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Peripheral retinal dystrophy (PD) is a pathological condition in which gradual destruction of eyeball tissue.
The disease is accompanied by decreased vision up to its complete loss. Over a long period of time, the pathological process can develop in an asymptomatic form.
With a standard ophthalmological examination, the initial stages of retinal dystrophy are not always possible to identify. The disease can provoke irreversible processes. Therefore, treatment must be started as early as possible.
Numerous internal and external factors can provoke the disease. PD eye occurs regardless of gender or age patients.
Some of its forms are classified as congenital pathological processes.
In most cases, peripheral dystrophy develops against the background of progression of existing diseases organs of vision (for example, with myopathy) or pathologies associated with poor circulation in the eyeball.
Causes of the disease:
Reference! PD can be provoked not only by pathological processes in the body, but also long-term abuse of bad habits, serious errors in nutrition, uncontrolled use of potent drugs with side effects that affect the organs of vision.
Intensity symptoms PD of the eyes directly depends on the stage of development of the pathology.
At its initial stages, the patient may notice minor deviations, for example, in the form of “flies” before the eyes.
Gradually symptoms intensifies and is complemented by other signs.
In the presence of complications, the patient exhibits a combination of characteristic signs of eye dystrophy.
Symptoms of the disease:
Important! The disease can be triggered by complications after surgery. The causes of PD are doctors' mistakes or individual characteristics the patient's body.
Damage to the tissue of the eyeball occurs in different ways. Depending on the degree of damage and morphological changes that occur with the progression of pathology, peripheral retinal degeneration divided into two main types.
Identifying the specific type of disease is necessary to make a prognosis and prescribe the most effective course of therapy for the patient.
Classification of the disease depending on morphological changes in tissues:
Classification of types of peripheral retinal dystrophy is carried out depending on the type of morphological changes, the degree of retinal detachment and other factors. Exists several types of pathological process, the most common in medical practice, each of which has its own characteristics of symptoms and prognosis for the patient.
On the fundus of the eye, a specific pattern is formed in the form of a mesh, formed from atrophied vessels to which blood has stopped flowing. Can provoke pathology retinal detachment. Its danger lies in the risk of the formation of cysts that have the ability to rupture. At risk are male patients. The disease progresses at a slow pace.
Photo 1. Lattice retinal dystrophy leads to the formation of cysts, which subsequently rupture.
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The pathology got its name due to the similarities of the dystrophic changes with the trace that the snail leaves behind. Well visible in the fundus peculiar perforated defects merging into ribbons of different widths and lengths. The pathological process provokes extensive ruptures. The disease develops due to myopic disease or cribriform complications retinal dystrophy.
Frost-like dystrophy is one of the pathologies that can transmitted at the genetic level. The development of the disease provokes the appearance on the retina specific formations resembling snow flakes. Inclusions rise above its surface and are clearly visible using ophthalmological equipment. Dystrophy is bilateral and develops in a symmetrical form.
Pathology in most cases is diagnosed in patients with myopathy. This type of dystrophy is characterized by formation of white ring defects.
The oblong shape of the formations and their large number visually resemble a cobblestone pavement, which is how the disease got its name.
Small cystic dystrophy is accompanied by the formation small cysts with the ability merge with each other. At the place of their connection, in the event of a rupture, deep perforated defects. Cysts have rounded shape and characteristic Red color.
Pigmentary dystrophy is characterized by disturbances in central and color vision. Its first manifestation is impairment of the ability to clearly see objects at dusk. A complication of this pathology can be loss of not only vision, but also hearing.
In most cases the pathology is inherited and is congenital. The acquired form develops predominantly in patients old age or against the background of progression myopathies. With retinoschisis occurs delamination retina of the eye.
Diagnosis of PD is complicated by the ability of the disease to develop asymptomatic for a long time.
Detection of the disease can occur when other diseases are diagnosed or in the presence of complications in the form of tears in the retinal tissue (the patient consults an ophthalmologist with complaints of “flashes,” “floaters,” or “fog” before the eyes).
When diagnosing PD, the following methods are used:
Some types of PD not treatable. This feature of the pathology is due to the degree of degenerative changes that lead to the progression of the disease. The goal of therapy is maximum vision restoration and prevention of its further decline.
General principles of treatment of peripheral dystrophy are the same for all its forms. The therapy complex includes the use medications, laser therapy and surgery.
Treatment options for different types of PD:
Photo 2. Eye drops Taufon 40 mg/ml, 10 ml, from the manufacturer Farmak.
Dystrophic processes in eye structures most often develop in the peripheral zones of the retina. Scientific language calls them peripheral retinal degenerations.
Such processes are dangerous for the eye both due to their consequences and late diagnosis due to the peculiarities of the eye structure.
With dystrophic changes, areas of the retina gradually become thinner. Tension zones form between the vitreous body and the retina, as a result of which it ruptures in some places. Through this hole, fluid components of the vitreous pass under the retina, which lifts the retina and detaches it.
So, as a result of degenerative processes, retinal detachment occurs - the most dangerous eye disease, which, moreover, does not immediately make itself felt by the manifestation of symptoms. Another problem with peripheral degeneration is the location of the area of the pathological process. It is located behind the “equator” of the eye, so it can be difficult to see during a routine ophthalmological examination.
This pathology occurs in people of all ages, including children. Some vascular, inflammatory and other changes in the structures of the eye lead to retinal dystrophy. Very often it is observed in nearsighted people. In this case, degenerative changes occur due to elongation of the eyeball. The main cause of dystrophic changes is a hereditary predisposition.
Also among the reasons:
Common diseases:
Lattice degeneration, in which the degenerative process is clearly localized. Varieties: cochlear trace, when degeneration occurs in the form of a white stripe, palisade - zones of degeneration are defined as white strokes. In the problem area, fusion with the vitreous occurs. Lattice degeneration is most often bilateral.
The primary diagnosis is made by an ophthalmologist at the clinic. To do this, you need to conduct an ophthalmological examination, which includes:
Laboratory tests of blood and urine are required.
Treatment is carried out in an ophthalmological hospital. It can be surgical or laser. Moreover, laser technologies are becoming more and more widespread every year, as they allow treatment to be carried out as quickly and accurately as possible.
Mandatory treatment is prescribed for lattice degeneration. Cystic and cobblestone degeneration require treatment when the patient complains of photopsia, when myopia progresses and significant retinal detachment is detected, or when there is blindness in the eye affected by peripheral dystrophy. In other cases, recommendations are given for maintaining eye health and regular monitoring of the condition of the retina.
Most often, preventive laser coagulation is performed for treatment. With its help, areas of dystrophy and healthy tissue of the eye are distinguished, a new line of attachment of the retina and fundus is created. As a result, the risk of its detachment is significantly reduced, which means that the patient’s vision is preserved. The success of treatment directly depends on the timing of receiving specialist help.
Peripheral retinal dystrophy is a pathological disease in which the tissues inside the eyeball undergo changes due to poor circulation. At the very beginning, the disease occurs without obvious symptoms.
Anatomically, the retina of the eye is a thin layer of nerve cells whose main function is to project images to the brain using optic nerves.
Next, the received information is processed in the visual cortex of the brain and interpreted. The cells inside the retina are light sensitive and are able to capture any images that come into view.
If for any reason these cells begin to die, then changes occur in their structure. This is how their degeneration begins, leading to dystrophy. Externally, a person feels these changes through a general deterioration of vision.
The rate of progression and severity of the disease depend on what type of dystrophy develops. If retinal diseases are not treated, this can lead to serious visual impairment and even complete loss of vision.
The destruction of cells in the retina occurs very slowly. This occurs due to damage to the blood vessels inside the eye. As blood flow deteriorates, mineral and oxygen metabolism is disrupted. Photoreceptors gradually die off. The great danger of this pathology lies in its asymptomatic nature.
In addition to deterioration of vision, the patient does not feel physical pain and other signs until the moment when degenerative changes become irreversible. It is difficult to detect peripheral dystrophy even during a doctor’s examination of the fundus.
The periphery of the retina is most often affected in nearsighted people. The reason for this phenomenon lies in their physiological characteristics of the structure of the eye. Since the eyeball in myopia has an elongated shape, this causes tension on the retina and its subsequent thinning.
In addition, people over the age of 60 who suffer from obesity, hypertension, diabetes, and atherosclerosis are at risk. All these diseases are associated with dysfunction of the cardiovascular system.
Dystrophic changes in the retina can be provoked by constant stress, viral diseases, bad habits, poor lifestyle, and insufficient intake of vitamins and important microelements.
Often, peripheral retinal dystrophy can develop in women during pregnancy. This is due to changes in blood pressure levels and a decrease in blood flow to the vessels of the eyeball. Sometimes the pathology is inherited.
Peripheral retinal dystrophy is of two types, depending on how morphological changes occur in its tissues:
Based on the nature of pathological changes, the following types of peripheral dystrophy are distinguished:
With age, the body's metabolic process is gradually disrupted, which leads to the accumulation of many wastes and toxins. Exposure to viruses and pathogens, frequent intoxications, and infectious diseases provoke disruptions in the functioning of the cardiovascular system.
The blood flow does not sufficiently supply oxygen and nutrients to the tissues of the eyeball, which becomes the prerequisite for pathological changes.
There are both general and private causes of the disease.
The biggest danger is that peripheral retinal degeneration does not have pronounced symptoms. Most often, doctors find pathology by chance when examining a patient in connection with other ophthalmological diseases.
Only after tears have occurred in the retinal tissue does a person begin to see flashes, large spots, etc. All these symptoms require immediate contact with a specialist.
Diagnosing developing pathological processes in distant parts of the eyeball is not so easy. This is simply not possible during a routine examination.
Scleropression is the most reliable way to confirm the diagnosis. However, it is painful and uncomfortable. During the procedure, the doctor moves the retina to the middle and thus can observe the condition of the tissues inside. The process involves photographing the fundus using a slit lamp.
If changes in the retina are minor, then treatment is not required. But the patient will definitely be under the supervision of a doctor. If the process of development of pathology begins to progress, then it will be necessary to begin treatment.
There are general and specific methods. General measures are carried out regardless of the type of pathology. Since it is impossible to completely eliminate degenerative changes in tissues, treatment is aimed at stopping this process and partially improving the patient’s vision. This way only the symptoms are eliminated. To do this, doctors use medications, laser therapy and surgery.
Medicines are taken in courses, which are carried out 2 times a year. If hemorrhage occurs in the eye, then Heparin, aminocaproic acid and other similar drugs are administered to eliminate the hematoma. Edema is eliminated with Triamcinolone injections.
Physiotherapy procedures give good results in the treatment of peripheral retinal dystrophy: electrophoresis in combination with a medicinal cocktail of heparin, nicotinic acid and No-Shpa, electrical and photostimulation of the retina, low-energy laser exposure, intravenous laser irradiation of blood (ILBI procedure), magnetic therapy.
If drug treatment does not produce results over a certain period of time, then proceed to the surgical method. The most common operations to treat this pathology are:
In addition to all the treatment methods described, it is important to completely give up bad habits, wear sunglasses, adhere to a healthy lifestyle, and eat food rich in nutrients.
Don't forget about vitamins. Vitamins of groups A, B, C and E are especially useful. They quickly return visual functions to normal. In addition, tissue nutrition in the eye is significantly improved. If you take vitamin complexes for a long time, this will help stop the degenerative process in the retina.
In addition to chemically synthesized vitamins, it is recommended to take care of your diet so that the foods you eat are as saturated with vitamins and microelements as possible. Thus, the most vitamins A, B, C and E are found in cereals, nuts, fresh vegetables and fruits, herbs, apricots, blueberries, carrots, beets, citrus fruits, beans and fish.
When the question arises about the prevention of such a serious disease as retinal dystrophy, you can follow just a few simple rules. They will help maintain good vision for a long time and get rid of problems:
By following these basic rules, you can protect yourself from retinal dystrophy and preserve your vision.
Peripheral vision and dark adaptation deteriorate. This means that they have difficulty seeing in dark rooms and have difficulty distinguishing objects located to the side of them. As complications develop, patients may experience more obvious and dangerous symptoms.
Depending on the nature of the pathological changes in the retina, several types of peripheral degeneration are distinguished. Only an ophthalmologist can distinguish them after performing an ophthalmoscopy - examination of the fundus of the eye. During the examination, the doctor can see the retina, which lines the inside of the eyeball.
It occurs in approximately 65% of cases and has the most unfavorable prognosis. According to statistics, it is lattice dystrophy that most often leads to retinal detachment and loss of vision. Fortunately, the disease has an indolent course and progresses slowly throughout life.
Lattice degeneration is characterized by the appearance of narrow white stripes on the fundus of the eye, which in appearance resemble a lattice. They are empty vessels of the retina filled with hyaline. Between the white cords, areas of thinned retina that have a pinkish or red tint are visible.
This type of peripheral retinal degeneration most often develops in people with high degrees of myopia. The pathology is characterized by the appearance of peculiar perforated defects on the retina, which outwardly resemble a snail's footprint on the asphalt. The disease leads to ruptures of the retina with its subsequent detachment.
It is a hereditary disease that affects men and women. Frost-like peripheral dystrophy is characterized by the appearance of whitish deposits on the retina of the eye, which outwardly resemble snow flakes.
Refers to the least dangerous retinal PVCRD. Occurs more often in older people and people with. The disease is practically asymptomatic and has a relatively favorable course. It extremely rarely leads to ruptures or.
In cobblestone dystrophy, multiple foci of degeneration are visible in the fundus. They are white in color, elongated in shape and have an uneven surface. As a rule, all lesions are located in a circle, at the very periphery of the fundus.
The disease is hereditary. It leads to delamination of the retina and the formation of huge cysts filled with fluid. Retinoschisis is asymptomatic. In some cases, it is accompanied by local loss of vision at the location of the cyst. But since the pathological foci are on the periphery, this goes unnoticed.
The pathology is also called Blessin-Ivanov disease. Small cystic retinal retinal retinal retina is accompanied by the formation of many small cysts on the periphery of the fundus. Usually the disease has a slow course and a favorable prognosis. However, in rare cases, cysts can rupture, causing retinal tears and detachments.
A considerable part of peripheral chorioretinal retinal dystrophies are hereditary diseases. In 30-40% of cases, the development of the disease is provoked by high degrees of myopia, in 8% - by. Retinal damage can also result from systemic or ophthalmic diseases.
Possible causes of the development of peripheral degenerations:
In young people, acquired retinal degenerations most often develop against the background of high myopia. In older people, pathology occurs due to disruption of normal blood circulation and metabolism in the tissues of the eyeball.
At first, peripheral retinal dystrophy does not manifest itself in any way. Occasionally, it may make itself felt with bright flashes or the flickering of spots before the eyes. If a patient has impaired lateral vision, he does not notice it for a long time. As the disease progresses, a person realizes that he needs brighter light when reading. Over time, he may develop other visual impairments.
The most common symptoms of PVCRD are:
When complications occur (retinal rupture or detachment), the patient experiences sparks, lightning, and bright flashes before the eyes. Subsequently, a dark curtain forms in the field of vision, preventing normal vision. These symptoms are extremely dangerous, so if they occur, you should immediately consult a doctor.
Peripheral chorioretinal retinal dystrophy most often affects people with a high degree of myopia. This is due to the fact that with myopia the eyeball grows in length. Consequently, this leads to severe stretching and thinning of the retina. As a result, it becomes extremely susceptible to dystrophic processes.
The risk group also includes people over 65 years of age and patients with diabetes mellitus, atherosclerosis, and hypertension. In all these people, the retina of the eye suffers from a lack of oxygen and nutrients for various reasons. All this is a powerful impetus for the development of dystrophy.
The treatment of retinal retinal retina is performed by a retinologist. He specializes in the diagnosis and treatment of diseases of the posterior segment of the eyeball (vitreous body, retina and choroid).
If complications develop, the patient may require the help of an ophthalmic surgeon or laser ophthalmologist. These specialists perform complex surgeries to treat retinal tears and detachments. In difficult situations, their help allows you to preserve and even restore partially lost vision.
Methods used to diagnose peripheral degenerations.
Method | Description | results |
---|---|---|
Visiometry | The patient is seated at a certain distance from Sivtsev’s table and asked to read the letters in different rows. If he experiences difficulties, his vision is checked with correction (lenses of different strengths). | The method allows you to identify myopia or other visual impairments. A decrease in visual acuity that cannot be corrected indicates damage to the retina of the eye. |
Perimetry | The patient's visual fields are checked. Instead of perimetry, campimetry can be performed or an Amsler grid can be used. | During the examination, a narrowing of the visual field or the appearance of scotomas is revealed. The location of the defects gives an idea of the localization of foci of degeneration. |
Ophthalmoscopy | Having previously dilated the pupil, the doctor examines the fundus of the eye. For this purpose, he can use a direct or indirect ophthalmoscope. If it is necessary to examine distant areas of the retina, he uses a three-mirror Goldmann lens. | With ophthalmoscopy, an experienced ophthalmologist can see pathological changes in the retina. Since all dystrophies look different, they can be distinguished visually. |
Sclerocompression | The manipulation is performed during ophthalmoscopy. The doctor gently presses the sclera, trying to move the retina closer to the center. | Sclerocompression makes it possible to examine the most distant areas of the fundus. |
Instrumental methods | To clarify the diagnosis, the patient may undergo optical coherence tomography or electrophysiological studies. | Modern techniques make it possible to obtain a clear picture of the condition of the retina and the location of degenerative foci. |
To date, there are no methods that can completely cure peripheral vitreochorioretinal dystrophy of the retina. The progression of the disease can be stopped with the help of medication, physiotherapy, laser and surgical treatment. The correct approach to combating the disease allows you to preserve your vision and avoid dangerous complications.
Drugs that help slow the progression of dystrophy:
You can strengthen the retina and prevent its detachment using laser treatment. During the procedure, the specialist solders the retina to the choroid, which is located underneath it. This allows you to limit the foci of degeneration.
There is currently no specific prevention of the disease. You can reduce the risk of developing dystrophy with the help of eye exercises and proper nutrition. Dietary supplements containing zinc, vitamins E, A, and B are very useful in this regard. Protecting your eyes from ultraviolet radiation with sunglasses also helps to avoid illness.
Peripheral retinal dystrophies often develop in older people and in people with high degrees of myopia. The reason for this is stretching of the retina or impaired blood circulation and metabolism in it.
To combat degeneration, medications, physiotherapy, laser and surgical techniques are used. Laser coagulation of the retina today is considered the most effective method of treating pathology. With its help, it is possible to limit dystrophic foci and prevent the spread of the pathological process.