Venous thrombosis of the retina - Causes, Symptoms and Treatment .MF .
Venous thrombosis of the retina - is an acute circulatory disorder in the central vein or its branches.
Thrombosis of central retinal vein
Causes of retinal thrombosis
veins arises due to blockage of a vessel that may be caused atherosclerosis, hypertension, diabetes, most often at the races in blood pressure and blood sugar.Young people to thrombosis may cause infectious diseases such as influenza, sepsis, focal infection of the oral cavity and paranasal sinuses.Also in the development of retinal vein thrombosis have ocular value (increased intraocular pressure), swelling of the optic nerve, the external pressure on the eyeball (the tumor).
sedentary lifestyle, obesity, heart disease and blood vessels, endocrine disorders, especially when inadequate treatment.
symptoms of thrombosis
retinal vein disease develops gradually and results in a complete loss of vision only at late begun treatment.Thrombosis of the central vein branches are often detected by chance during routine
occlusion types: non-ischemic (visual acuity above 0.1) and ischemic (extensive retinal hemorrhages, large areas of the absence of capillary perfusion determined during fluorescein angiography).
are several stages:
1. Stage pretromboza - enlarged, twisted, stagnant veins uneven caliber shtrihoobraznye sporadic bleeding, possible swelling of the macular area.Complaints may be absent, sometimes slightly reduced visual acuity, and there are periodic blurred vision.
2. Thrombosis of central retinal vein or its branches - the fundus appear shtrihoobraznye hemorrhages throughout the retina (if struck central Vienna) or in a pool of one or more branches, soft exudates, optic disk border unclear or not defined, swelling inmacular area may vitreous hemorrhage.There are typical complaints: decreased visual acuity to counting fingers, appearance scotoma (loss of the field of view), the veil, the fog before his eyes.
3. Postthrombotic retinopathy - comes a few months after vein thrombosis.Visual acuity is slowly recovering.In the fundus determined old hemorrhages, hard exudates, newly formed vessels.In the central zone of cystoid macular edema in the optic nerve head neovascularization (abnormal growth of blood vessels, where normally they should not).
4. Possible repeated thrombosis of the central retinal vein or its branches .
Diagnostics retinal vein thrombosis
The diagnosis is not too difficult.Use the following methods:
- visometry - may be the visual acuity of the rules to account fingertips,
- perimetry - may cause scotoma,
- biomicroscopy - possible clouding of the vitreous,
- ophthalmoscopy, including examination with Goldman lens - onfundus - syndrome "crushed tomatoes" -shtrihoobraznye hemorrhage in all or part of the retina, its swelling, the veins dilated and tortuous, newly formed vessels,
- fluorescence angiography - for the final diagnosis.
- Optical coherence tomography,
- general blood tests, urine tests, blood glucose, coagulation time of blood coagulation, cholesterol, lipids, protein fractions,
- measurement of blood pressure, ECG,
-consultation of the therapist, cardiologist, neurologist, endocrinologist may be needed.
thrombosis Treatment of retinal vein
Treatment should be initiated immediately after diagnosis.Groups of drugs that are prescribed for thrombosis, retinal vein:
- antihypertensive drugs .Often the cause of thrombosis is high blood pressure.Assign nifedipine or fenigidin 1 tablet under the tongue, intravenous papaverine and Dibazolum, Lasix intramuscular injection, which, in addition to lowering blood pressure, reduces retinal edema.To reduce the pressure on the blood vessels of the retina from the outside, dig hypotensive drops, such as timolol 0.5% (Arutimol, Kuzimolol).
- fibrinolytic to restore blood flow in the affected vessels - parabulbarno plasminogen (an injection under the eyes) of 0.5 ml daily for 1-2 weeks
- direct anticoagulants, such as heparin, fibrinolytic shown after treatment is administered at 500 IU parabulbarno5 days.
- antiplatelet agents used for the prevention of recurrent thrombosis.For example, acetylsalicylic acid (aspirin), clopidogrel (Plavix) and others. Necessarily under the control of indicators of blood coagulation.
- hormonal drugs are used topically and systemically.They reduce inflammation and swelling.Parabulbarly injected Dexon 1-2 ml per day for 7-10 days.It is also possible intravenous drip every other day for 1-2 weeks.
- to improve microcirculation used intravenous infusion reopoliglyukina and pentoxifylline (Trental).
- angioprotectors (etamzilat, Dicynonum, emoksipin).
- antispasmodics (papaverine, no-spa, Riabal).
- vitamins (C, B).
retinal laser coagulation spend a few months, while increasing macular edema delimit a central zone of the affected vessels.
forecast disease in a timely begun treatment favorable.When inadequate therapy may develop subatrophy and optic nerve atrophy, degeneration of the central area of neovascularization of the retina, retinal hemorrhages, and recurrent hemophthalmus, secondary glaucoma.
Ophthalmologist Letyuk TZ