Types and symptoms of retinal angiopathy

Initial retinal angiopathy is the first stage of the disease. In many cases, angiopathy during this period of time proceeds without any symptoms noticeable to the patient. But soon, as the disease progresses, peculiar "flies", dark spots before the eyes, flashes of light, etc. appear. But visual acuity still remains normal, and when examining the fundus, changes in the eye tissues are not yet noticeable.

It can be said that at the first stage of the disease all processes can be reversed, that is, to make sure that the eye vessels are restored. In this case, there will be no disruption of the structure of the eye tissues, and visual acuity will remain normal, the same as before the disease.

For this purpose, it is necessary to start treatment of both the vascular problems themselves and the underlying disease that caused this serious complication in a timely manner. Only in this case, at the initial stage of the process, can the progression of negative changes in the eyes be stopped.

All of the above applies to cases of the disease caused by hypertension. In diabetic angiopathy, which is provoked by diabetes mellitus, even at the initial stage, the processes of destruction of blood vessels in the eyes become irreversible.

There are three degrees of retinal angiopathy.

Angiopathy of the retina of both eyes

Since angiopathy is a consequence of other systemic diseases of the body and affects vessels throughout the human body, it is almost always observed in both eyes of a person.

Angiopathy of the retina of both eyes is a disorder of the structure and functioning of blood vessels, which leads to various problems with the eyes and vision, depending on the degree of the disease itself. Progressive myopia or blindness, as well as glaucoma and cataracts of the eyes, may occur.

The causes and symptoms of the disease, which can be diagnosed, were described in the previous sections. Also, for vascular problems in both eyes, it is typical to divide into diabetic, hypertensive, traumatic, hypotonic and juvenile, which also occur in the case of retinal vascular disease in one eye. At the same time, the treatment of this problem is also associated, first of all, with improving the general condition of a person and getting rid of the underlying disease. Of course, symptomatic local treatment is also important, which will maintain the condition of the eye vessels in some stability, preventing irreversible changes.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Angiopathy of the retina grade 1

In hypertension, there are several stages of angiopathy, which were caused by problems with high blood pressure. This classification arose due to the degrees of damage to the eye vessels that are observed with this complication. There are three stages of the disease - the first, second and third. It is possible to find out at what stage the disease is only by ophthalmological examination of the patient's fundus.

The process of vascular changes in hypertension is characterized by the dilation of the veins of the fundus, as they overflow with blood. The veins begin to twist, and the surface of the eyeball becomes covered with small pinpoint hemorrhages. Over time, hemorrhages become more frequent, and the retina begins to become cloudy.

The first degree of angiopathy is characterized by the following changes in the eyes, which are called physiological:

• the arteries located in the retina begin to narrow,
• the retinal veins begin to dilate,
• the size and width of the vessels becomes uneven,
• there is an increase in the tortuosity of the vessels.

Angiopathy of the retina of the 1st degree is a stage of the disease, at which the processes are still reversible. If the cause of the complication itself is eliminated - hypertension, then the vessels in the eyes gradually return to normal, and the disease recedes.

Moderate retinal angiopathy

Moderate retinal angiopathy is the second stage of the disease, which occurs after the first stage.

In the case of second-degree retinal angiopathy, the appearance of organic changes in the eyes is characteristic:

• the vessels begin to differ more and more in width and size,
• the tortuosity of the vessels also continues to increase,
• in color and structure, the vessels begin to resemble light copper wire, because the central light stripes located along the course of the vessels become so narrow,
• with further progression of narrowing of the light strip, the vessels resemble a kind of silver wire,
• the appearance of thrombosis in the retinal vessels is observed,
• hemorrhages appear,
• characterized by the occurrence of microaneurysms and newly formed vessels, which are located in the area of the optic nerve disc,
• the fundus of the eye is pale upon examination, in some cases even a waxy tint is observed,
• a change in the field of vision is possible,
• in some cases there are disturbances of light sensitivity,
• blurred vision occurs,
• visual acuity begins to decrease and myopia appears.

The first two have already been discussed in previous sections. Now let's touch on the third and most severe stage of the disease.

3rd degree retinal angiopathy

At this stage of the disease, the following symptoms and manifestations are observed:

• the appearance of retinal hemorrhages,
• the occurrence of retinal edema,
• the appearance of white spots in the retina of the eye,
• the occurrence of blurring that defines the boundaries of the optic nerve,
• the appearance of optic nerve edema,
• severe deterioration in visual acuity,
• the occurrence of blindness, that is, complete loss of vision.

[ 5 ], [ 6 ], [ 7 ]

Hypertensive angiopathy of the retina

Hypertension is a disease characterized by periodic or constant increases in blood pressure. One of the main causes of the disease is the narrowing of small vessels and capillaries throughout the vascular system, which leads to difficulty in blood flow. And so the blood begins to press on the walls of the vessels, which leads to an increase in blood pressure, since the heart makes more effort to push blood through the vascular bed.

Hypertension causes various complications in the human body, such as heart disease, brain disease, kidney disease, etc. Vascular diseases of the eyes, namely, the retina, one of which is angiopia, are no exception.

With this disease, the veins begin to branch and expand, frequent pinpoint hemorrhages appear, which are directed to the eyeball. Clouding of the eyeballs of one or both eyes may also be observed.

If you take steps to treat the underlying problem and achieve good results and a stable condition, hypertensive retinal angiopathy will go away on its own. If you neglect the disease, it can result in serious vision problems and other eye problems.

Retinal angiopathy of the hypertensive type

This type of disease is characterized by a deterioration in visual acuity, expressed in blurred vision in one or both eyes. Myopia may also develop, which progresses as the patient's condition worsens with hypertension.

Hypertensive type retinal angiopathy occurs as a complication of hypertension. With this disease, the pressure on the walls of blood vessels increases so much that it leads to problems in various organs of the human body.

Eyes are no exception, and they begin to experience difficulties in functioning. This especially concerns the retina, in the vessels and tissues of which degenerative changes begin to occur.

[ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ]

Hypotonic angiopathy of the retina

Hypotension, that is, a strong decrease in blood pressure, is observed in a disease called arterial hypertension. In this case, the pressure drops so much that this process becomes noticeable for a person and leads to a deterioration in well-being.

There are two types of arterial hypertension - acute and chronic. In the acute condition, manifestations of collapse can be observed, in which the vascular tone drops sharply. Shock may occur, which is characterized by paralytic vasodilation. All these processes are accompanied by a decrease in oxygen supply to the brain, which reduces the quality of functioning of vital human organs. In some cases, hypoxia occurs, which requires immediate medical care. And in this case, the determining factor is not the pressure in the vessels, but the rate of its decrease.

Hypotonic angiopathy of the retina is a consequence of arterial hypertension and manifests itself in a decreased tone of the vessels of the retina. As a result, the vessels begin to overflow with blood, which reduces the speed of its flow. Subsequently, blood clots begin to form in the vessels due to blood stagnation. This process is characterized by a feeling of pulsation, which is observed in the vessels of the eyes.

Hypotonic type retinal angiopathy

Usually, this type of complication disappears with proper therapy of the underlying disease. The tone of the vessels of the whole body improves, which also affects the condition of the eye vessels. The blood begins to move faster, blood clots stop forming, which affects the improvement of the blood supply to the retina, the eyeball, and so on.

Hypotonic angiopathy of the retina is caused by the main human disease - hypotension. In this case, there is a decrease in the tone of the vessels of the whole body, and, in particular, the eyes. Therefore, the blood begins to stagnate in the vessels, which leads to the appearance of blood clots in these vessels. Thrombosis of capillaries and venous vessels causes various hemorrhages in the retina and eyeball. Which leads to visual impairment, as well as other eye problems.

[ 14 ], [ 15 ], [ 16 ]

Mixed type retinal angiopathy

With this type of disease, pathological changes begin to appear in the vessels of the eyes, which are caused by dysfunctions in the regulation of their activity by the autonomic nervous system.

Mixed-type retinal angiopathy is an eye disease caused by systemic diseases of a general nature that affect the vessels of the entire body. In this case, the capillaries and other vessels that are located in the fundus are subject to disturbances first of all.

This type of vascular dysfunction can lead to very serious consequences for a person’s vision, such as its deterioration or loss.

This form of complication occurs in all age categories of patients, since systemic diseases are characteristic of any age. However, an increase in cases of angiopathy has been noted in people who have crossed the thirty-year age limit.

Usually, the condition of the retinal vessels begins to return to normal during therapy of the underlying disease. This concerns not only the vascular system in the eyes, but also blood circulation throughout the body. In this case, treatment should be comprehensive, taking into account the therapeutic and ophthalmological diagnoses.

[ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ]

Dystonic retinal angiopathy

This type of complication is characterized by serious visual impairments, which can manifest themselves in the active development of myopia. In some cases, even complete loss of vision is observed. Problems with eye vessels and deterioration of vision usually affect people after thirty years of age.

Dystonic angiopathy of the retina is a complication of another pathology that occurs in the human body. At the same time, this dysfunction affects all the vessels of the circulatory system, the eye vessels suffer no less, and sometimes even more.

The patient's condition is characterized by symptoms such as the appearance of a veil before the eyes, the presence of pain or discomfort in the eyes, the appearance of flashes of light in the eyes, deterioration of visual acuity, and the appearance of local hemorrhages that occur in the eyeball.

If such symptoms are observed, a person should definitely consult an ophthalmologist to find out the cause of vision problems and select an appropriate treatment plan.

[ 23 ], [ 24 ], [ 25 ]

Diabetic retinal angiopathy

Diabetes mellitus is a group of diseases caused by disorders in the endocrine system. In this case, there is a deficiency of the insulin hormone, which plays an important role in regulating metabolic processes in the body, for example, in glucose metabolism, etc. But these are not the only dysfunctions caused by this disease. Not only glucose metabolism is disrupted, but all types of metabolic processes suffer - fat, protein, carbohydrate, mineral and water-salt.

Diabetic angiopathy of the retina occurs as a complication against the background of diabetes mellitus. Blood vessels are affected due to the neglect of the disease and its impact on all tissues of the body. Not only small capillaries located in the eyes suffer, but also larger vessels throughout the human body. As a result, all vessels narrow, and blood begins to flow much more slowly. As a result, the vessels become clogged, leading to problems in the tissues that they should supply with nutrients and oxygen. All this causes metabolic disorders in the eyes, namely in the retina, which is most sensitive to vascular dysfunctions. In such a situation, visual impairment, myopia and even blindness are possible.

[ 26 ], [ 27 ], [ 28 ]

Background retinal angiopathy

The causes that cause dystrophic changes in the retina are the following problems: poisoning of the body, the presence of arterial hypertension, the appearance of autoimmune vasculitis, genetically determined problems with the walls of blood vessels, eye and cervical spine injuries, various blood diseases, the presence of diabetes, constant working conditions with high eye strain, high intracranial pressure.

Background angiopathy of the retina got its name because it occurs against the background of various diseases. In this case, changes occur in the walls of the vessels, which affect their normal functioning. There is a violation of blood circulation in the eyes, which becomes a chronic dysfunction. Such changes in the vessels become the causes of persistent visual impairment, which in many cases are irreversible. Some patients experience complete loss of vision.

[ 29 ], [ 30 ], [ 31 ], [ 32 ], [ 33 ]

Retinal venous angiopathy

The blood begins to flow more slowly, and sometimes stagnates, which leads to blockage of blood vessels, the appearance of blood clots, and the occurrence of hemorrhages in the eyeball. The veins also begin to change their shape, expand and twist along their entire length. Later, changes in the structure of tissues begin to occur in the retina.

Venous angiopathy of the retina is a complication of systemic diseases of the body, which manifests itself in a violation of venous blood flow.

With such problems with the eye veins, the patient may experience various visual impairments. For example, there may be clouding in the eyes, slight or constantly progressing myopia. To eliminate problems with the eye veins, it is necessary to treat the underlying disease in combination with the treatment of the vascular disorders themselves.

Symptoms of this type of angiopathy are observed in hypertension, which caused such a complication in the vessels of the eyes.

Traumatic retinal angiopathy

Any injuries, even seemingly minor ones, can lead to serious complications and health problems. For example, cervical spine injuries, brain injuries, and sharp compressions in the chest often lead to complications in the eye organs.

Traumatic angiopathy of the retina is characterized by narrowing of the vessels in the eyes due to compression of the vessels of the cervical region. Also, the consequences of injuries are an increase in intracranial pressure, which can become permanent and affect the tone of the retinal vessels. Subsequently, the patient develops visual impairments, which are expressed in its constant and steady deterioration, called progressive myopia.

The mechanism of occurrence of this complication is as follows: sharp and sudden compression of the vessels of the body leads to spasm of arterioles, which causes hypoxia of the retina, during which transudate comes out. Some time after the injury, organic changes in the retina appear, which are accompanied by frequent hemorrhages.

In this disease, lesions are often not only in the retina, but also atrophic changes in the optic nerve.

Contusions cause changes in the eyes, which are called Berlin's retinal opacities. In this case, edemas appear, which affect the deep retinal layers. Signs of subchoroidal hemorrhage, in which transudate comes out, are also observed.

To sum up, we can say that with the traumatic form of angiopathy, the retina is shaken. This is caused by damage to the optic nerve, namely, its thin cribriform plate. Damage to the plate occurs because sharp blows provoke it to shift back, which causes hemorrhages in the retina and the appearance of edema in the optic nerve disc.