The term "angiopathy" refers to the process of changing blood vessels caused by a disorder of the nervous regulation of the vascular tone, a difficulty in the outflow (inflow) of blood in the lumen of the vessel.Angiopathy is not called any problems with blood vessels, but only those that are associated with a change in their tone due to a disorder of nervous regulation.

Angiopathy is not an independent disease. Pathological changes are a consequence of a number of diseases affecting the blood vessels of various body systems, including the retina. Vascular defects, found in the patient, allow the doctor to determine the underlying disease even before his clinical manifestations.

Definition of disease

Angiopathy is more common in older people (after 35 years) who have chronic ailments. However, such features are sometimes found in childhood (even in newborn infants).

In those cases when signs of disturbance of the normal operation of the eye vessels are found, the formulation "retinal angiopathy" is insufficient. This is too broad a designation of the ongoing processes, which may include a violation of the tone, tortuosity, permeability, shape (narrowing or widening) of the vessels of the fundus. An important factor that specialists pay attention to is the possibility of normal blood flow (presence or absence of blood clots, narrowed parts or other obstacles).

The retina (the inner shell of the eye) contains cells that capture and transform light waves. In the form of nerve impulses, visual information is transmitted to the brain. Such a complex "work" requires high-quality blood supply with the help of a branched network of capillaries.

An important system is the outflow of blood through the veins. In the case of the development of serious changes in the vessels of the retina, its nutrition can be disturbed, cells can not perform their functions.Not always the word "retinal angiopathy" should mean signs of a dangerous pathology.Determining the degree of changes in the vessels is a very subjective factor. Much depends on the experience of the specialist who conducts the examination.

If there is a possible retinal angiopathy, you should take care of a qualitative examination of the fundus.Disorders of the functioning of the vessels of the eye may indicate the presence of a variety of diseases: neurological, cardiac or endocrine. In addition, the changes that occur, when they are significant, can cause extremely dangerous consequences. This may be a malfunction in the functioning of the eyes, the development of retinal dystrophy up to loss of vision.

Examination of the fundus

Types and Classifications

The following types of angiopathies are distinguished:

1. Hypertensive angiopathy.Hypertension leads to changes in the vessels of the eyes: dilatation and branching of the veins, opacities in the eyeball area of ​​pinpoint hemorrhages.
2. Hypotonic angiopathy.The disease causes a decrease in the tone of small vessels, which causes a deterioration in blood flow, leads to blood clots, blood clots.
3. Diabetic angiopathy.The blood vessels of the whole body are affected. This causes a slowing of blood flow and blockage of blood vessels.
4. Youthful angiopathy.The reasons for the development of this type of pathology have not yet been fully investigated. This type of angiopathy causes inflammation of the blood vessels, hemorrhage into the retina or into the vitreous. Sometimes a retina is formed on the retina of the eye.
5. Traumatic angiopathy.It can be a consequence of damage to the spine of the cervical region, severe compression of the chest or craniocerebral injuries.
6. Angiopathy in premature newborns.Sometimes it occurs as a consequence of complicated birth or birth trauma.
7. Angiopathy in pregnancy.It can manifest itself in the second half of pregnancy as a consequence of increased pressure or other problem states, for which the weakness of the vascular walls is characteristic.

Experts in the development of diabetic angiopathy call two types of pathology:

• microangiopathy- Thinning of capillary walls, which can result in hemorrhage into nearby tissues;
• macroangiopathy, the development of which affects the larger vessels of the eye.

Both types of angiopathy lead to a violation of the general circulation of blood

Causes

Angiopathy is not an independent ailment, but a signal about a disease that negatively affects the vessels, in this case, the vessels of the fundus.The retina of the eye reacts sharply to disturbances in the blood supply system. As the causes of the changes, called angiopathy, can act as various diseases, and other factors.Diseases that provoke the pathology of the retina vessels:

• hypertonic disease;
• hypotension;
• diabetes;
• systemic autoimmune vasculitis;
• osteochondrosis of cervical department;
• increased intracranial pressure;
• violation of the nervous regulation of the vascular wall tone;
• renal dysfunction;
• vascular syndromes;
• all kinds of hematological defects;
• pathology of the thyroid gland;
• trauma to the skull, spine or eyes.

Factors that adversely affect retinal vessels include:

• advanced age;
• intoxication of the body, caused by the presence of bad habits, acute or chronic poisoning, work in harmful production;
• congenital anomalies of the walls of blood vessels.

"Eye" factors that cause angiopathy: embolism, thrombosis or other acute circulatory disorders of the retina, the chronic hypotonic state of the central artery of the retina.

Embolism of the retina as the cause of angiopathy

Symptoms

In the early stages of the disease is almost asymptomatic.This is a serious problem since, starting from a certain period, the process becomes irreversible. For a long time a person can feel a number of inconveniences, which are of a transient nature. These can be "flies" or "spiders" appearing in the field of view. The image is sometimes perceived as blurry, partial shadows appear. There may be manifestations of myopia. Such symptoms quickly disappear, being perceived as manifestations of any existing disease (for example, high blood pressure).

Over time, transient symptoms turn into permanent symptoms.

Common manifestations of angiopathy are:

• decreased visual acuity;
• fog or spots in sight;
• narrowing of the field of vision;
• sensation of pulsation in the eyeball;
• Buried blood vessels or yellow spots, visible on the conjunctiva.

Yellow patches on the conjunctiva as a symptom of angiopathy

Additional signs that allow the suspected development of angiopathy are:

• nasal bleeding;
• pain in the legs.

Rarely an indirect sign is the blood in the urine.

Possible complications

Angiopathy of the retina quite often has temporary and reversible consequences: dystonia, spasms or paresis (decrease in strength) of the vessels.With the unfavorable development of the pathological process, changes in the blood vessels lead to serious consequences:

• atrophy of the optic nerve;
• narrowing of the fields of vision;
• retinoschisis;
• vitreous hemorrhage;
• partial loss of vision.

Hemorrhage in the vitreous humor as a complication of angiopathy

If treatment is wrong, angiopathy can result in complete loss of vision.

Diagnostics

Since the development of angiopathy at the initial stages occurs without special manifestations, it is important to have prophylactic examinations with an ophthalmologist when it is detected.The doctor conducts a questioning of the patient, analyzes his condition. To clarify the diagnosis, instrumental examination methods can be assigned:

• Ultrasound;
• Magnetic resonance imaging;
• CT scan;
• radiography;
• ophthalmoscope chromatography;
• angiography.

Optical coherence tomography

The examination of the fundus is mandatory.

Treatment

What treatment is necessary for angiopathy, the doctor determines, depending on the disease that provoked changes in the vessels of the retina.In some cases, treatment is premature. The initial stages of angiopathy specialists can simply observe.In those cases where changes in the retinal vessels require medical intervention, it is primarily about the treatment of the underlying disease. Many changes in the eye fundus area disappear when the disease causing them recedes.

The problem of angiopathy of the retinal vessels requires an integrated approach and participation of physicians of various specialties: oculist, therapist, cardiologist, neuropathologist endocrinologist, rheumatologist.

Medicines

Medical treatment of angiopathy is carried out taking into account the nature of the disease and the degree of severity of the condition for each patient. Appointments of medicines are done strictly individually and are aimed at eliminating the causes that cause pathology.For example, with hypertension, the patient takes antihypertensive drugs. Diabetes mellitus presupposes the administration of drugs that lower the level of sugar.
Therapeutic measures include the following types of preparations:

• medicines for eliminating or correcting the disease that caused angiopathy;
• drugs that stimulate blood microcirculation, strengthening the walls of blood vessels;
• drugs that reduce vascular permeability;
• vitamins of group B, C, P, E.

Additionally, drugs that prevent the formation of blood clots are prescribed.

Folk remedies

Methods of traditional medicine can influence the factors that cause pathological changes in the vessels of the eyes.When treating with the help of folk recipes, an individual approach is also important: every case requires well thought-out treatment.

Popular methods of traditional medicine for vascular pathology are herbal infusions from melissa, chamomile, bird mountaineer, yarrow, St. John's wort.

Surgically

In those cases when the disease progresses, extremely dangerous consequences can arise: the growth of newly formed vessels, the formation of exudates, the appearance of edema, severe forms of retinopathy.To eliminate dangerous complications, a surgical operation can be prescribed. Modern surgery uses methods of laser retinal coagulation, photocoagulation, vitrectomy.

Laser Coagulation Procedure

Such techniques can not guarantee the restoration of vision in cases of complications resulting from angiopathy of the retina.

Prevention

For the prevention of vascular changes, it is important to exclude from the daily life the factors provoking the development of angiopathy:

• excessive physical exertion;
• bad habits;
• stress;
• work with toxic substances without adequate protection.

General strengthening procedures, adequate nutrition and rest will strengthen the regulation of vascular tone, preventing the appearance of angiopathy.

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conclusions

Angiopathy of the retina is a consequence of a number of ailments that cause vascular function disorders.Such a state in its initial forms is reversible. However, without the timely treatment of the underlying disease, the process of changing the vessels of the fundus can lead to serious consequences: severe deterioration of vision and even complete loss of it.