Hypertensive retinopathy is considered a very serious complication that occurs as a result of the development of hypertension. In the presence of such a pathology, a complex lesion of the retina occurs, as well as the vessels of the eye. If treatment is not started in time, then a serious violation of blood circulation in the optic nerve and retina can occur.
As a rule, retinopathy in hypertension is more common in people who have problems with high blood pressure, suffer from diseases of the adrenal glands, renal hypertension. This disease is also common in older people. When the disease is just beginning to develop, a person does not have any symptoms. Already at the later stages of development, the disease begins to make itself felt with a sharp and severe deterioration in vision.
Stages of disease development
Specialists distinguish only four stages of hypertensiveretinopathy:
- Hypertensive angiopathy. During the development of this stage, changes occur that can still be reversed. Only small vessels located in the retina of the eye are affected.
- Hypertensive angiosclerosis. At this stage, modifications of the organic type occur, which affect the retinal vessels.
- Hypertensive retinopathy. A characteristic feature is the change in the vessels of the retina. Around them, lesions gradually begin to appear, which develop in the retinal tissue itself. Focal opacities also appear, hemorrhages, a variety of degenerative abnormalities, which are localized in the central part of the retina, begin to clearly appear.
- Hypertensive neuroretinopathy. According to its characteristics, this stage may resemble angiopathy or angiosclerosis. In addition, clouding of the upper part of the retina, located directly above the optic nerve head, is clearly visible, swelling appears. It is at this stage that a sharp deterioration in vision occurs.
Causes of hypertensive retinopathy
The main cause of the appearance of pathology is considered to be very high blood pressure, which worries a person for a long time. A particularly high risk of developing hypertensive retinopathy is in those people who have incorrectly or incompletely treated hypertension. Other causes of pathology include diabetes mellitus, atherosclerosis, or excessive smoking.
Signs of disease
It is not a secret for specialists that hypertension has an extremely negative effect on the state of the vessels located in the retina. Most people with hypertensive retinopathy have little or no symptoms in the early stages. At the last stage of the development of the disease, a sharp deterioration in vision occurs. Complete loss of vision is observed only in isolated cases.
Symptoms that few people pay attention to include the appearance of floating spots or "flies" before the eyes. Over time, images become blurry, dark bands appear, and vision deteriorates significantly at night.
The main danger of hypertensive retinopathy is that it can cause retinal detachment. Such a problem will manifest itself in the form of spots or stripes floating in front of the eyes, sometimes there are sharp flashes of light, shadows in a certain interval of the field of view. Images sometimes blur or become black.
Diagnosis of eye pathology
The main method of diagnosis in this situation is a thorough examination of the fundus. For this, a procedure such as ophthalmoscopy is used. Also, such a procedure allows you to examine the optic nerve head, to determine the state of the vessels located in the retina. Sometimes ophthalmoscopy allows you to determine other abnormalities, in addition tohypertensive retinopathy. For example, hemorrhages, fat deposits that are uncharacteristic of the fundus of the eye, and so on.
An ophthalmoscope is used for the procedure. The device looks like a concave mirror having a round shape. There is a small hole in the middle of the device. To date, more and more people are starting to use a similar device, but of an electric type. With it, you can easily see the bottom of the eye in detail and even take a picture. In order to study in more detail the changes in the fundus in hypertensive retinopathy, the maximum expansion of the pupil is carried out. To do this, a special agent is instilled into the eyes.
What can a doctor see during a diagnosis
During the diagnosis of the disease, the ophthalmologist may find the following:
- The presence of spasm of the arterioles of the patient's retina.
- Hemorrhages in the affected area.
- The vitreous body of the human eye.
- The presence of fat deposits directly on the retina.
- Swelling of the optic disc (especially common in advanced situations).
- Vessel walls can become too dense and opaque.
- Sometimes even complete or partial retinal detachment is detected.
Fluorescein angiography as a diagnostic method
If the need arises, the ophthalmologist may prescribe a fluorescein angiogram for the patient. Such a procedure will detect possible deviations that have appeared in the vessels of the retina. To do thisa special dye is injected intravenously into a person, and after that, ophthalmoscopy is repeated.
Coherence tomography
Another method of diagnosis is coherence tomography. Using this technique, you can get very detailed information about each of the layers of the affected retina. You can also identify possible thickening and fatty deposits, hemorrhages.
Treatment of pathology
Treatment of hypertensive retinopathy very much depends on the stage of development of the disease. In almost all cases, a variety of medications are used first for treatment. It is mandatory to use vasodilators, take vitamin complexes and anticoagulants.
If there is no result from such treatment, or if hypertensive retinopathy is at the last stage of development, then it will be impossible to do without surgical intervention. Today, the operation is performed using a laser and is called laser coagulation.
The main principle of the treatment of the disease is the elimination of the main causes that provoked its development. In no case should treatment be postponed until later. After all, such actions can lead to serious consequences and completely deprive you of your sight.
As a preventive measure, it is necessary to regularly conduct an examination with an ophthalmologist, because only a doctor can determine the presence of deviations at the earliest possiblestage of development and prevent the occurrence of complications in the future. Therefore, even if you do not notice the symptoms of hypertensive retinopathy, a consultation with an ophthalmologist will not be superfluous. As experience shows, the diagnosis often reveals diseases that a person did not even suspect. Better safe than sorry in the future.
