Lattice retinal dystrophy treatment. Peripheral retinal dystrophy: main symptoms and treatment methods

Retinal dystrophy is one of the most serious eye pathologies that can lead to blindness. The reason for this process is violations in vascular system eye. The peripheral zone of the retina is hidden behind the eyeball, which makes it invisible when examining the fundus.

To determine peripheral vitreochorioretinal dystrophy (PVCRD), a special study is necessary. The possibility of blindness, mild symptoms and the need for special diagnostics make retinal PVCRD a very dangerous and insidious disease.

The disease does not have symptoms that fully characterize this type pathology. With PVCRD the following are observed:

• loss of visual acuity;
• pop-up spots, flies, blots in front of both eyes.

Patients have different characterizations of interference that appears and obscures the field of vision. The presence of such problems requires contacting an ophthalmologist.

Causes

Retinal dystrophy is caused by vascular disorders of the eye and lack of blood supply. Degeneration can be triggered by:

• eye and traumatic brain injuries;
• different shapes diabetes;
• infectious diseases;
• myopia;
• inflammatory diseases eye.

Pathological changes can occur in both eyes at the same time or affect only the left or right eye.

Retinal PVCRD can affect only one eye or develop in both eyes at once.

There are many reasons contributing to the development of peripheral vitreochorioretinal retinal dystrophy. Their action is based on the deterioration of blood circulation in the vessels of the retina, which subsequently changes the biochemical processes occurring in it, as well as in nearby parts of the vitreous body. As a result of these disorders, adhesion of the retina and vitreal body occurs. Such processes can occur in individuals with emmetropic visual acuity.

With myopia, there is an increase in the anteroposterior size eyeball, as a result of which stretching of the eye structures is observed. The retina becomes thinner, angiopathy develops, blood supply is disrupted, the peripheral parts are especially affected, and in the presence of a vitreoretinal mooring, rupture is possible.

Inadequate blood supply causes dystrophic thinning of the retinal layer, which can lead to rupture and loss of vision. Ruptures occur from excessive physical activity, heavy lifting, climbing to heights or going under water in places of greatest degenerative tissue changes.

Myopia is a serious provoking factor in the development of retinal degeneration. Myopia causes the eyeball to stretch out. This leads to a change in the entire structure visual organ– the periphery of the retina becomes thinner, blood flow worsens.

High myopia should be the reason for regular visits to the ophthalmologist in order to diagnose it in a timely manner peripheral vitreochorioretinal dystrophy of the retina.

However, most ophthalmologists consider heredity to be the main factor in the development of PVCRD. Eye pathologies are often familial and are passed on from parents to children.

Heredity is one of the factors that provoke PVCD.

The meaning of the difference between PCRD and PVKHRD

Both types of pathology – chorioretinal and vitreochorioretinal – are associated with vascular disorders eyes that lead to the development of retinal degeneration.

Peripheral vitreochorioretinal dystrophy is more dangerous looking diseases, because degenerative changes also affect the vitreous body of the eye. Vitreo – vitreo agg – from Latin glassy, ​​glassy.

The second type of disease, PRCD, affects only the retina itself and blood vessels.

The first type of disease is less common, but requires increased attention from the doctor and the patient, because it threatens retinal detachment and loss of vision. Vitreoretinal adhesions of the vitreous body to the retina provoke destruction of its layer and rupture.

Do not confuse PVKHRD and PHRD - these are two various pathologies.

Classification (types and types of retinal tears)

According to the course, peripheral vitreochorioretinal dystrophy occurs:

1. 1. With a benign course:
      • Cobblestone degeneration consists of white areas of atrophy. With it, the choroidal vessels are visible through the affected retina against the background of the sclera. The cause of development is occlusion of choroidal vessels, which leads to post-ischemic atrophy of the pigment epithelium and outer layers of the retina. Found in the lower half of the fundus between the dentate line and the equator. It is not complicated by ruptures or detachment.
      • Equatorial drusen. Pale formations are not large sizes, may have pigmentation along the contour. Located along the jagged line.
      • Pigmented oroparallel degeneration. An age-related change manifested by increased pigmentation along the “jagged” line.
      • Honeycomb degeneration. Appears in older people. It is represented by perivascular pigmentation and can reach the equator.
   2. With a poor quality course:

1. 1. • "Lattice" dystrophy. The “grid” is visible under ophthalmoscopy as thin stripes white, forming a lattice-like outline. Between these stripes, erosions, cysts and micro-tears, zones of hypopigmentation or hyperpigmentation appear, and there may even be diffuse pigmentation. The vitreal body above the “grid” area is liquefied, but along the contour, on the contrary, it is compacted and fused to its edges. As a result, vitreochorioretinal moorings appear, promoting the formation of valvular retinal ruptures.
      • Dystrophy of the “snail track” type. The pathology develops due to vascular lesions and is manifested by the appearance of whitish inclusions consisting of microglia and astrocytes. With the presence of point erosions and perforated defects. Degenerative lesions can connect and form large defects. Has a high risk of developing detachment.
      • Frost degeneration is an inherited retinal disease. Retinal manifestations are usually located symmetrically and affect both eyes. Ophthalmoscopically it appears as large formations of yellowish-white color, similar to “snow flakes”. Progresses slowly and does not often lead to complications.

PVKhRD is classified according to the flow and type of rupture.

Depending on the type of retinal tear, there are the following types:

1. 1. • Hole - part of the retina is completely torn off due to PVD. Occurs with lattice dystrophy.
      • Valvular - the rupture site is partially covered, a valve is formed. Formed in the presence of vitreoretinal adhesion.
      • According to the type of dialysis, the retina is torn along the dentate line. Dialysis develops with eye contusion.

The stages of the disease indicate the severity, degree and types of ruptures and tractions, and range from I to V. Starting from stage IV, laser coagulation is always indicated. PVCRD grade 2 or stage, for example, has no absolute indications, and the decision to further treatment accepted individually.

PVHRD during pregnancy

According to medical organizations By the beginning of the reproductive period, more than 25% of women have myopia, more than 7% of them have a high degree. Against the background of a normal pregnancy, women with myopia experience a narrowing of the retinal vessels.

This occurs due to increased load on cardiovascular system and the need for additional blood circulation for the unborn child. Therefore, during pregnancy, patients are examined twice by an ophthalmologist with a complete examination of the fundus.

In case of development of PVCRD during pregnancy, laser coagulation is indicated. It can be performed up to 32 weeks. After a successful operation, a woman can give birth on her own.

Necessity caesarean section During pregnancy, a woman with PVCRD of the retina is identified one month before the estimated date of birth.

The decision on the need for a cesarean section due to degenerative conditions of the retina is made a month before birth. A high degree of myopia (more than 6.0 diopters) is not an indication for surgery.

Diagnostics

The initial stage of peripheral vitreochorioretinal degeneration occurs without symptoms, weakening of vision and the appearance of interference before the eyes begins when the layer is destroyed. During a routine fundus examination, the peripheral areas are hidden by the eyeball.

Patients with a high degree of myopia are more often examined by ophthalmologists, as they belong to a risk group. In many patients, PVCRD is often discovered when the peeling process has already begun. Therefore, for mild and moderate myopia with an obvious and constant deterioration in visual acuity, it is worth undergoing diagnostics.

To diagnose the disease, the following is carried out:

1. 1. • examination of the fundus with a Goldmann lens using medications that dilate the pupil;
      • determination of visual fields;
      • Ultrasound, optical tomography and electrophysiological study;
      • sclerocompression.

Using modern digital devices, it is possible to obtain a color image of the peripheral part of the retina and assess the extent and area of ​​the lesion.

Fundus examination with a Goldmann lens helps diagnose PVCD.

An ophthalmological examination includes diagnosing PVCRD before military enlistment. Depending on the degree and nature of the disease, a delay is given for laser coagulation.

Treatment

Retinal degeneration is an irreversible process; the tissue cannot be returned to normal. Treatment is aimed at slowing destruction and improving vision.

Medicinal methods

For PVCRD at the initial stage, they are used conservative methods treatment - appointment medicines. Shown:

1. 1. • Multivitamins and microelements, nourishing tissues, stop the processes of degeneration. You should follow a healthy diet, giving preference to nuts, fish, vegetables and fruits.
      • Drugs that stop the development of blood clots in blood vessels (Aspirin, Ticlopidine).
      • Vasodilators (No-spa, Ascorutin).
      • Eye drops, improving metabolism.
      • Eye injections to improve microcirculation.

These products help stop the process of tissue destruction. Complex drug administration is carried out twice a year.

Ascorutin is prescribed as a vasodilator.

Physiotherapy

The procedures help stop tissue degeneration. Electrophoresis, electrical or photostimulation of the retina, and laser are prescribed. Treatment is carried out in courses.

Laser procedure

To prevent retinal detachment, laser coagulation is used, this is the most effective method, which has proven its effectiveness. The laser beam glues the retina in places of stretching with the vascular fundus of the visual organ, preventing detachments.

Barrier laser coagulation (BLC) is performed under local anesthesia, the procedure lasts 10-20 minutes. The patient is sent home immediately after the procedure. IN modern medicine This the best remedy, warning severe consequences PVCRD and angiopathy.

Surgery

Surgeries for peripheral vitreochorioretinal dystrophy are performed in severe cases, when neither drug treatment, nor laser coagulation has any effect.

The operation is performed only if other treatment methods fail.

Prevention

When a disease is detected, prevention is aimed at preventing further development pathological process and preventing retinal tears.
Patients with PVHRD should remember - only careful attitude to health, strict adherence to preventive measures and doctor’s instructions will help avoid terrible complications.

Must be avoided physical activity, lead healthy image life, visit an ophthalmologist twice a year and undergo courses of treatment.

People at risk should be careful and undergo medical examination on time. Need to give up excessive hobby computer, do eye exercises, take vitamins.

Proper nutrition, giving up bad habits will help minimize the risk of hereditary factors of the disease and avoid PVCD.

Nov 28, 2017 Anastasia Tabalina

- This dangerous condition, in which gradual, often asymptomatic, destruction of the retina occurs, causing noticeable deterioration visual functions. One of the types of dystrophy is PVHRD - peripheral vitreochorioretinal dystrophy of the retina. This degenerative process is often a consequence of impaired blood supply to the fundus and can be eliminated either conservatively or surgically.

PVKhRD - what is it? This is dystrophy peripheral parts retina, which is common and can occur at any age. The exact mechanism of development of the pathology is unknown. The following factors can provoke the appearance of peripheral vitreochorioretinal dystrophy:

• high blood pressure;
• genetic predisposition;
• myopia;
• hypermetropia;
• diabetes;
• vascular atherosclerosis;
• inflammatory processes;
• damage to the organs of vision;
• infectious diseases;
• intoxication of the body.

Under the influence of a number of factors, the blood supply to the visual apparatus is disrupted, material metabolism is disrupted, as a result of which the walls of the retina become thinner and the vitreous body is damaged. Such degenerative changes lead to visual impairment and in the presence of such provoking factors as physical or emotional overstrain, excessive visual stress or exposure to vibration, rupture or rupture may occur.

Symptoms

A peculiarity of the occurrence of peripheral vitreochorioretinal dystrophy of the retina is its asymptomatic course, which complicates the timely diagnosis of the problem. The first signs of PVCRD are often observed already in the presence of retinal tears. Dystrophic changes in the periphery of the eye can be suspected by the following symptoms:

• flashing “flies” before the eyes;
• bright flashes of light;
• blurred vision;
• color vision impairment;
• decreased visibility in the dark;
• narrowing of the field of view.

Central vision is not impaired in PVCRD, only a gradual deterioration in peripheral visual functions is observed. If treatment for a retinal rupture is not started in a timely manner and the degenerative process continues to progress, then bleeding into the vitreous or retinal detachment is possible, which ultimately leads to loss of vision.

Difference from PCRD

Dystrophy of the peripheral parts of the retina comes in 2 forms: PHRD (peripheral chorioretinal dystrophy) and PVHRD (peripheral vitreochorioretinal dystrophy). The difference between PCRD and PVCD is that in the first case, the pathological process affects only the retina and choroid, and in the second case, the vitreous body is also involved in the degenerative process.

Classification

Modern medicine identifies several types of peripheral vitreochorioretinal dystrophy of the retina:

1. Lattice. The most common type of pathology, which is most often inherited and is diagnosed mainly in men. With lattice PVCRD, degenerative changes occur in the upper outer quadrant of the fundus in the form of a lattice of empty vessels, between which cysts, tears and thinned walls of the retina are visible. With this form, both organs of vision are most often affected, and retinal detachment is observed.
2. Frost-like. Degenerative changes look like empty vessels, between which there are dark spots and foci of degeneration, similar to snow flakes. This form of the disease is hereditary and is characterized by symmetrical damage to both eyes. It is characterized by a long course and a reduced likelihood of retinal breaks.
3. "Snail Trail". Dystrophic changes have the appearance of shiny white ribbon-like stripes with multiple holes and areas of thinning, reminiscent of a snail's footprint. The pathology is accompanied by large ruptures.
4. "Cobblestone Pavement". Distant areas of the peripheral retina are affected, most often in the lower parts of the right or left eye. Degenerative changes take the form of individual white spots surrounded by pigment spots.
5. Small cystic. Dystrophic processes are observed in the extreme parts of the periphery and take the form of multiple round red cysts that can merge to form large formations. Mechanical damage provokes rupture of cysts.

Sometimes a form of PVCRD is diagnosed as retinoschisis, a hereditary retinal separation that occurs as a result of age-related changes or against the background of myopia.

Diagnostic methods

Peripheral vitreochorioretinal dystrophy long time It is asymptomatic, which is why it is often diagnosed in the presence of large tears and significant deterioration of vision. It is impossible to detect PVCRD using a routine examination of the fundus, so ophthalmoscopy is performed with maximum pupil dilation and using a special Goldmann lens, which allows for a detailed examination of the most distant parts of the retina.

In addition, the following diagnostic measures can be carried out:

• perimetry;
• sclerocompression;
• visometry;
• refractometry;
• optical coherence tomography;

In some modern clinics There is special equipment that allows you to study the periphery of the retina in color, detect areas of ruptures and estimate their sizes as accurately as possible.

Drug treatment of PVCRD

At the initial stages of development of peripheral vitreochorioretinal dystrophy, as well as several months after laser intervention, it is prescribed drug therapy, aimed at improving material metabolism and compensating for dystrophic processes. The following medications may be prescribed for the treatment of PVCRD:

• Riboflavin;
• Trimetazidine;
• Taurine;
• Nicergoline;
• Pentoxifylline;
• Atropine;
• Tropicamide.

For achievement better effect The ophthalmologist prescribes several medications at once, the combination of which allows you to eliminate degenerative processes, prevent complications and restore visual functions.

An effective remedy for PVCRD are tablets with Spirulina platentis extract.

Physiotherapy

To achieve a better result and quickly eliminate degenerative processes, in addition to the main method of treatment, physiotherapy is prescribed to help strengthen muscular system and normalization of ophthalmotonus. The following physiotherapeutic procedures may be recommended:

• magnetic therapy;
• electrophoresis;
• electrical and photostimulation;
• laser stimulation.

Along with physical therapy, various computer programs may be prescribed. Amblyocor, visual gymnastics.

Physiotherapeutic procedures for PVCRD are low in effectiveness, so they must be combined with vitamin therapy.

Laser surgery

The best treatment method for PVCRD is laser coagulation of the retina, the essence of which is gluing the thinned areas of the retina or cutting off torn tissue. Laser coagulation is carried out in outpatient setting under local anesthesia, its duration is no more than 20 minutes.

Laser intervention is effective and safe, the recovery period is quick and without complications. For the speedy formation of adhesions during the first 2 weeks after surgery, you should refrain from physical and visual stress, thermal procedures and taking alcoholic beverages and vasodilators.

Surgical intervention

If peripheral vitreochorioretinal dystrophy of the retina is accompanied by multiple ruptures or severe detachment of the membrane, then a more serious procedure is necessary. surgical intervention, in which the affected areas are excised and the remaining tissues are stitched together. Vitreous implantation is possible.

The operation lasts 40-60 minutes, is slightly traumatic and highly effective.

PVHRD during pregnancy

During the gestation period, the immune system weakens, as a result of which the likelihood of developing various degenerative processes increases. If a pregnant woman has been diagnosed with PVCRD of the eye, then laser coagulation is prescribed. In the absence of contraindications, the operation is possible at any time, but it is not recommended to do it later than 31 weeks. With this diagnosis, doctors in most cases recommend giving birth by cesarean section, since natural childbirth can cause retinal detachment.

Prevention

The prognosis for peripheral vitreochorioretinal dystrophy of the retina in most cases is favorable; after completing a course of treatment, degenerative phenomena disappear and vision is restored. PVCRD is asymptomatic and is often detected at an advanced stage. To avoid this, it is recommended to undergo an annual preventive medical examination with an ophthalmologist and take the following preventive measures:

• avoid excessive visual strain;
• control blood sugar levels;
• Check your blood pressure regularly and stabilize it if necessary;
• Healthy food;
• to refuse from bad habits;
• to live an active lifestyle;
• promptly treat concomitant diseases;
• strengthen the immune system.

If degenerative processes have already occurred, then it is necessary to avoid physical overload, vibration exposure and extreme sports. Timely treatment can help avoid severe complications.

Restrictive peripheral laser coagulation of the retina.

Peripheral retinal dystrophies are an invisible danger. The main problem with this is, of course, dangerous disease is that a person is not bothered by any subjective manifestations, up to the occurrence of retinal detachment.

There is a common misconception that this condition occurs only in people with a high degree of myopia (myopes), however this is not true and occurs in people with 100% vision (emmetropes) and farsighted people (hypermetropes).

The peripheral zone of the retina is practically invisible during normal fundus examination. To visualize these sections, pupil dilation is required (mydriasis, cycloplegia). It is there that degenerative changes develop, which can lead to retinal tears and detachment.

Peripheral vitreochorioretinal dystrophy (PVCRD)– a disease that can be caused by many reasons: inflammatory diseases of the eyes, craniocerebral and injuries of the organ of vision, hypertonic disease, atherosclerosis, diabetes, intoxication, past infections, hereditary factors, an increase in the size of the anteroposterior size of the eyeball.

The occurrence of dystrophies is possible at any age, with equal probability in men and women. However, it has been proven that in people with myopia, peripheral degenerative changes in the retina are much more common, because With myopia, the length of the eye increases, resulting in stretching of its membranes and thinning of the retina at the periphery. The essence of this pathological process is the deterioration of blood flow in local areas of the retinal periphery, which leads to metabolic disorders and the appearance of dystrophic foci. The dystrophic focus is a sharply thinned area of ​​the retina.

Under the influence of a) physical activity, and especially work associated with lifting, carrying heavy objects, vibration, climbing to a height or diving under water, acceleration, and b) psycho-emotional stress, increased visual load - breaks occur in the weakest areas of the retina. The occurrence of ruptures is facilitated by changes in the vitreous that appear in the form of adhesions (vitreoretinal adhesions). These adhesions, connecting one end to a weak area of ​​the retina and the other to the vitreous body, more often than not, contribute to the occurrence of retinal breaks. The presence of even very small holes in the retina, located close to each other, poses a threat of their fusion and the formation of a large holey defect. The combination of retinal tears and stretching in myopia (myopia) is especially dangerous.

The main types of peripheral retinal dystrophies:

• lattice dystrophy;
• dystrophy of the “snail track” type;
• frost-like dystrophy;
• cobblestone degeneration;
• cystic retinal dystrophy;
• retinoschisis - retinal separation.

Retinal tears.

Based on their type, retinal tears are divided into:

• perforated;
• valve;
• by type of dialysis.

Retinal disinsertion.

Through the hole formed in the retina, intraocular fluid enters under the retina and peels it off. The retina that has lagged behind its usual place ceases to function, i.e. ceases to perceive light as a stimulus. Patients with retinal detachment describe this fact as the appearance of a black or gray opaque “curtain” in front of the eye, through which nothing can be seen. The size of the “curtain” that interferes with viewing depends on the area of ​​the detached retina. As a rule, part disappears first peripheral vision. Central vision is initially preserved. Quite high visual acuity is also maintained. But it won't last long. As the detachment spreads, the area of ​​the “interfering curtain” increases. As soon as the retinal detachment reaches the central parts, visual acuity drops from 100% to 2-3%, i.e. Such a person with a sore eye is able to see only the movement of objects near the face. This “vision” can be provided by a partially preserved or partially adjacent retina in other areas. If the retinal detachment is total, then there is no need to talk about any vision. For such a person, complete darkness sets in in this eye.

Diagnostics.

A complete diagnosis of peripheral dystrophies and retinal tears is complex and is only possible when examining the fundus of the eye by an ophthalmic surgeon under conditions of maximum medicinal dilation of the pupil.

Treatment of dystrophies and ruptures.

When peripheral dystrophies and retinal tears are detected, treatment is carried out, the purpose of which is to prevent detachment. Execute limiting peripheral laser coagulation of the retina, as a result of which “sticking” occurs, and within 2-4 weeks the retina fuses with the underlying membranes of the eye at the points of exposure to laser radiation. Restrictive peripheral laser coagulation It is performed on an outpatient basis and is well tolerated by patients. The essence of the operation is to treat thinned areas of the retina with a laser. Using laser radiation, the so-called “soldering” of the retina is performed. weak points and around the breaks, adhesions of the retina with the underlying tissues form. The operation is performed on an outpatient basis, under local drip anesthesia. Before treatment, the pupil is dilated with special drops, then anesthetic drops are instilled, and the patient is placed behind the device, pressing his forehead and chin to a special stop. A special contact lens, through which light is directed into the eye and laser ray. The patient returns home on the same day.

It must be taken into account that the process of formation of adhesions takes some time, so after laser coagulation it is recommended to follow a gentle regime.

Prevention.

Speaking about prevention, first of all, we mean the prevention of the formation of breaks and retinal detachment. The main way to prevent these complications is timely diagnosis peripheral dystrophies, followed by regular monitoring and, if necessary, limiting peripheral laser coagulation.

Specialists Ophthalmological Center Laser microsurgery clinics "Medina" are fluent in both the method of peripheral peripheral laser photocoagulation of the retina and other methods of laser interventions for eye pathology.

Contact your ophthalmologist for a referral to the Medina Clinic and receive a 5% discount on laser eye treatment!

Peripheral dystrophy(PD) of the retina of the eye - what is it? pathological condition, at which it occurs 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.

During a standard ophthalmological examination initial stages It is not always possible to identify retinal dystrophies. The disease can provoke irreversible processes. Therefore, treatment must be started as early as possible.

Peripheral eye dystrophy in humans: what is it, causes and symptoms

The disease can be provoked by numerous internal and external factors. 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:

• genetic predisposition;
• strong intoxication of the body;
• inflammatory diseases eye;
• progression myopia;
• complications diabetes mellitus;
• frequent stressful situations;
• eye injuries;
• disorders in the circulatory system;
• impact critical loads on the body;
• acute lack of vitamins and useful macroelements;
• progression chronic diseases;
• complications infectious lesions body;
• consequences traumatic brain injuries.

Reference! PD can be provoked not only by pathological processes in the body, but also long-term abuse bad habits , serious errors in nutrition, uncontrolled use of potent drugs with side effects extending to 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 experiences a manifestation of a combination of characteristic features eye dystrophy.

Symptoms of the disease:

• color perception disorder surrounding conditions;
• a sharp deterioration in visual acuity in the twilight and at night;
• blurred vision in one or both eyes;
• excessive fatigue eye;
• image distortion surrounding objects (blurred boundaries);
• regular the appearance of “fog” before the eyes;
• periodic the occurrence of flashes or “floaters” before your eyes.

Important! The disease can be caused by complications after surgical intervention. The causes of PD are doctors' mistakes or individual characteristics the patient's body.

Division of retinal degeneration according to the degree of damage

Damage to the eyeball tissue occurs different ways. Depending on the degree of damage and morphological changes occurring as the pathology progresses, peripheral retinal degeneration divided into two main types.

Identification of a specific type of disease is necessary to make a prognosis and prescribe the maximum effective course therapy to the patient.

Classification of the disease depending on morphological changes in tissues:

• peripheral chorioretinal retinal dystrophy (PCRD)- during its development damage occurs choroid and retinal cells;
• peripheral vitreochorioretinal dystrophy (PVRD)- provokes complete damage vitreous body of the eye, largely affects the retina and its choroid.

Description, symptoms and pathogenesis of common types of disease

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, most often found in medical practice, each of which has its own characteristics of symptoms and prognosis for the patient.

Lattice

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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Snail trail disease

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 degeneration

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.

Cobblestone type

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

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.

Pigmented

Pigmentary dystrophy is characterized by a disorder in the 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.

Congenital and acquired retinoschisis

In most cases the pathology is inherited and is congenital. The acquired form develops mainly in patients old age or against the background of progression myopathies. With retinoschisis occurs delamination retina of the eye.

Methods of medical diagnosis

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:

• scleropression(displacement of the retina for its full study);
• dilation of pupils with special medicines;
• procedure optical coherence tomography;
• Ultrasound of the organs of vision;
• inspection with a three-mirror Goldmann lens;
• electrophysiology.

Treatment methods of different types

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 treatment of peripheral dystrophy are the same for all its forms. The therapy complex includes the use medicines, laser therapy and surgical intervention.

Treatment Options different types PD:

• Application of vitamin drops to improve the process of tissue regeneration of the eyeball ( Taufon, Emoksipin).

Photo 2. Eye drops Taufon 40 mg/ml, 10 ml, from the manufacturer Farmak.

• Conservative treatment drugs, reducing the risk of blood clots in blood vessels ( Ticlopidine, Aspirin). The method is used regardless of the form of pathology.
• Treatment strengthening and vasodilating means ( Askorutin, Papaverine). The method refers to the mandatory stages of general therapy.
• In the presence of hemorrhages or hematomas, use special absorbable drugs ( Heparin, Triamcinolone, Aminocaproic acid).
• Laser coagulation. The procedure is used in the treatment of all types of retinal PD; the operation is aimed at separating the affected area with a laser; in some cases, laser coagulation is prescribed for prophylactic purposes.
• Physiotherapeutic procedures(In most cases magnetic stimulation And electrical stimulation fabrics). Used in therapy pigmentary dystrophy. The maximum effectiveness of procedures is achieved only when they are used on early stages pathology.
• Revascularization(the operation is performed using drugs Alloplant and Retinalamin). The procedure not only normalizes ocular blood circulation, but also significantly improves the patient’s vision for several years.

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.

What happens with peripheral retinal degeneration?

With dystrophic changes, areas of the retina gradually become thinner. Tension zones are formed between vitreous and the retina, as a result of which it is torn 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.

Why is it developing?

This pathology occurs in people of different ages, in children, including. 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 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:

• atherosclerosis,
• hypertonic disease,
• diabetes,
• infections,
• intoxication.

Kinds

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.

• Microcystic degeneration appears as a mass of red dots on a white-gray background. Localization of the lesion at the dentate line. This type of degeneration is also more often bilateral and occurs more often in people over 40 years of age.
• Cobblestone degeneration results in the formation of white, depigmented lesions. This type of pathology rarely leads to retinal detachment, that is, it has the most gentle consequences.

Diagnosis and treatment

The primary diagnosis is made by an ophthalmologist at the clinic. To do this you need to carry out ophthalmological examination which includes:

• Perimetry,
• Visometry,
• Ophthalmoscopy with Goldmann lens or scleral depression.

Must be appointed laboratory research blood and urine.

Treatment is carried out in an ophthalmological hospital. It can be surgical or laser. Moreover, every year laser technologies are becoming more widespread, since they allow therapeutic measures 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 eyes, create a new line of attachment of the retina and fundus. 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.