Retinal angiopathy: causes of development, types of disease

The human eye is one of the most complex organs. Retinal vascular angiopathy in children and adults occurs when blood vessels and capillaries change, and blood flow in the retina is disrupted. This occurs when the nervous tone changes.

Due to impaired blood flow to the eye organs, the nutrition of the fundus and retina is reduced. This leads to weakened vision, possible myopia (especially in young children), and retinal dystrophy. A person with angiopathy feels many unpleasant sensations when his vision is impaired.

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Causes of the disease

Retinal angiopathy in a child occurs due to impaired blood flow in the vessels of the eyes.

The pathology is severely manifested in premature babies. If a child has increased intracranial pressure, this negatively affects the condition of the optic nerve. When diagnosing the disease, it is noticeable that the nerve disc has changed its shape and expanded. Thus, it puts pressure on the vessels and interferes with blood circulation. Without treatment, angiopathy in children leads to retinal separation or deformation and hemorrhage. The causes of the pathology are head and eye injuries, cerebrospinal fluid pressure. In children, angioretinopathy occurs, which is a consequence of oxygen starvation and affects the condition of the retina of both eyes and capillaries.

The root causes also include the following violations:

• poor-quality nutrition of a woman during pregnancy;
• oxygen starvation;
• retinal phlebopathy in newborns;
• congenital features of the vascular system.

If a baby is diagnosed with a blood flow disorder in the capillaries of the eyes, it is necessary to undergo diagnostics that will help determine the deformation in detail.
If abnormalities are detected, it is necessary to undergo a thorough diagnosis, since a superficial examination of the retina will not be enough. This is necessary because the circulatory system in infants is unstable in the first year of life. A visible change in the plethora of blood vessels can be caused by stress when the baby stands or sits. Therefore, before starting treatment, it is necessary to identify vascular deformation.

Factors that increase the risk of developing abnormalities in the eyes of children

The main provoking factors that significantly increase the risk of developing various types of disorders in the eye area in young children include cervical osteochondrosis, poisoning of the body, blood diseases, disorders of the nervous system, autoimmune vasculitis, and intracranial pressure.

The presence of several of the above reasons should alert you. This is due to the fact that various abnormalities in the functioning of the vascular system of the eyes are becoming more common. But proper blood supply is extremely important not only for children, but also for adults. The main signs of the onset of angiopathy are abnormalities in the capillary system, which can be detected during regular preventive examination. This will allow timely elimination of foci of ocular vascular pathology. To most effectively eliminate all negative factors of angiopathy, the attending physician often prescribes additional examinations, which make it possible to clarify the causes of the disease. Examples of these include ultrasound and x-rays. In parallel, it is possible to use MRI, which can determine the condition and structural features of the soft tissues of the eyes in children and adults. The disease is also accompanied by a variety of arterial spasms, which manifest themselves as pulsations inside the eye and subsequently turn into yellow spots on the white of the eye.

Angiopathy in any of its manifestations is a reversible phenomenon that should be taken seriously in order to maintain your vision and not lose it in the future.

Forms of pathology

Retinal vascular angiopathy is divided into certain types, which are highlighted in the table:

Variety	Characteristic
Hypotonic	With low blood pressure, the tone of blood vessels in the eyes worsens (angiodystonia), which leads to the disease
Diabetic	This type of disorder is the most difficult to cure.
	Appears due to diabetes mellitus
Traumatic	Occurs due to injuries to the head, chest, spine
Hypertensive	Manifests itself due to increased pressure, which leads to thinning of blood vessels

Retinal vascular angiopathy in children

Angiopathy is not a congenital disease; a child cannot be born with such a disorder.

In newborns, the disease occurs due to birth trauma or difficult childbirth. If angiopathy is detected in a baby, parents should under no circumstances panic. The causes of this disease in the first days of life are also associated with disorders of the child’s intrauterine development:

• with impaired development of the fetal vascular system;
• with poor maternal nutrition during pregnancy;
• with the occurrence of hypoxia during childbirth or in late pregnancy;
• with a neck or head injury during childbirth.

Angiopathy of retinal vessels in newborns, as a rule, goes away within a few months after birth, provided that proper tone and blood circulation in the fiber vessels are restored.

The disease in older children is a serious disease associated with the pathological functioning of the retinal vessels. In the presence of metabolic or vision disorders, angiopathy can develop quickly and lead to severe visual impairment.

Children may develop the following types of this disease:

1. Diabetic - associated with disruption of the pancreas and insulin secretion. The vessels lose their tone and do not nourish the retina well; hypoxia of the eye may develop. It is very difficult to treat this cause of the disease, especially in children.
2. Traumatic. This type is quite common in children. Kids run a lot, jump and, of course, fall. Any injury to the neck or a strong blow to the chest can lead to increased intracranial pressure and disruption of the blood vessels in the eye.
3. Hypertonic and hypotonic. Rarely occurs in children, as it is associated with a violation of pressure in the blood vessels.
4. Youthful. This type of disease is extremely rare and has another name - Eales disease, and occurs mainly in adolescents. The mechanism of its occurrence has not yet been studied, but is associated primarily with inflammatory processes that occur in the eyes.

Symptoms of the disease

If a child, for no apparent reason, becomes tearful and has nosebleeds, this indicates retinal disease.
Parents can identify abnormalities in the retina if their child has a nosebleed. There is also blood in the baby's urine. Babies become whiny, this is associated with pain. When you press your fingers in the area under the eyes, the baby experiences spasms. Swelling or changes in the shape of the retina are visible. The quality of vision decreases, so the newborn may no longer recognize familiar objects or people.

Symptoms of angiopathy

Due to impaired nutrition and blood circulation inside the organ of vision, symptoms of angiopathy occur. First of all, the quality of vision deteriorates. Sometimes a veil appears before a person’s eyes. It seems that the eyes become clouded, the image of objects literally “fogs up”.

The following disturbances in the quality of vision are noted:

• myopia and astigmatism, retinal dystrophy.
• flashes, lightning and spots before the eyes;
• scotoma (vision sometimes disappears when turning the head; lateral vision is impaired);
• photospheres (a person, even with his eyes closed, can “see” bright flashes or luminous balls; when you press the eyeball, lightning may appear);
• photopsia (the patient sees false luminous objects in the eyes; they do not disappear when rubbing the eyes or blinking).

Since angiopathy is always a manifestation of another pathology, patients may experience dizziness, headache, pain and difficulty moving in the cervical spine, and changes in blood pressure. Due to the fact that their cerebral vascular tone is impaired, blood vessels in the nose burst and frequent nosebleeds may occur. If the kidney vessels are damaged, blood will appear in the urine.

Treatment of angiopathy

When a problem is identified, complex therapy is begun, which will help prevent the development of further visual impairment. The course of treatment is aimed at eliminating the root cause of retinal angiopathy in newborns. In order for the baby to recover, drug therapy and physical therapy are carried out. Additionally, doctors recommend following a diet to restore health. Ophthalmologists monitor the healing process and monitor changes in the capillaries, since sometimes retinal angiopathy in children under one year of age is not caused by serious damage and goes away on its own.

Specialists from the CRISO research agency (Australia) have developed a unique method that allows one to analyze the retina at a distance.

Medicines and physical therapy

In addition to the basic treatment prescribed by the doctor, it is also advisable to take vitamins to strengthen the vascular walls.
To improve blood flow, doctors prescribe the following pharmaceuticals: Pentilin, Solcoseryl, Trental, Arbiflex. They help restore circulation not only in the eyes, but throughout the body. To strengthen the vascular walls, it is advisable to take vitamins C, A, E, PP. As an auxiliary measure to strengthen the capillaries, procedures such as:

• magnetic therapy;
• laser;
• pneumomassage;
• acupuncture;
• color therapy.

Retinal angiopathy symptoms and clinical signs:

- deterioration and subsequent loss of vision;

- the appearance of blood in stool, urine, coughing up blood, nosebleeds, and bleeding in the stomach.

The diagnosis of retinal angiopathy is established only after examination by an ophthalmologist. The specialist evaluates all the patient’s complaints, concomitant pathologies, and conducts an additional examination (examination): Doppler, duplex scanning of retinal vessels, X-ray. This allows you to assess the speed of blood movement and the condition of the walls of blood vessels. Ultimately, the doctor makes a diagnosis and makes the final decision on the treatment of retinal angiopathy.

How and with what to treat the disease

Therapy for the disease is developed in such a way as to cure not only angiopathy, but also related problems. During this period, the ophthalmologist prescribes a maintenance treatment course that allows you to normalize intraocular pressure.

Treatment of the disease:

1. Medicinal. Tablets and injections are used to normalize blood circulation in the retinal area. They saturate tissues with oxygen and help strengthen vascular walls. Drug therapy is also prescribed to correct concomitant pathologies.
2. Physiotherapy. Sometimes cervical back massage is indicated, as well as other physiotherapeutic methods to achieve a better therapeutic result. Most often, this treatment is prescribed for diabetes mellitus. Electrophoresis, hydrotherapy, magnetotherapy, oxygen therapy, acupuncture, ultrasound and other techniques are used.
3. Surgical method. Surgery is indicated for severe forms of the disease. In most cases, it is performed using a laser, which avoids many complications after surgery. For example, it is performed in case of possible risks of retinal detachment.
4. Lifestyle changes. You will need to give up bad habits. A ban is imposed on smoking, alcohol, and junk food. You should not use salt or sugar in large quantities when preparing food. The diet should be healthy and varied, contain a large amount of vitamins and microelements. You can perform various breathing exercises and engage in therapeutic physical exercise. All this strengthens blood vessels, saturates tissues with oxygen and prevents the formation of blood clots.

Concomitant diseases will also need to be treated. The required course is selected only after a complete examination of the body.

Types of therapy, depending on the root cause of the pathology:

1. Hypertonic and hypotonic. Treatment is prescribed by a cardiologist. Drugs are used to increase or decrease blood pressure, respectively. It is also necessary to establish a drinking regime, give up large amounts of salt in food, cigarettes, and alcoholic beverages. Some pills will have to be taken for life.
2. Diabetic. With this form of the disease, you will need to completely reconsider your diet. It is recommended to give up alcohol and sugar in food. If necessary, medications are used to lower blood sugar levels, as well as insulin.
3. Traumatic. It is mandatory to wear a corrective corset for fractures. Experts also prescribe medications to normalize blood circulation and prevent oxygen starvation of tissues.

Drug and surgical therapy are individually selected in each clinical case. Since angiopathy tends to progress rapidly, treatment should be carried out immediately.

Military service

Young boys are interested in the likelihood of being drafted into the army with angiopathy of the retina of both eyes. According to the law, this pathology is considered secondary, and does not serve as a reason for obtaining a military ID outside of service.

But such a diagnosis is considered a good reason for a more complete examination of the body before the army. Since angiopathy in most cases occurs against the background of other hidden diseases, their presence can relieve one from obligations to the Motherland.

If such a diagnosis is confirmed, the conscript is sent for a full examination, which allows us to determine the main cause of the eye problems.

Symptoms

In addition to visual signs in the form of redness of the conjunctival membrane, indirect signs of angiopathy in children may include:

• narrowing of the field of view;
• blurred vision;
• painful sensations in the eyes and a feeling of pressure on the eyeballs;
• the appearance of visual anomalies before the eyes in the form of spots, floaters and fog.

Depending on the cause of angiopathy, symptoms of primary diseases may appear.

General ideas about the disease

Angiopathy is accompanied by a violation of the outflow and flow of blood to the eyeball. In addition, changes in the nervous regulation of the vascular bed play a significant role in the development of this disease.

Retinal angiopathy occurs due to the following reasons:

• type 1 diabetes mellitus;
• increased intracranial pressure;
• features in the structure of the vascular wall in newborns;
• birth injury;
• congenital diseases of the blood and other systems;
• autoimmune diseases;
• disorders during intrauterine development;
• maternal malnutrition during pregnancy;
• fetal hypoxia.

All these reasons can affect the formation of angiopathy.

Treatment principle

It is not advisable to treat angiopathy as an independent disease. It is necessary to identify the cause of the violation and take measures to eliminate it. To do this, you should undergo a comprehensive examination.

If angiopathy is caused by diseases of the spine, the patient is advised to take a course of physiotherapy and take medications that normalize cerebral blood flow.

For diabetes mellitus, it is necessary to choose the optimal regimen to lower blood sugar levels. This is true in cases where diabetes is caused by a metabolic disorder (type 2). The patient is prescribed a special diet and glucose-lowering medications. In case of type 1 diabetes, it is necessary to consult with an endocrinologist about adjusting the insulin administration regimen.

Having figured out why hypertensive retinal angiopathy appears and what it is, it becomes clear that antihypertensive drugs should be taken for treatment. If the blood supply to the retina is impaired due to hypotension, it is necessary to identify the cause of the decrease in pressure. This is usually associated with the functioning of the nervous system.

Drug therapy: tablets and eye drops

For angiopathy, measures are taken to restore normal blood flow. Along with medications to treat the underlying disease, the following medications are taken:

• Actovegin, Piracetam, Pentilin - to stimulate blood flow;
• Ginkgo Biloba – to reduce vascular permeability;
• Acetylsalicylic acid - to reduce blood viscosity;
• B vitamins to improve nervous regulation.

Additionally, the patient is advised to take vitamins and antioxidants, as well as restorative medications. Drug therapy is carried out twice a year. The duration of the course is determined by the degree of disruption of the blood supply to the retina and on average takes about three weeks.

In addition to the medications listed, the ophthalmologist selects eye drops with a vitamin composition. Popular drugs for the treatment of angiopathy are Anthocyanin, Lutein. Therapy can be supplemented with drops to improve the tone of the blood vessels of the eye (Emoxipin).

For retinal angiopathy, treatment should only be selected by a specialist. If prescribed by a doctor, treatment can be supplemented with physiotherapy aimed at improving blood circulation.

Eye drops, like tablets, cannot be prescribed to yourself

Folk remedies

In folk medicine, the treatment of angiopathy with medicinal herbs is widely used. In therapy, decoctions of chamomile, St. John's wort, and valerian are used. Such drugs have a sedative and antispasmodic effect, thereby improving blood flow. You can use folk remedies for the hypertensive form of the disease, since such preparations lower blood pressure.

Folk remedies should absolutely not be taken by pregnant women.

As practice shows, treatment of angiopathy with herbal decoctions is ineffective. Therapy of the underlying disease and strengthening of retinal vessels can stop the progression of the disorder, while folk remedies only relieve symptoms.

Varieties of the disease

Retinal angiopathy OU (OU-oculi utriusque - both eyes) can develop for various reasons. Almost always it indicates the presence of serious pathologies inside the body. Diseases are divided into several types.

• Hypertensive. The consequence of this disease is the presence of a history of hypertension. This clinical form practically does not manifest itself at stage 1. As a rule, symptoms become noticeable only after irreversible changes have occurred in the retina. Pathology can be determined by examining the fundus of the organ of vision.

Possible stages of hypertensive angiopathy:

1. initial - venous vessels will be dilated, arterioles will be narrowed;
2. angiosclerosis - the vascular walls thicken, and compression of the venous and arterial system occurs;
3. retinopathy – small hemorrhages are observed on the surface of the retina as the vessels burst;
4. neuroretinopathy - a pathological process affects the optic nerve, causing it to become swollen and uneven.

The disease can be reversible if serious disorders have not developed in the vascular system of the eyes. When hypertension occurs against the background of atherosclerosis, the progress of angiopathy will be more pronounced.

• Diabetic. As the name implies, the pathology develops against the background of severe forms of diabetes. A patient with this diagnosis experiences elevated glucose levels, which causes toxic metabolites to form in the circulatory system. This condition, in turn, leads to the formation of plaques in the blood vessels.

Forms of diabetic angiopathy:

1. microangiopathy – capillary walls become thinner;
2. macroangiopathy – thinning of the walls of larger blood vessels occurs.

When the disease occurs, tissue cells do not receive enough oxygen and hypoxia occurs, followed by hemorrhage.

• Hypotonic. This type of disease occurs against the background of hypotension (severe decrease in blood pressure). This pathology is characterized by a violation of vascular tone, which causes oxygen starvation of tissues. The arteries may be dilated and excessively tortuous.

• Traumatic. This type of angiopathy is observed after serious injuries to the upper spine and brain. Any strong combined fracture leads to a deterioration in the functioning of the circulatory system, which causes irreversible changes in the fundus of the eye.

• Youthful. This type of pathology is diagnosed in patients under 30 years of age. Most often, the cause of changes in blood circulation is serious infectious pathologies, in which the inflammatory process affects the blood vessels in the organs of vision.