eyes as often as possible so as not to miss important signs that may indicate the development of a serious and complex pathology.

In later stages, serious visual impairment occurs, which gradually leads to its complete loss. Usually the disease does not progress too quickly and therefore it is quite possible to seek help from a doctor. Deteriorating vision is already a sufficient reason to go to the hospital.

Causes of retinal angiopathy

In fact, retinal vascular angiopathy does not occur on its own without underlying diseases. This problem develops against the background of a complex change in the functioning of the body’s blood vessels.

Often changes in blood vessels occur not even against diseases, but against conditions of the body, for example, retinal angiopathy during pregnancy.

The problem is that the blood supply to the fundus of the eye is deteriorating. Against this background, the vessels become too fragile, their walls become thinner, and the vessels can easily collapse. The situation is complicated by the fact that such changes are irreversible.

If an area of ​​the retina has already detached or necrotic changes in blood vessels have begun, then it is no longer possible to establish normal blood supply there.

Angioneuropathy can have different origins, but usually has a background nature due to some pathology, and therefore is called background retinal angiopathy.

So it could be:

• intoxication of the body;
• leukemia;
• high blood pressure;
• A disorder of the nervous regulation, which is responsible for the tone of the walls of blood vessels;
• vasculitis of autoimmune origin, rheumatoid arthritis;
• congenital pathology of vascular connective tissue;
• blood diseases (anemia);
• increased intracranial pressure;
• violation of the nervous regulation of vascular tone;
• damage to the cervical spine or its osteochondrosis.
• Angiodystonia of retinal vessels is common and can be background in smokers or people taking drugs that affect general vascular tone.

If we consider in more detail the causes of most angiopathy, then we should first of all immediately determine the nuance: this pathology is usually considered not an independent disease, but a symptom. Therefore, it is important to determine which diseases caused such manifestations.

In addition, you need to understand that there is a certain risk group - people who, due to some characteristics of the body, are predisposed to such manifestations.

Based on this, we must understand that if a person has some kind of disease that can provoke such a diagnosis, then it is necessary to at least minimize the influence of factors that only aggravate the situation and further provoke this disease.

It can also occur when various diseases blood or immune system and with various types of age-related changes (for example, at a young age, when a restructuring of the body and all its systems occurs).

If we consider the potential risk group, we can identify the following categories of people who are initially most predisposed to the development of such diseases:

1. Aged people. According to statistics, in people under 30 years of age, diagnosis practically does not show the presence of this disease.
2. Smokers.
3. Pregnant women.
4. Overweight people.
5. Specialists whose retinas are constantly exposed to significant stress at work (for example, welders, workers at metallurgical enterprises).
6. People whose body is systematically exposed to intoxication. This means not only workers in such industries, but also patients who are forced to take harmful drugs consistently for a long time.
7. Those who have congenital disorders of vascular development.

This does not mean guaranteed development of such a disease if a person has some underlying pathologies or provoking factors. This can be completely avoided. By the way, it is clear that this does not mean the need to urgently quit your job, even if there are no symptoms.

This just means that if a person is initially at risk, then he must not forget about periodic diagnosis. This is what will prevent the serious development of the problem until a late stage.

At timely treatment It is quite possible to soon forget about this illness.

In addition, in the presence of provoking factors, it is important to follow basic safety rules, and also not to forget about eye exercises, adequate rest, sunglasses, limited time watching TV and working at the computer, as well as basic moisturizing and antibacterial drops.

Types of disease

Source: medikoff.net Angiopathy of the vessels of the retina, being a consequence of a certain genesis, can be called diabetic, hypotonic, hypertensive, traumatic, juvenile.

The classification is based on diseases that cause retinal angiopathy. Angiopathy occurs:

• Diabetic.

In this case, damage to the blood vessels of the fiber occurs due to neglect of diabetes mellitus, which affects not only the capillaries of the retina, but also all the blood vessels of the body. This leads to a significant slowdown in blood flow, blockage of blood vessels and, as a result, decreased vision.

Against the background of diabetes, as is known, damage to the circulatory network in general occurs, affecting large and small vessels. Diabetic angiopathy occurs when high concentrations of glucose damage the endothelial layer of microvessels, as a result of which their permeability is impaired and swelling of the capillary wall occurs.

Also, changes in blood composition in diabetes mellitus lead to the formation of blood clots, which easily clog the small vessels of the retina.

With the combination of these changes, the retinal vessels become narrowed, and the blood flow in them slows down or stops altogether. This leads to disruption of the blood supply to the tissue, oxygen starvation and, as a consequence, to atrophy.

In addition to small blood clots and edematous vessels, microbleeds often occur on the retina in diabetes, since the vessels are easily injured. The accumulation of glucose and metabolic products in the walls makes the capillaries extremely fragile.

• Hypertensive.

Hypertension in a person very often leads to retinal angiopathy. This is manifested in the branching of veins, their expansion, frequent pinpoint hemorrhages in the eyeball, and opacities of the eyeball.

Retinal vascular angiopathy is still more often caused by high blood pressure.

The picture of the fundus is mixed, since changes affect both the vessels and the retinal tissue itself, but it is always directly dependent on the stage of development of the disease and its severity.

High blood pressure damages the central artery and small vessels. As a result, their parts are replaced by glial cells, and the vessel loses its elasticity; sclerosis increases the risk of rupture and hemorrhage.

Another mechanism for damaging blood vessels and reducing their internal diameter is the deposition of atherosclerotic plaques. Damage to the retina occurs mainly due to sweating exudate, which delaminates the tissue.

Hypertensive vasopathy gives the vessels a branched appearance (Gwist's sign), they are dilated, the diameter is uneven, and tiny hemorrhages are observed in places. Usually retinal vascular angiopathy hypertensive type may undergo reverse development during treatment of the underlying disease.

• Hypotonic.

Symptoms of retinal angiopathy can also occur when the total blood pressure decreases (hypotension) in the peripheral vessels. Blood flow slows down, which is a prerequisite for blood thickening and the formation of blood clots.

Violation of resistance to blood pressure in peripheral vessels, as a rule, occurs due to pathology in the vasomotor center of the brain or the vagus nerve.

Retinal angiopathy of the hypotonic type gives a certain picture during ophthalmoscopy:

1. small vessels are clearly visible, but have a pale appearance;
2. there is no “doubling” of the wall;
3. the shape is sluggish, sinuous, instead of usually more rectilinear.
4. The lumen of the arteries increases, the pressure decreases, blood clots may form, with prolonged blood stasis, swelling increases, and clouding appears on the retina.

• Traumatic.

It can develop with injuries to the cervical spine, brain injuries, or sudden compression of the chest. The appearance of retinal angiopathy in this case is associated with compression of blood vessels in the cervical spine or with increased intracranial pressure.

• Youthful.

The most unfavorable type of retinal vascular angiopathy, the causes of which are not fully understood. The most common manifestations: inflammation of blood vessels, frequent hemorrhages in both the retina and vitreous. It is also possible for connective tissue to form on the retina.

Such symptoms often lead to cataracts, glaucoma, retinal detachment and blindness.

• Retinal vascular angiopathy in children

Retinal damage in newborns is usually associated with heredity, congenital diseases or the birth process.

Narrow arteries, papilledema, hemorrhage along the vessels of the fundus can be detected with glomerulonephritis or wrinkled kidneys. This is a manifestation of renal retinopathy. Angiodystonia in this case requires elimination of kidney inflammation as the root cause.

Angiopathy of the retina in a child in the form of limited pouch-shaped or spindle-like dilations and tortuosity of blood vessels, spreading first to the periphery and then to the central region of the fundus of the eye is a manifestation of diabetes mellitus.

Given the hereditary nature of this disease, a test for diabetes in infants should be performed in order to begin treatment for this endocrine disease in a timely manner. This will allow you to avoid further damage to blood vessels and the optic nerve head, and diabetic blindness.

Instability of blood pressure regulation in children can provoke hypertensive angiopathy. Most often it occurs in the cerebral form of hypertension. Damage to the optic nerve is associated with changes in the blood vessels of the child’s eyes.

In children and adolescents, a sudden decrease in visual acuity due to vascular pathology and minor hemorrhages may occur after undergoing infectious diseases– tuberculosis, toxoplasmosis, viral infections.

A special symptom of the so-called Eales disease (retinal angiopathy in a child) is often recurrent pinpoint hemorrhages, manifested by the sudden appearance of a dark spot or painful loss of vision due to hemorrhages.

• Retinal angiopathy during pregnancy

Toxic hypertension in pregnant women often affects the condition of the retinal vessels. High blood pressure is caused by an increase in blood volume to ensure fetal growth, a change in hormonal levels, pressure fluctuations during a woman’s emotional reactions.

Hypertensive angiopathy occurs. At the same time, the walls of the vessels become more and more tensile. Retinal angiopathy during pregnancy is dangerous due to the possibility of vascular rupture and the formation of large hemorrhages, which threaten vision loss and retinal detachment.

A woman with an ophthalmological diagnosis must necessarily prepare for childbirth under the supervision of the attending physician, and in the event of a threat of retinal detachment, delivery is carried out by cesarean section.

Research methods

Source: doctorcardio.ru Fundus vessels and their condition are important diagnostic value. Most often, a mirror ophthalmoscope is used in a clinic setting. This is a concave mirror with a hole in the center. This shape makes it possible to collect and direct a beam of light through the pupil dilated with the help of special drops onto the retina.

A more detailed study is carried out using fluorescent vasography. A special substance is injected into the bloodstream. It spreads throughout the bloodstream. Fundus vasoconstriction can be detected and photographed in great detail using contrasting light of specific wavelengths.

Angiopathy is diagnosed with a comprehensive ophthalmological examination. The main diagnostic method is various options of ophthalmoscopy - examination of the fundus.

Diagnosis and treatment of retinal angiopathy should be carried out by a highly qualified specialist. In case of angiopathy, the doctor always prescribes drugs that improve blood circulation in the vessels of the eyeball: pentilin, solcoseryl, trental, vasonit, arbiflex, emoxipin and others.

These drugs increase the bendability of red blood cells, which helps normalize blood flow in the capillaries. For patients with fragile vessels, calcium dobesilate is prescribed. The drug thins the blood, significantly improves blood circulation in the vessels, and normalizes the permeability of the vascular walls.

What does the doctor see?

Angiopathy is characterized by a violation of the lumen of blood vessels or their course: they can be narrowed, dilated, tortuous, congested, etc., depending on the reason that caused their change.

The disease usually develops in both eyes at once. In complicated situations, pathological changes in the retina and/or optic nerve head are determined.

Performed according to indications additional methods examinations: computer perimetry, optical coherence tomography central zone of the retina and optic nerve, ultrasound scanning of intraocular structures.

The disease is diagnosed by an ophthalmologist after taking into account the symptoms of retinal angiopathy and a general examination of the patient.

In order to clarify the diagnosis, special studies are used, such as ultrasound scanning of blood vessels (carried out to obtain information about the speed of blood circulation and study the condition of the walls of blood vessels) and X-ray examination(carried out by injecting a radiopaque substance).

Also, if necessary, magnetic resonance imaging is used, which makes it possible to clearly determine the structure and condition of soft tissues.

Treatment of retinal angiopathy

How to treat angiodystonia depends on its type and cause. The diagnosis of retinal angiopathy only indicates the nature of the changes that have befallen this structure.

If the reason for the changes is high blood pressure, then first of all, hypertension is treated with various groups of antihypertensive drugs.

Relaxation of the wall of narrowed vessels is achieved by vasodilators - a group of vasodilators. They are usually taken as a course according to the instructions.

In critical situations they are administered as follows: nitroglycerin - sublingually, retrobulbar - solution of atropine and papaverine sulfate, intravenous - aminophylline, intramuscular - nicotine solution acids, under the conjunctiva - caffeine solution 10%.

Angioprotectors are also used. This group of drugs is indicated for use in any type of angioretinopathy. Depending on the mechanism of action, they block the production of inflammatory mediators and vascular-damaging factors (hyaluronidase).

In addition, the drugs dicinone, parmidine, complamin, doxium, and peritol help to dilate blood vessels, improve microcirculation, and reduce swelling. Enalapril, Prestarium, Tritace, vitamins K and rutin strengthen the walls of the capillary network.

The group of retinoprotectors usually represents agents that improve metabolism in the retina and eliminate angiodystonia of its vessels. Drops for angiopathy that can be prescribed by an ophthalmologist are Emoxipin, Taufon, Quinax, Emoxy - Optic.

Diabetic form

Since diabetic angiodystonia of the retina is caused by the damaging effects of glucose, it is first necessary to eliminate hyperglycemia. For this purpose, either insulin or glucose-lowering drugs are prescribed (depending on the type of diabetes).

In addition, we have to deal with impaired capillary patency and eliminate increased vascular permeability.

The basis of treatment is diet correction, antidiabetic drugs, blood pressure control, angio- and retinoprotectors. In some cases it may be necessary surgical intervention– photocoagulation of the retina or removal of large hemorrhages, restoration of retinal detachment.

Folk remedies for the treatment of angiopathy