Diseases of the blood and eye changes

Diseases of blood affect all systems and organs, including the organ of vision.

With anemia (aplastic, hypochromic, pernicious, secondary), paleness of the skin and mucous membranes, hemorrhages under the conjunctiva and in the thickness of the eyelids, which are based on hypoxia of the tissues, may lead to the paralysis of the external muscles of the eyeball. Characteristic symptoms are vasodilatation of the retina, vascular microaneurysms, hemorrhage in the form of bands, swabs along the vessels or rounded, if they are located in the outer layers of the retina. Most often, hemorrhages concentrate around the optic nerve and the yellow spot. Preretinal hemorrhages and hemorrhages in the vitreous can be observed. The most severe manifestations of anemia are exudation in the form of a star in the macular area, as well as exudative retinal detachment and congestive optic nerve disk.

With leukemia, there is a violation of microcirculation in the vessels of the conjunctiva of the eyeball. It manifests itself in the unevenness of the caliber and the tortuosity of the veins, the formation of single aneurysms. As the process progresses, the arterioles narrow down. In some patients, microtroma of conjunctival veins are detected. In the late stages of the disease, almost half of the patients have subconjunctival hemorrhages, more pronounced in chronic myeloblastic leukemia.

A peculiarity of the condition of the fundus in leukemia is the general pale background with a yellowish tinge, the decoloration of the optic nerve disk is noted, the streak of its borders due to peripapillary retinal edema. In acute leukemia, 15% of patients have a congestive optic nerve disc. Retinal vessels are pale, accompanied by white bands. With chronic lymphocytic leukemia, the earliest changes in the vessels are the expansion and tortuosity of the retinal veins, the unevenness of their caliber.

As the process progresses, the arteries of the retina narrow down, and in the terminal stage - their expansion (a prognostically unfavorable sign). Hemorrhages oval or round, bordered by a reddish ring, are characteristic only of leukemia. There may also be preretinal hemorrhages. The cause of hemorrhages are thrombocytopenia, anemic dis-proteinemia and anticoagulant effect of globulins.

With myeloid leukemia in the retina there are many nodules rising above its surface, surrounded by a hemorrhage ring - myeloma. The same formations exist in the bones, the dura mater, but they can not be seen there. The ocular bottom is pale, the disc of the optic nerve is difficult to detect. The tone of the vessels is reduced, the artery can not be distinguished from the vein: visual acuity decreases with centrally located myelomas and hemorrhages.

Often, eye symptoms are detected earlier than other clinical manifestations of the disease.

Treatment of ocular manifestations is carried out together with a hematologist. With massive hemorrhages in the retina, the general treatment is supplemented with angioprotectors (dicynon, ascorutin) and corticosteroids (locally - dexazone in drops).

In the stage of improving the general condition of patients, the condition of the organ of vision is also improved. The tendency to resorption of hemorrhage into the retina is established.

With hemorrhagic diathesis there is a general increased bleeding. Hemorrhages are found in the conjunctiva and in the inner layers of the retina near the optic nerve disc. Hemorrhages are often accompanied by exudation.

With erythremia, microcirculation is disturbed due to a change in the rheological properties of the blood, which leads to the formation of thrombi in both small and large retinal vessels. The disc of the optic nerve is swollen, red, the veins are convoluted and dilated, around them there is a large number of hemorrhages. Arteries are not changed. The ocular bottom is dark, cyanotic. The study of changes in the fundus of the eye in case of blood diseases makes it possible to establish a diagnosis in a timely manner, monitor the dynamics of the process and the effect of drugs, and evaluate the prognosis.

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