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Eye damage in rheumatism
Last reviewed: 23.04.2024
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At the root of tissue changes in rheumatism is the systemic disorganization of connective tissue, the deepest in the heart and vessels, in combination with specific exudative-proliferative reactions and the defeat of the vessels of the microcirculatory bed, which are found in all organs.
Changes in the organ of vision in rheumatism are most often manifested in the form of toxic-allergic uveitis, vasculitis and retinovasculitis, which can affect both the arteries and veins of the retina and proceed according to the type of peri-and panangiitis.
Arterioles and arteries develop destructive-proliferative vasculitis, perivascular cell infiltration, sometimes plasma impregnation, fibrinoid swelling and necrosis of the vessel wall, less often thrombosis.
With retinoskulitah around the vessels of the 2-4th order, grayish couplings and pinpoint hemorrhages are formed. Couplings can cover several vessels. Due to macular edema, a slight decrease in visual acuity is possible.
For rheumatism, a tendency to intravascular thrombosis is characteristic, and therefore a central artery or vein of the retina can be obstructed. In such cases, a significant decrease in visual acuity is noted.
The diagnosis of rheumatic vasculitis is easier to establish if there are cuffs or cuffs that are located on one side of the vessel and which look like snow on a tree branch, a pathognomonic symptom of rheumatism. With the widespread defeat of arteries and veins involving the process of vascular branches on the optic nerve disk, the course of rheumatic perivasculitis is very difficult.
On the optic disc, exudate may appear, covering the vascular funnel and most of the disk surface in the form of a grayish cap. Multiple hemorrhages in the retina, fibrin deposits and sometimes the figure of a star in the macular area are possible.
Early treatment (with a rheumatologist) leads to a reverse development of the process and recovery of vision. In children, rheumatic retinopathy rarely develops.
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