Kidney Disease and Eye Changes
Last reviewed: 23.04.2024
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In chronic glomerulonephritis, changes in the retinal vessels are frequently observed-narrowing of the retinal arteries (renal antiopathy). With prolonged course of kidney disease, sclerotic changes occur in the walls of the vessels, renal retinopathy develops in the retina. Renal retinopathy is characterized by narrowing of the retinal vessels and sclerosing them, there is retinal edema around the optic disc and in the central part of the fundus. In the macular region, multiple small foci form a star shape. Renal retinopathy can be complicated by hemorrhages or retinal detachment. With worsening of the kidneys, retinopathy can go to the third stage - renal neuroretinopathy, in which the ophthalmoscopic picture resembles that of neuroretinopathy in hypertensive patients. The disc of the optic nerve is edematous, its boundaries are indistinct, the retina is edematous, hemorrhages in the area of the yellow spot, foci of exudate in the form of a star. This is always a poor prognostic sign for the patient's life.
Kidney diseases, especially chronic glomerulonephritis, often cause changes in the retinal vessels. Even with a short duration of the disease, narrowing of the retinal arteries is noted, which is considered the beginning of the development of renal angiopathy. With the long course of the disease, sclerotic changes occur in the walls of the vessels, the retina is involved in the pathological process and renal retinopathy develops, the consequences of which are heavier than in hypertensive disease.
With renal retinopathy, the retinal vessels are narrowed and moderately sclerosed, there is retinal edema around the optic nerve disc and in the central part of the fundus. A large number of superficial, flocculent white exudative foci are characteristic. In the macular region, multiple small foci form a star shape, which is characteristic of this pathology.
Renal retinopathy can be complicated by hemorrhages or retinal detachment, complete or partial. With acute glomerulonephritis, there are no such gross changes on the fundus and changes in the retina may undergo reverse development, although often degenerative changes both in the retina and in the optic nerve are preserved.
With worsening of the kidneys, retinopathy can go to stage III - renal neuroretinopathy, in which the ophthalmoscopic picture resembles that of neuroretinopathy in hypertensive patients. The disc of the optic nerve is edematous, its boundaries are indistinct, retinal edema, hemorrhages, foci of exudate are almost always located in the region of a yellow spot in the form of a star. This is always a poor prognostic sign for the patient's life.
Changes in the yellow spot in the form of a star can appear after acute infections - influenza, meningitis, measles, tuberculosis, syphilis, and also with focal infections. In such cases, the pathological changes in the retina are reversible.
Treatment is carried out together with a nephrologist. Locally used funds that promote the strengthening of the vascular wall (dicinone, prodectin) and improve the trophic processes (ATP, vitamins A, B, C).
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