The central vein of the retina, as well as its branches, are the most important vessels. At the time of occlusion, the blood flow slows down, which provokes serious complications. Pathology often affects one eye, a bilateral form is much less common. So, let's talk today about the history of the disease with thrombosis of the central vein of the retina.
Disease Central venous thrombosis develops in most cases in the elderly. As for younger patients, the disease is much less common among them.
It can even provoke a disease that, it would seem, is not directly related to the eyes. For example, here you can include focal or viral infections( pneumonia, influenza, etc.). The central vein is more often occluded, and its branches are clogged only in 30% of cases.
About the thrombosis of the retina artery, Elena Malysheva will tell in her video:
Classification of the central vein of the retina
In stages, the occlusion can be divided into several stages:
- Pretrombosis. It is characteristic that the veins become uneven in size, enlarged and convoluted. In the macular area, edema is often found, there are also small( filiform) hemorrhages. The patient can not feel the development of the ailment at all, only sometimes the vision becomes clouded, however in most cases this phenomenon is written off as a malaise.
- Initial thrombosis, in which the dashed hemorrhages spread almost to the entire retina. If they are blocked by a clot of the branch of the central vein, they are located in this area or in the basin of the central vein. At this stage, there is a more marked impairment of vision, more often the appearance of flies, fog in front of the eyes.
- Retinopathy post-traumatic develops immediately after the onset of blockage of the vein. To some extent, there is a restoration of lost sharpness and quality of vision, but very slowly. In the central zone, edema is preserved in the cyst form. Particular complexity and danger at this stage is the pathological proliferation of the vascular network, even in the area where it should not be normal.
Thrombosis of the central vein of the retina can also be of two kinds:
- Non-ischemic thrombosis. The retina is the least affected by changes in this form of the disease. In this case, visual acuity is often at a high level.
- Ischemic form. The blood flow is severely impaired, vision deteriorates significantly. On the retina a noticeably large number of edema and hemorrhages. This type of disease needs not only timely treatment, but also in constant monitoring.
The cause of thrombosis of the central branch is often diabetes, atherosclerosis, as well as hypertension. Against the background of these diseases there is a gradual thickening of the vessel, so the adjacent artery can squeeze the veins of the retina. Blood flow worsens, and this process leads to the appearance of a thrombus in his cavity. Congestion of blood negatively affects the condition of the fundus: the vessels become permeable, the hemorrhages become more extensive, the swelling appears.
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The opinion of doctors. .. & gt; & gt;
The central vein is often clogged with glaucoma, as well as in diseases that are characterized by an increase in the viscosity of the blood. A blood clot can also occur due to taking some medications( contraceptives, diuretics).
People who prefer a sedentary lifestyle, having problems with blood vessels and the heart, obesity are at risk. A special category is occupied by patients with endocrine disorders, as well as those who prefer to treat them with the help of folk methods. About the symptoms of retinal vascular thrombosis, let's talk further.
Pathology proceeds almost asymptomatically, with the exception of a gradual loss of visual acuity. If there is no proper therapy, the risk of blindness increases significantly. Sometimes there may be "blind zones"
Detection of thrombosis is difficult for a doctor of high qualification. Complete diagnostics can consist of the following methods:
- Perimetry. Especially valuable is the identification of scotoma.
- Visometry. The current visual acuity is determined.
- For the examination of the vitreous body biomicroscopy is used.
- Ophthalmoscopy helps to know the condition of the fundus. With the help of this technique, all the signs characteristic of thrombosis, whether it be a change in the veins, puffiness, new vessels or the presence of hemorrhages, are revealed.
Use, in addition to the above survey techniques, as well as laboratory studies. The ECG, blood pressure measurement, coherent optical tomography of the retina are performed without fail.
Sometimes, as a summary for the final confirmation of the diagnosis, fluorescent angiography is used.
Thrombosis treatment should be started as soon as possible, otherwise the health consequences will be serious. It will be necessary to dose the load, exclude from the diet any products that affect the level of blood pressure and are capable of provoking its increase.
One of the most important measures in the drug treatment of thrombosis is the dissolution of the clot formed, which was the reason for the blockage. Means such as gemaz and streptokinase partially contribute to this, but more help to resolve hemorrhages.
For the full treatment use the drugs of the groups that are on the following list:
- Fibrinolytics. Restore the damaged parts of the vessels.
- Hypotensive drugs. Often the impetus for the development of pathology becomes unstable blood pressure, so you need to apply the appropriate medications. Many of the drugs have the ability to reduce swelling. The greatest efficacy of injections, but in addition to them are often used antihypertensive drops.
- Vitamin preparations. Particular attention is paid to vitamin B and C, as they play a special role in the treatment of pathology.
- Hormonal drugs are used in the presence of indications, not only systemically, but also locally. This group of drugs is needed to reduce not only swelling, but also inflammation.
- Antiaggregants are used to eliminate the risk of recurrent thrombosis. These funds necessarily require monitoring of blood coagulability.
Injections of diprospan and dexamethasone are necessary if swelling of the vessels is formed. Also helps to reduce puffiness and stop the formation of new blood vessels ozurdex and lucentis. In many cases, use Trental or rheopolyglucin, as they help restore blood microcirculation.
Laser intervention can hardly be considered a full-fledged operation, however its role is very great. It is with the help of the laser that all the new vessels coagulate.
Thus, permanent hemorrhages are eliminated and the treatment gives a greater effect. Laser coagulation is used after the end of medical treatment.
The main preventive measures are the constant monitoring of blood pressure, as well as the exclusion of the probability of falling into a risk group. For this it will be enough not to miss the medical examination, actively engage in sports and not overload the body with harmful products.
In central venous thrombosis, complications develop with incorrect or untimely treatment. In such cases, there may be the appearance of glaucoma, nerve atrophy, retinal neovascularization, its subatrophy or dystrophy, retinal hemorrhages.
Against the background of all these complications, vision can seriously deteriorate.
A favorable prognosis is almost always provided with timely therapy. The development of various complications begins only under the influence of inadequate treatment.
In the next video, the doctor will tell more about retinal vein thrombosis: