All about thrombosis of the central vein of the retina

Central retinal vein thrombosis or retinopathy of venous stasis is an acute ophthalmologic disease caused by a violation of blood flow in the CVT and nearby small capillaries. According to statistics, even timely and competent treatment rarely leads to a positive result, since irreversible degenerative and atrophic processes in the visual apparatus develop with a high speed. This pathology occurs much more often occlusion of the arterial bed, which has similar symptoms and causes.

Definition of disease

Vein vein thrombosis is always an acute condition, which most often occurs in people with pathology of the visual apparatus,so the initial signs of the disease are rarely diagnosed on time. Appeal to a specialist almost always occurs when a significant thrombus is formed, which can lead to the most serious complications. Often the onset of the development of the disease occurs after the narrowing of the vein or the closure of the lumen of the vessel, which can arise due to a variety of reasons.

Depending on the degree of decrease in the lumen of the blood vessel, there may be ischemic or non-ischemic vein thrombosis. With ischemia, a critical condition of the blood flow is observed, retinal hemorrhages are possible, puffiness arises, and visual acuity is lost.

The process of thrombosis always goes through several stages:

1. Pretreblosis. There are no external manifestations of the disease, but with an ophthalmologic examination of the fundus, you can see the first signs of stagnation of venous blood. At the same time veins expand, their structure changes. In the macular area there is swelling, often there are small capillary hemorrhages;
2. Initial thrombosis. The patient has blurred vision, there are flies or flicker before the eyes. When examining the eyeball, you can notice significant hemorrhages of various degrees that spread to the retina, there is swelling of the optic nerve disc. A decrease in visual acuity may begin;
3. Directly retinopathy. Small hemorrhages begin to resolve, degenerative changes and retinal atrophy develop. Within 2-3 months the blood vessels branch out over the entire area of ​​the cellulose, numerous ophthalmologic dysfunctions are observed. Vision is almost always reduced.

Since vein thrombosis at the initial stages can be diagnosed only with a careful ophthalmologic examination of the fundus, the disease is found when there are visible external manifestations, beginning with the second stage disease.

Causes

The disease occurs due to pathological changes in the functioning of the walls of blood vessels or a violation of the viscosity of the blood.As a rule, this is due to the fact that the enlarged arteries with some functional or Ophthalmic diseases begin to squeeze nearby veins, thereby violating the natural outflow blood. Similar problems are most often observed with the following ailments:

• Arteriosclerosis;
• Diabetes mellitus of any type;
• Blood pressure disorders;
• Diseases accompanied by changes in blood coagulability;
• Ophthalmic pathologies, which increase intraocular pressure, for example, glaucoma.

In most cases, retinal vein thrombosis is diagnosed in the elderly at the age of 65 years.In addition, it is this group in every 10 cases that a bilateral defeat occurs. The disease can develop at a young age, usually as complications after acute infectious diseases or severe inflammation of the nasopharyngeal organs.

It is believed that the risk of the emergence of pathology increases in people leading a sedentary lifestyle, suffering from obesity and disruption of the endocrine system.

There are clinical cases of retinal vein thrombosis in patients with cancerous blood and hemopoietic organs. But in a separate group of risk they are not allocated.

Symptoms

The clinical picture of the disease largely depends on the severity of the thrombotic process in the retina vein. In this connection there can be 2 types of pathology:

• Ischemic thrombosis. Serious bleeding occurs in the retina, and the damage to blood flow leads to a reduction in visual acuity and the development of serious ophthalmic disorders;
• Non-ischemic or incomplete occlusion. The lesions of the retina and blood vessels are much less pronounced, there are no profuse hemorrhages, visual acuity can remain intact.

The disease often develops rapidly, with the critical state occurring a few hours after the onset of thrombosis.First there is a general malaise and weakness, painful sensations in one or both eyes, and only then add characteristic visual disturbances - fog or flies before the eyes, distortion of perception of objects.If the hemorrhages do not affect the central part of the retina, the visual acuity may remain unchanged for some time, but then gradually decrease.

During the diagnosis of the fundus, the so-called symptom of a "crushed tomato" is often found. It is characterized by the appearance of puffiness on most structures of the visual apparatus, and extensive hemorrhages pass from the cellulose to the vitreous.

Usually 1-2 months after thrombosis vision begins to return to normal, but complete recovery is extremely rare.Even after a full course of therapy, maculopathy and cellulose degeneration are possible, as well as a general thinning of the blood vessels, which can lead to their rupture. Each 5 patients with thrombosis develops glaucoma.

Possible complications

The consequences of the disease largely depend on the overall health, the degree of visual impairment to thrombosis, and the time to consult a specialist.With timely treatment, it is almost always possible to keep the visual function at least partially. A greater risk of venous thrombosis in the retina is the risk of subsequent relapse. To avoid this, you need to regularly undergo ophthalmic examinations in time to notice the onset of the disease. In 100% of cases, there are changes in the fundus. They can be completely harmless, but with extensive ischemic thrombosis, the following pathologies are likely to develop:

• Glaucoma;
• Degeneration of the retina of various degrees;
• Atrophy of the optic nerve;
• Violation of the functioning of blood vessels - development of uveitis and iridocyclitis;
• Complete or partial loss of vision.

The risk of complications can only be reduced if the ophthalmologist is treated in a timely manner and treats this disease properly.

Treatment

Therapy is always assigned immediately after the diagnosis and confirmation of the diagnosis, because the faster the treatment begins, the lower the risk of irreversible atrophic processes. With thrombosis of the central vein of the retina, only conservative therapy is always assigned at the initial stage, the main task of which is:

• Depression of hemorrhages on any element of the eye;
• Restoration of blood circulation in the affected vein;
• Removal of edema of the retina;
• Nutrition and improvement of trophism of the main components of the visual apparatus.

To do this, usually given the reception of fibronolytics, as well as coagulants direct action. Of no less importance for the treatment of thrombosis is the normalization of arterial eye pressure, which makes it possible to alleviate the general condition of the patient and prevent the possibility of ischemic thrombosis. In the future, it is necessary to take antiplatelet agents to improve blood circulation, as well as hormonal drugs to relieve swelling and inflammation of the retina. At the expressed painful sensations also reception of spasmolytics of wide action is necessary. And throughout the treatment is a mandatory condition - the use of vitamins and biological mineral supplements for the overall strengthening of health and immunity.

Lower intraocular pressure can be Arutimol.

In most cases, after 2-3 months of drug therapy, laser retina coagulation is performed to reduce the likelihood of recurrence of the disease.

Prevention

To date, there are no effective measures to prevent the development of this serious pathology.Due to the fact that people with functional diseases, such as diabetes mellitus and hypertension are at risk, it is necessary to undergo medical examinations on time and monitor the blood pressure and glucose levels in blood.And for the normal functioning of the circulatory system of the body should abandon the excessive use of caffeine and nicotine, which increase blood pressure and affect blood clotting, causing the risk of thrombosis.

Of great importance is the timely access to a specialist at the first sign of the development of the disease, since the disease develops at a high rate, time plays an important role for a favorable prognosis treatment.

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conclusions

Thrombosis of the central vein of the retina is one of the most serious ophthalmologic diagnoses, since even with competent treatment there is a chance of a relapse of the disease. The disease often affects the elderly, but this does not mean that at a young age you do not need to take care of your health. Retinopathy directly depends on the normal operation of the cardiovascular system as a whole, so already Since early years, you need to take care of your body and go on time medical survey.

Also read about optic neuritis and chorio-tetinitis.