Thrombosis of the ophthalmic artery. What is central retinal vein thrombosis, why is it dangerous
- Symptoms of a blood clot in the eye
- Methods for diagnosing and treating a blood clot in the eye
Thrombosis of the eye is dangerous pathology, in which, due to the formation of blood clots, the blood flow in the blood vessels that feed certain tissues is completely or partially blocked. It is worth noting that blood clots can form in absolutely any organs and tissues, while their appearance can provoke extensive tissue death.
The main risk group for the formation of a blood clot in the eye is represented by people over 40 years of age, and statistics show that in men this pathology is much more common than in women. With age, the risk of developing a blood clot in the blood vessels of the eyeball increases significantly.
Etiology and pathogenesis of a thrombus in the eyeball
In most cases, the appearance of a blood clot in a blood vessel is associated with human diseases that contribute to thickening of the blood and disruption of the normal functioning of blood vessels. The causes of the development of a blood clot in the eye are often rooted in the following diseases;
- diabetes;
- atherosclerosis;
- hypertension;
- heart disease and blood vessels;
- focal infections oral cavity and paranasal sinuses;
- acute respiratory infections.
Especially often, CVD thrombosis occurs with sharp jumps in blood sugar, as well as the level blood pressure. A special role in the development of retinal vein thrombosis is played by an increase in intraocular pressure, and in addition, swelling of the optic nerve head of various etiologies.
In rare cases, a blood clot appears due to pressure on the blood vessel from the outside, for example, with the development of an intraocular tumor.
When considering the etiology of the appearance of a blood clot, it should also be noted that there are quite a few predisposing factors for the appearance of such a pathological condition, for example:
- obesity;
- sedentary lifestyle;
- malnutrition;
- avitaminosis.
Predisposing factors alone are not able to provoke the appearance of a blood clot, but nevertheless, under certain conditions, they can contribute to this process. For example, a sedentary lifestyle leads to stagnation of blood in all blood vessels and contributes to the development of atherosclerosis and other pathologies of the cardiovascular system.
The pathogenesis of the development of a thrombus in the eye has a pronounced staging.
At stage 1, the so-called prethrombosis is observed, characterized by the development of venous blood stasis. In this case, the veins acquire a dark shade, expand, and in addition, there are obvious arteriovenous crossings and tortuosity. When conducting an angiovenous study, a clear slowdown in blood flow is revealed. At this stage, there is an expansion and darkening of the vein, small pinpoint hemorrhages.
At stage 2, a clear circulatory disorder develops in the central retinal vein. The walls of the blood vessels are very tense, so extensive hemorrhages in the retina, vitreous body and other tissues of the eyeball are not uncommon. The permeability of the vein increases, so there is a transudative edema of the tissues along the location of the vein. At stage 3, complete or incomplete thrombosis develops, which may be accompanied by atrophic and degenerative changes in the retina.
Approximately 1-2 months after thrombosis, the development of post-thrombotic retinopathy is often observed. This condition is accompanied by a very slow recovery of vision.
When examining the fundus, residual effects after hemorrhages that have taken place, newly formed vessels and solid exudates are still visible. Newly formed vessels have significant permeability, so macular edema is often observed.
In addition, during this period, the appearance of newly formed vessels in the region of the optic disc may be observed, although anatomically they should not be there.
At the initial stage of the development of a blood clot, most people do not notice obvious signs of decreased vision. In rare cases, there may be periodic blurring of vision, and in addition, a slight decrease in acuity. Most often, the patient learns about the appearance of a blood clot early in the morning, when, having opened his eyes, he discovers obvious vision problems.
The thing is that during sleep, all stagnant processes progress, which is why the detection of a blood clot, as a rule, occurs in the morning. To the most characteristic symptoms a blood clot in the eye is a strong decrease in visual acuity up to its loss, loss of part of the visual field, the presence of a veil in front of the eyes.
Blockage of blood flow in the blood vessels of the eye is a very dangerous phenomenon. In the absence of rapid targeted treatment, tissue necrosis is observed, which leads to a complete and irreversible loss of visual ability. Vision loss is observed due to optic nerve atrophy, retinal neovascularization, recurrent hemorrhages, secondary glaucoma.
If you find the slightest sign of a blood clot in the eye, it is very important to immediately contact an ophthalmologist. The thing is that even with complete thrombosis of a vein in the eye, if within an hour it is possible to restore blood flow, it is possible to avoid a decrease in visual acuity, and in some cases, complete blindness. In addition to questioning the patient and collecting anamnesis to identify the features of circulatory disorders of the eye, the following studies can be carried out:
- visometry;
- perimetry;
- biomicroscopy;
- ophthalmoscopy;
- angiography;
- retinal tomography;
- measurement of blood pressure;
- general analyzes blood and urine.
In addition to consulting an ophthalmologist, you may need to visit a cardiologist, neurologist, endocrinologist and other highly specialized doctors.
In severe cases, an operation is prescribed to eliminate the thrombus.
In cases where there is incomplete thrombosis, drug treatment gives a good effect. Drugs used in the elimination of a blood clot include:
- antiplatelet agents;
- angioprotectors;
- antihypertensive drugs;
- hormonal agents;
- antispasmodics;
- fibrolytics;
- vitamin complexes.
http://www.youtube/watch?v=F0loauBG3LE
Even if the treatment was carried out in a timely manner, blood clots do not pass without a trace, therefore, after a few months, laser coagulation of the retina is performed.
Source: http://ZdorovyeGlaza.ru/lechenie/tromboz-glaza.html
The article discusses the main features of an ophthalmic disease, the causes of its development, the characteristic symptomatic manifestations of thrombosis, as well as modern methods of treatment in order to restore vision and prevent possible consequences and complications.
In modern medicine, vascular eye thrombosis is considered as a disease of the organ of vision, which is associated with impaired blood circulation. central vein or certain branches.
Quite often, cases of occlusion of the arteries and veins of the retina turn out to be a serious problem due to the rapid development and nature of the possible consequences. It should be emphasized that the advanced form of this problem can provoke the development of complete blindness. In most cases, the disease has an “age-related” nature, since it develops in conjunction with other diseases that occur with age.
Pathology can be dangerous
Despite this, in recent years, the development of thrombosis of the arteries of the eyes is also characteristic of young people. In this case, the disease may be associated with various infectious stimuli. In addition, the treatment instruction also reports on a number of other common causes of the above ophthalmic pathology.
Reasons for development
This pathology can be associated with various concomitant health problems of the human body.
In medicine, all possible causes of vascular thrombosis of the organ of vision are divided, depending on the age category of the patient.
| Age category of the patient | Possible reasons diseases |
| Elderly patients |
|
| Young patients | Diseases of infectious origin:
|
| All age categories of patients |
|
The development of the disease in the elderly is characterized by thickening and hardening of the walls of the arteries. Due to the compression of the artery adjacent to the retinal vein, the blood flow slows down significantly, provoking the formation of a blood clot, as in the photo.
No less common factors predisposing to the development of the disease are the following:
- excess body weight;
- overuse alcoholic beverages;
- maintaining a sedentary lifestyle.
Thrombosis of the ocular arteries occurs with an identical frequency in both women and men.
What symptoms are accompanied by pathology?
characteristic feature disease is painless. The patient has a gradual decrease in vision for no apparent reason. Quite often, the doctor diagnoses in this case defects (blind spots) in the field of view.
In most cases, the problem is diagnosed by the doctor during the next examination for preventive purposes, since it is very difficult for the patient to independently suspect such a serious pathology. It is for this reason that doctors recommend regularly attending ophthalmological examinations, being attentive to vision, and in case of the slightest suspicion, seek help from a specialist (for example, objects begin to distort or fogging appears).
It is worth emphasizing that the symptoms can accumulate over several days and even months, so it is quite difficult for a person to feel a sharp deterioration in vision.
The main features of the disease
Retinal vascular thrombosis is associated with occlusion or blockage of one of the vessels or branches due to a blood clot. In this case, the blood flow is directed in the opposite direction, so it enters the capillaries.
Due to the reverse flow of blood, the pressure is increased, resulting in an increased risk of retinal hemorrhage, progression of edema and the occurrence of hypoxia. (when there is not enough oxygen for normal functioning)
Ignoring the first symptoms or unwillingness to immediately begin treatment can lead to the development of glaucoma.
The consequences of thrombosis are also different: the video in this article shows that the affected area has the greatest impact on visual impairment in the patient. Thus, blockage of the branch of the retinal vein allows the doctor to remain more optimistic in prognosis: with the help of gradual resorption of retinal hemorrhage, vision can gradually improve.
Hemorrhage into the capillaries
At the same time, the formation of a thrombus in v. centralis retina turns out to be much more serious. This is due to the involvement of a part of the retina, which in medicine is called the macula.
In this case, the prognosis is more unfavorable, since the ability to restore vision is significantly reduced to the minimum chance. An important role in such clinical cases is played by the degree, as well as the neglect of the disease, on which the prescribed treatment depends.
How to deal with the problem?
One of the main features of a thrombus forming in the vessels of the eye is the possibility of its dissolution within the first five minutes after formation. That is why the treatment of the disease does not consist in the use of drugs for resorption or enzymatic treatment of a blood neoplasm.
This feature is associated with its lack of effectiveness due to the missed time for the formation of a blood clot (see also Vessels burst in the eyes: why does this happen?).
It is necessary to pay attention to the fact that modern methods the fight against thrombosis in the vessels of the eyes are focused on the treatment of not the disease itself, as such, but its possible complications. To this end, doctors conduct a preliminary diagnosis to determine the degree, which, in turn, is associated with the direct localization and neglect of the thrombus.
Diagnostic study
Vitreous hemorrhage is considered a fairly common complication. In most cases, the cost of such treatment will be significantly higher, since the patient needs surgery to remove clotted blood. This surgical intervention is called vitrectomy in modern medicine.
No less effective is laser coagulation of the retina, which is widely used to prevent the formation of newly formed vessels localized on the retina, as well as on the iris.
The result of the operation is to improve the metabolism in the retina. Thus, it is possible to prevent the development of such a serious complication as glaucoma.
Glaucoma is one of the complications
In addition to surgical intervention, complex therapy that allows you to restore vascular patency, normalize homeostasis and thrombus lysis, consists in taking three types of medications, among which:
- antiplatelet agents;
- anticoagulants;
- thrombolytic agents.
Thanks to long-term treatment, the consequences of hemorrhage and retinal edema can be cured. On average, treatment lasts about several months, after which the patient's vision is restored (see also Inflammation of the vessels of the eye: causes and treatment).
The use of a laser is explained by the presence of ischemic areas of the retina, as well as if newly formed vessels are constantly developing, provoking regular hemorrhages. With the help of injections of lucentis, the growth of such vessels stops, as a result of which the swelling of the macula decreases.
Features of the treatment of lesions of large vessels
In modern medicine, occlusion in the central vein is of two types. As for the ischemic type, it consists in a severe violation of blood flow, when visual acuity is greatly reduced.
Due to the risk of complications, the patient is required to undergo frequent follow-up examinations during the first three months of treatment.
Ischemic type of lesion
Non-ischemic thrombosis is characterized by less pronounced changes in the retina and a fairly high visual acuity. Repeated examinations in this case are carried out regularly after one, three, six and twelve months.
After a comprehensive diagnosis, the doctor prescribes the appropriate treatment and, if necessary, surgery. To combat hemorrhages, hemase and streptokinase injections show themselves effectively.
To improve blood circulation, drops are used that can reduce intraocular pressure. Dexamethasone and diprospan help reduce retinal swelling. At the same time, with the help of injections of Ozurdex or Lucentis, it is possible to stop the formation of vessels that provoke swelling and hemorrhage.
Complications
In addition to ignoring the disease, which can lead to the development of more serious vision problems, side effects differs in rare cases and treatment of thrombosis. This may be due to the individual reaction of the patient's body and its inability to tolerate certain medications.
For example, fibrinolytics can cause bleeding, and laser coagulation can cause exudative retinal detachment and hemorrhage.
Source: https://uflebologa.ru/klinicheskaya-simptomatika/tromboz-glaza-sosudov-318
Cardiovascular diseases have become the problem of the century, the main cause of disability and death of people of working age. Central retinal vein thrombosis (CRV) is one of these most dangerous diseases leading to a rapid loss of visual function. This pathology is a condition when the central vein that feeds the retina or its branches is thrombosed in the human eye, as a result of which the venous outflow of blood is disturbed.
The overflow of veins and vessels with an excess amount of blood causes their stretching and deformation, while the fluid enters the intercellular space, which forms edema and leads to hemorrhages. The vein becomes tortuous, affected by hemorrhages, and the retina around it becomes pale and edematous. All this threatens with the development of ischemic zones, dead areas of the shell of the eye, unable to continue to perform the visual function.
The reasons
In very rare cases, retinal thrombosis occurs as an independent disease, it is mainly the result of already existing problems such as:
- vascular atherosclerosis;
- eye tumors;
- diabetes;
- hypertension;
- systemic vasculitis;
- glaucoma;
- violations of blood coagulation processes.
The listed ailments contribute to the thickening and deformation of the walls of the color of its branches, and this inevitably leads to impaired blood flow and the formation of clots. Provocateurs of the thrombus formation process can be some medications taken by the patient, such as contraceptives or diuretics.
According to statistics, out of a thousand people forty years and older, every two are diagnosed with retinal vein thrombosis. Basically, this disease is characteristic of older people and is more often observed in patients older than sixty years.
There are also cases when the disease develops in young people. At risk are people with endocrine pathologies and congenital blood diseases (leukemia, clotting disorders).
It can also be caused by complications after suffering infectious diseases, for example, flu, sinusitis, sinusitis), or occurring chronically inflammatory processes mouth and paranasal sinuses.
In addition, thrombosis of the central retinal vein often develops in people who lead a sedentary lifestyle, have excess weight or alcohol abusers.
Signs and symptoms
Thrombosis of the central vein of the retina is very difficult to detect in time, since the disease mainly manifests itself in people already suffering from any problems with the organs of vision. At the initial stage, reddening of the vessels of the retina of the eyes is simply observed, minor minor hemorrhages may occur. An important sign is the unilateral nature of the lesion, that is, the process occurs in only one eye.
Another feature is that most often the signs of thrombosis develop during sleep, so patients find them in the morning after waking up.
The disease in its development goes through several stages.
- Prethrombosis - outwardly has no manifestations, but on examination, the doctor can see venous congestion of the fundus. The veins are deformed, blood circulation is slowed down. At this stage, there are rare petechial hemorrhages, a slight decrease in visual acuity, and there may be complaints of occasional mist in the eyes. But the disease does not reveal itself in anything else.
- The stage of developed CVD thrombosis is characterized by hemorrhages various forms and sizes throughout the retina. If the pathology has touched the branches of the vein, then hemorrhages occur only along them in a limited area of the fundus. The ophthalmologist detects redness and swelling of the optic disc and the erasure of its contours. Such signs are also called the “symptom of a crushed tomato”. The patient complains of a significant, but not very sharp deterioration in the quality of vision (from several hours to several weeks), there may be a partial loss of the field of vision in places of dead vessels. This stage is also accompanied by fog and a veil in front of the patient's eyes, flies flickering.
- During the period of post-thrombic retinopathy, which occurs several months after the previous one, hemorrhages resolve in the retina and degenerative and atrophic processes begin to occur. Vision slowly returns, but not to full recovery. Growths of newly formed vessels are observed in the region of the disk and the fundus, and even where they should not normally be, which threatens with the occurrence of repeated hemorrhages. Pathological changes lead to various complications: maculopathy, glaucoma, optic nerve atrophy.
Diagnostics
For accurate diagnosis and right choice treatment requires diagnostic testing. First of all, this is an appointment with the attending ophthalmologist, who will:
- visual acuity test;
- perimetry - determination of the presence of affected visual fields and narrowing of the visual field due to them;
- biomicroscopy - examination of the vitreous body of the eye and its iris, pupil:
- study of the state of the retina - fluorescent antiography (FAG), - an examination that makes it possible to determine the type, degree of thrombosis, the size of the lesions, the condition of the veins and blood vessels, the presence of neoplasms;
- computed tomography of the retina.
In addition, the doctor prescribes blood tests for sugar content and clotting, as well as a urine test. If necessary, the patient is referred for examination by such specialists as a therapist, cardiologist, endocrinologist and neuropathologist.
Treatment
The appointment of treatment by the attending physician depends on the definition of one of the types of ocular thrombosis, which differ in the complexity of restoring functioning:
- ischemic - with pronounced pathological changes (multiple hemorrhages, a pronounced degree of swelling, a significant decrease in vision and the appearance of blind spots, a critical violation of blood flow). In this case, after the start of treatment, it is necessary to undergo control examinations every two to three weeks during the first three months, since there is a risk of developing serious complications;
- non-ischemic, with minimal abnormalities. In this case, the first examination is carried out after a month of treatment, then after three, repeated after six months and a year.
Treatment of thrombosis of the CVV of the eye should begin immediately immediately after diagnosis. With proper treatment, after two to three months, the patient's symptoms disappear and vision returns.
In the early stages of development, usually assigned medicines and injections for vasodilatation, resorption of hemorrhages, liquefaction of formed clots, removal of edematous syndrome and improvement of the quality of nutrition of the retina.
Fibrinolytics are prescribed to dissolve existing blood clots and restore blood circulation. These include plasminogen, as well as streptodecase and hemase in injections. They are administered parabulbarno (injections into the eye) daily for a week or two.
Direct anticoagulant preparations are shown that act on blood proteins in such a way as to prevent the conversion of prethrombin to thrombin, which forms a thrombus. These include, for example, heparin. They are also injected into the eye for five days.
Antiplatelet agents may be prescribed to thin the blood. They have a milder effect than anticoagulants, and their effect is directed at platelets, blocking signals that cause blood to clot. These include aspirin, emoxipin and others. During treatment, it is necessary to constantly monitor changes in blood coagulation parameters.
To reduce pressure in the eye and reduce swelling, eye drops are prescribed - timolol, and intramuscularly - lasix. The drugs nifedipine and fenigidin help to lower blood pressure. Antispasmodics can be prescribed - no-shpa, papaverine.
In some cases, with a significant amount of edema and the occurrence of inflammation, it may be necessary to treat the disease with hormonal drugs. Dexol is used for these purposes.
After several months of treatment, if the edema persists, there is a possibility of swelling of the mocular zone, which is dangerous for the development of complete blindness. Then laser coagulation of the retina is performed. it surgical method, designed for rapid removal of fluid, cauterization of newly formed vessels and veins, as well as limiting the affected area. Application laser treatment hinders in further development secondary glaucoma and other complications in the patient.
For a speedy and more complete restoration of all functions, it is useful to drink a course of vitamins A, E, C and B.
Consequences, possible complications
With the ischemic nature of the disease, complications such as atrophy of the optic nerve, recurrence of glaucoma and mocular edema, or the appearance of a membrane - the mocular fold, or fibrosis, often occur.
After the treatment prescribed by the doctor, vision usually returns to its original value, but degenerative changes of varying degrees occur in the eye in all one hundred percent of cases of the disease.
Thrombosis of vessels and the central retinal vein (TRV) is a dangerous pathological condition, characterized by blockage of the central vessel of the retina and its branches with blood clots. The result of the disease is a violation of blood circulation.
This pathology is diagnosed in many people, is a common cause of visual loss and disability.
Most often in humans, thrombosis of the central retinal vein and its individual branches is determined. The condition is characterized by a sharp violation of the normal blood flow through the ophthalmic veins and vessels.
If there is a blockage of the central vein, then there is a violation of the outflow of blood. It begins to accumulate in the vessels, which contributes to their deformation. The vascular walls become denser, which leads to a slowdown in blood flow. Gradually, a thrombus forms, which disrupts normal blood circulation.
Prolonged stagnation of blood leads to the release of its liquid part into the tissues around the vessel. There is an increase in pressure inside the eye, it is possible to develop hemorrhage and swelling. One possible consequence is macular edema, swelling of the central area of the retina.
In such a case, the condition is dangerous, the full restoration of vision remains in question.
In violation of the blood supply to the eye, ischemia of the optic nerve is often diagnosed, characterized by a sharp decrease in visual function, monocular blindness. The disease occurs more often in men, can lead to complete loss of vision.
Occlusion of the central retinal artery (CAS) and its branches is a serious danger due to the rapid development of unpleasant symptoms and irreversible consequences.
Types of thrombosis
Depending on the degree of damage to the retinal veins, two types of thrombosis are distinguished:
- Ischemic. With this form, most of the vessels in the eyeball are affected. A serious retinal hemorrhage is diagnosed, visual function is seriously reduced. Perhaps the development of irreversible consequences in the absence of timely treatment started.
- Not ischemic. Damage to a small area of vessels is noted, there is no hemorrhage, visual impairment is minimal and imperceptible to the patient.
In medicine, there is also the concept of complete and incomplete CVD thrombosis. The first group includes the ischemic form, the second - non-ischemic. The degree of ischemia directly affects the quality of human vision.
Reasons for development
This pathological condition develops as a result of various health problems of the patient.
There is a division of the most common causes according to the age of the patient:
There are also factors provoking the development of the disease:
- Increased body weight.
- Passive lifestyle.
- Alcohol abuse.
- Lack of vitamins in the body.
These factors are not able to independently provoke the development of thrombosis, but their combination increases the likelihood of its occurrence several times. This disease affects women and men equally.
Clinical picture
Thrombosis develops gradually. With partial occlusion, a person does not notice bright signs, the change in vision is minimal. The disease is often diagnosed by chance, on examination by a doctor.
A sick person may experience:
- A slight decrease in visual function.
- Peripheral hemorrhages.
- Paleness of the arteries.
- Areas of excess blood content are poorly distinguishable.
The ischemic form of thrombosis is characterized by the presence of more pronounced signs:
- Massive hemorrhages.
- Severe swelling.
- Excess accumulations of blood are very noticeable.
- Perceptible loss of vision.
- Poor pupillary response to light.
- Marked narrowing of the ophthalmic artery.
There are several stages in the course of thrombosis. Each of them is characterized by the development of different symptoms.
- The first stage is called prethrombosis. At this stage, there is stagnation. venous blood. The veins become wider, darken, tortuosity of the vessels appears. The center of the retina becomes edematous. At the first stage, a person may have clouding before his eyes, such a phenomenon is not perceived as a symptom of the disease.
- The second stage is thrombosis. It is characterized by a serious violation of blood circulation, the occurrence of hemorrhages in the retina and other parts of the eyeball. The boundaries of the optic nerve are poorly visible or not noticeable at all. There is macular edema, visual function is seriously impaired. The patient notes the presence of a veil before the eyes, the loss of visual boundaries. In the absence of adequate treatment, complete or incomplete thrombosis develops, pathological changes in the retina are noted.
- Post-thrombotic retinopathy is the third stage of the disease. The return of vision in humans occurs in slow motion. Unnatural formations of capillaries are diagnosed. There are residual hemorrhages in the fundus. During the recovery period, new blood vessels may form in places where they should not be.
Unfortunately, recurrence of the disease is possible in the absence of proper treatment.
Diagnostics
An experienced ophthalmologist can easily determine the degree of thrombosis. Diagnosis of the disease consists in questioning the patient and conducting specific examinations. The doctor finds out when the changes in visual functions began, what medications the patient takes, whether there are certain diseases in a person.
After conducting a survey and collecting information, studies are assigned using special techniques:
- Visometry. The method involves the study of visual acuity. With an ischemic form of thrombosis, the severity exceeds 0.1, with a non-ischemic form, it is below this indicator.
- Tonometry. During the study, the pressure in the eyeball is measured. Indicators are taken during the day. In a diseased organ, the numbers will be 2-3 mm Hg. Art. lower than in healthy.
- Perimetry. A method to help determine the narrowing of the field of view (cattle). With thrombosis, a similar phenomenon is observed in the area of the affected retina. The density of scotoma varies with different masses of hemorrhage and the presence of ischemic foci.
- Microperimetry. The method is used to determine the reaction to light of certain parts of the retina, which allows you to accurately identify the area of the lesion.
- Biomicroscopy. Allows you to see the signs of thrombosis: grinding of the anterior chamber of the eye, suspension of blood in the vitreous body, the absence of a friendly reaction of the pupils when illuminating the diseased eye.
- Optical coherence tomography. A study using a scanning beam helps to determine the structure, size of puffiness and features of the course of the disease. The method is used to evaluate the effectiveness of treatment.
- Fluorescent angiography (FAG). An effective technique that determines the type of thromboembolism, the degree pathological process, areas of damage, the period of onset of the disease. The method is often used at the first examination, it helps to determine the presence of thrombosis, if other methods have not helped.
After confirming the diagnosis, a suitable treatment is prescribed, aimed at eliminating the causes and symptoms of thrombosis, restoring visual function.
Self-identification of the disease early stage impossible.
Symptoms are minimal, people often do not pay attention to a slight visual impairment. Intense signs are noted with a serious course of the disease, when a person already sees poorly.
Preventive ophthalmological examination is required at least once every 6 months. Regular visits to a medical specialist will help not to miss the onset of the disease and choose the right therapy in time.
Principles of treatment
Treatment for thrombosis depends on the severity of the disease. With uncomplicated types, the use of drugs is sufficient.
Complicated forms of thrombosis will require surgical intervention. The choice of treatment method remains with the doctor.
Conservative treatment
The use of medications helps to restore normal blood circulation in the eyeball and visual functions.
The doctor will select medications based on the degree of thrombosis and the patient's condition. Before treatment, the patient is obliged to inform the doctor about the medications taken.
Medicines used in therapy:
- Medications that lower blood pressure. It can be tablets - Nefedipine, Fenigidin. A solution of the drug Dibazol is administered through a vein, Lasix is used for intramuscular injection. Timolol will help reduce pressure in the eyes.
- It is possible to normalize blood flow with the use of fibrinolytic drugs. Plasminogen is injected into the subocular space for two weeks.
- To avoid recurrence of the disease, the patient may be prescribed Acetylsalicylic acid. Reception is carried out under the supervision of a physician to monitor blood clotting.
- Special hormonal preparations used to reduce swelling and inflammation. Often, Dexamethasone is used for this purpose - it is injected under the eyeball, or in the form of droppers.
- In the presence of pain analgesics are used.
- Complexes of vitamins are necessarily prescribed, the main attention is paid to ascorbic acid and B vitamins.
All medicines are prescribed by a doctor. Self-selection of medicines can lead to an aggravation of the process and serious negative consequences.
Surgical methods
Even after successful drug treatment The patient is recommended to undergo laser photocoagulation of the retina. The operation is performed under local anesthesia on an outpatient basis. Its duration is no more than half an hour.
It is performed by a qualified ophthalmologist. At surgical intervention the thrombus is exposed to a laser, as a result of which it resolves. The result is the restoration of normal blood flow in the vessels of the eyeball.
The operation has some contraindications:
- Retinal disinsertion.
- Presence of a cataract.
- Hemorrhages are diagnosed in the fundus of the eye.
- Reduced transparency of the media of the eye.
Possible consequences
In 10% of all cases of vascular thrombosis, complete loss of vision is possible. This complication often occurs as a result of ischemia of the entire central vein and atrophy of the optic nerve.
Insufficient blood supply leads to other complications after thrombosis:
- Atrophic changes in the nerve.
- Recurrent macular edema.
- secondary glaucoma.
The appearance of a scotoma is not excluded - an area of the retina of the eyeball with an altered or lost visual function.
Forecast
With proper and timely treatment, vision can be restored completely. Incomplete recovery or loss is diagnosed in 10% of all cases of the disease.
For quick recovery after thrombosis of the vessels of the eye, it is recommended to limit physical activity, not to make sudden movements, cover your eyes with sunglasses, and keep pressure under control.
It is necessary to stop watching TV for a long time and working at the computer.
Prevention of recurrent thrombosis
It is possible to avoid recurrence of the disease if preventive measures are observed:
- Monitor pressure readings.
- Glucose control for diabetes taking prescribed medications.
- Diseases endocrine system require careful attention and treatment.
- Be sure to visit an ophthalmologist every six months.
For prevention, it is permissible to perform some exercises that help improve vision.
Compresses from tea leaves have a good effect on the condition of the eyes, herbal infusions, cucumber juice. In the infusion of any element, gauze is moistened and put on the eyelids for half an hour. Repeat this procedure for 14 days, take a break for the same amount of time and perform again. It is recommended to use infusions of hawthorn flowers, mint leaves, lemon balm, sage, brewed in the form of tea.
Thrombosis of the eye is a disease that develops against the background of impaired blood circulation in the tissues of the organ of vision. This is a serious pathology that requires timely treatment.
The concept and causes of a blood clot in the eye
Violation of the blood supply to tissues leads to their death. A blood clot that clogs a vessel can lead to complete or partial loss of vision.
The formation of a blood clot in the eye can occur for the following reasons:
- Disturbed metabolism.
- Increased arterial and intraocular pressure.
- Cardiovascular diseases.
- The development of infectious diseases of the oral cavity, paranasal sinuses.
- External pressure on the vessel (with an eye tumor).
Retinal thrombosis is a disease that affects both the elderly and those who have not yet celebrated their 40th birthday. At risk are people suffering from obesity, physical inactivity and lack of vitamins due to malnutrition.
Diagnosis of retinal thrombosis
The main symptom of retinal vascular thrombosis is a deterioration in visual acuity, the appearance of fog in front of the eyes, especially in the morning.
The determination of the presence of a blood clot in the vessels of the tissues at the first stage is carried out by questioning the patient and his external examination.
To obtain more detailed information about the state of the organ of vision, laboratory research: visometry, perimetry and others.
To find out the general state of health of the patient, the doctor needs to measure his blood pressure, and give a referral for an ECG and blood and urine tests.
The test results may require, in addition to consulting an ophthalmologist, an additional examination by a neuropathologist, cardiologist, endocrinologist.
Treatment of retinal thrombosis with laser and drugs
Thrombosis of the branch of the central retinal vein (RCV) is characterized by a decrease or defects in vision, which is not accompanied by pain.
The prerequisites for development are diabetes mellitus, hypertension, atherosclerosis of blood vessels, as the walls of the vessels become thicker.
This reduces the throughput of veins and arteries and is a favorable environment for.
The superior temporal branch of the CVD is most commonly affected. It is of particular importance for the blood supply to the macular region.
If the disease is accompanied by the appearance of new vessels or in the presence of ischemic areas on the surface of the retina, the use of pharmaceutical drugs does not give tangible positive results.
In this case, the treatment of ocular thrombosis is performed by a laser. The procedure is called laser coagulation.
Its essence lies in the fact that under the influence of laser beams, the blood clot is destroyed, and blood circulation is restored.
If there is a sharp deterioration in the vision of one of the eyes, we are talking thrombosis of the central retinal vein.
Among the causes of impaired patency of the veins are increased blood density, glaucoma, atherosclerosis and arterial hypertension.
Blood passes through the artery, and the vein clogged with a thrombus prevents the outflow of the liquid medium. As a result, the veins fill up with blood. This causes swelling and bleeding.
Thrombosis of the central retinal vein is classified into 2 subtypes: ischemic and non-ischemic. includes taking pharmaceuticals.
If the blood supply to the eye is difficult or completely stopped due to the formation of a clot in the vessel, this process is called central artery thrombosis.
The prerequisites for the onset of the disease are the same as when exiting the vein.
Treatment of retinal thrombosis with folk remedies
A patient who is prescribed a treatment that does not include surgery and does not require laser correction, to get rid of his illness, can turn to alternative medicine.
The treatment course is aimed at stopping the further impact of factors of other diseases on the blood circulation.
The use of decoctions and tinctures from hawthorn, cudweed herb, leaves of magnolia grandiflora contributes to a decrease in blood pressure.
In its pure form, chokeberry berries are useful.
Retinal edema helps relieve plants and herbs that have diuretic properties.
Strengthen the walls of blood vessels in order to avoid hemorrhages will help bee products: bee bread and honey.
Reduces blood viscosity, promotes decoction of sweet clover grass with extract horse chestnut and the addition of propolis.
Eating zinc-rich foods, such as sugar beets and carrots, improves eyesight. Vegetables can be consumed both as ingredients in dishes and in their pure form.
One of the most important components circulatory system, contributing to the enrichment of the eyes with vital components, is the central vein of the retina.
The formation of blood clots contributes to the disruption of normal blood flow in the vessels of the eyes.
Retinal vein thrombosis interferes with the normal functioning of the system, which causes deterioration that provokes the development of ophthalmic diseases. With such a violation, vision is most often reduced and blindness occurs.
The reasons
Most often, thrombosis of the vessels of the eye occurs due to the formation of blood clots. At the same time, blood is thrown into the capillary of the eye, in which the blockage has occurred. As a result, there is an increase in blood pressure, due to which retinal hemorrhages can occur, and significant swelling appears.
Common causes of blood clots in the vessels of the eyes are:
- the development of atherosclerosis of the arteries most often causes blockage of the central vein of the retina;
- the presence of arterial hypertension;
- progression of diabetes mellitus, regardless of type (pathology occurs with sharp jumps in sugar that occur with poor compensation for diabetes);
- flu;
- the presence of blood poisoning;
- infections in the mouth and sinuses;
- regular high pressure inside the eyes;
- the presence of edema of the optic nerves;
- the presence of a tumor.
Most of the reasons mentioned above provoke thickening of the vessels, due to which nearby arteries can compress the retinal veins. The result of this effect is a slowdown in normal blood circulation, which causes the formation of blockages. With stagnation of venous blood, the inner surface of the eye suffers, since the vascular walls become permeable, extensive hemorrhage and edema open.
Risk group
The following factors contribute to the development of blockage of the retinal veins:
Non-surgical eye treatment for 1 month.
- passive lifestyle;
- excess body weight;
- the presence of cardiovascular diseases;
- problems with the functioning of the endocrine glands;
- wrong choice of therapy for the treatment of hypertension, diabetes and other diseases.
The risk group includes people with problems with the normal functioning of the endocrine system, in particular, if the pathology is treated incorrectly and out of time. Thrombosis is no less common in older patients. In this case, there is an age-related deterioration in the quality of vision, but blockage of the veins develops suddenly. Also, the development of pathology can be provoked in the presence of primary glaucoma, trauma to the eyeballs and changes in blood viscosity.
Stages of thrombosis
Thrombosis of the central vein of the retina is divided into stages of development:
- The state of prethrombosis - at this stage, the veins of the patient's eyes are uneven, dilated and tortuous with hemorrhages that have the structure of threads. There is swelling of the central region of the retina. This stage is characterized by an inconspicuous course of the disease. The patient may feel a slight deterioration in the general condition, against this background, malaise and isolated cases of blurred vision may occur.
- Thrombosis - the surface of the retina is covered with numerous hemorrhages. At the same time, vision drops significantly, a veil appears on the eyes and flies.
- Retinopathy is a post-thrombotic condition that is a chronic form. The first manifestation is noted after a couple of months. The fundus of the eye is covered with old hemorrhages, solid liquids. It is also noted the presence of new formed vessels, which should not be in healthy eyes. Edema of the central zone is still preserved. At this stage, it is important to continue treatment, since the pathology is able to resume.
Symptoms
Thrombosis of the central retinal vein of the eye can be diagnosed on the basis of the symptoms accompanying the development of the disorder.
Symptoms of pathology are:
- Sudden loss of visual acuity. As a rule, the violation develops over a period of several hours to several weeks. During this time, the patient does not feel pain or discomfort.
- Flies may appear before the eyes. The view is blurred. Such manifestations are not necessarily long-term, they can appear periodically and disappear again. Most often, patients experience this manifestation in the morning after waking up after sleep. Often, blind spots may appear when looking at any objects. The scale of such manifestations depends on the severity of the blockage.
- Gradually, swelling begins to appear. It is clearly visible during the examination through ophthalmoscopy, since the specialist has difficulty in determining the edge of the optic disc.
- The vitreous body is covered with hemorrhages, which can resolve within a few months. In this case, the quality of vision is not restored.
- There may be damage to the back of the retina. In this case, the pathology does not provoke loss of vision. Maculopathy is characterized by the development of secondary posthemorrhagic glaucoma and degeneration of the retina.
Diagnostics
Put accurate diagnosis the specialist can after applying several methods of diagnosis. In one case, ophthalmoscopy of the fundus is sufficient for this. Angiography is used to determine the extent of the lesion. An examination of the anterior areas of the eyes is also carried out. Additionally, the following indicators may be needed:
- level blood pressure;
- blood clotting index;
- indicators of urine and blood analysis, biochemistry.
Treatment
To avoid the negative consequences of blockage, it is necessary to identify and begin treatment of pathology in a timely manner. In the treatment of central vein thrombosis, it is necessary:
- ensure the resorption of the formed hemorrhages;
- improve the quality of blood supply to the retina and reduce its swelling;
- improve the quality of nutrition of retinal cells;
- reduce pressure inside the eyes.
For the treatment of the disease, the following medications are used:
- Nifedipine, Fenigidin - normalize blood pressure;
- Lasix - lowers blood pressure and relieves swelling;
- Timolol - reduces external pressure on the retina;
- Plasminogen - accelerates the destruction of thrombotic formations;
- Clexane, Novoparin - prevent the formation of new blockages and stop the development of existing ones;
- Plavix and Trental - used as a prevention of the formation of new blood clots;
- Lucentis and Ozurdex - help reduce macular edema and prevent hemorrhages.
If conservative methods fail, the specialist may prescribe a surgical operation. This procedure is called laser coagulation.
Complications
A blood clot in the eye can be cured if diagnosed early. In this case, the restoration of vision begins within a few months after the end of therapy. Swelling gradually decreases, hemorrhages resolve.
If you ignore the appointment of a specialist, complications may develop in the form of:
- secondary glaucoma;
- retinal dystrophy;
- optic neuropathy;
- entry of blood into the vitreous body.
Forecast
Improper treatment of central retinal vein thrombosis can worsen the quality of vision without a return. In this case, the patient will not only become blind, but will also lose his ability to work, acquire the status of a disabled person. In order not to face negative consequences pathology, attention should be paid preventive measures and regular check-ups with a specialist. When making a diagnosis of "thrombosis of the central vein", one should strictly adhere to the appointments of an ophthalmologist, an improvement in the condition can be expected in a short period.
The course of the pathology may be accompanied by a significant decrease in the quality of vision. Complete loss of visual functions is possible. The severity of possible complications directly depends on which vein is affected by the disease. The least harm is caused by the defeat of the lateral veins, since in this case the quality of vision will be gradually restored. Damage to the central veins is eliminated much longer. In severe forms of pathology, the probability of restoring visual functions is minimal.
Prevention
Blockage of the central retinal vein is easier to prevent than to treat. To do this, follow the recommendations of experts:
- should be healthy lifestyle life, give up bad habits;
- as much as possible to exclude from the diet foods that increase blood pressure;
- move more, increase activity through sports;
- develop the ciliary muscle by performing special exercises;
- visit an ophthalmologist as often as possible, check the condition of the retina and eyes in general;
- timely and correctly treat problems of the cardiovascular system, do not forget to control blood pressure.
The eyes are important human organs. The condition of the eyes largely depends on the way of life of the patient. We must not forget about the need to take care of them.
Source: proglazki.ru
Thrombosis of the central retinal vein
Retinal vein thrombosis is a violation of blood circulation in the most important vessels of the eye - the central retinal vein (CRV) and its branches. It is the most common cause of visual impairment or even blindness. Out of a hundred thousand people, two hundred have this pathology. Only in 30% thrombosis of the branch of the central vein occurs, and the vein itself is more often affected.
The reasons
As a rule, retinal thrombosis most often occurs in elderly people against the background of diseases:
- atherosclerosis;
- hypertension;
- diabetes;
- inflammatory and destructive processes of the walls of blood vessels (vasculitis);
- various disorders that affect blood clotting.
Possible causes of thrombosis of the CVV of the eye:
- complication after viral and infectious diseases;
- increased pressure inside the eye;
- swelling of the optic nerve;
- swelling inside the eye;
- autoimmune ophthalmopathy.
Patients at risk:
- obese;
- with diseases thyroid gland;
- leading a sedentary lifestyle;
- alcohol abusers.
Symptoms
This disease goes away without any symptoms. The development of thrombosis can occur in just a few hours, manifest itself in deterioration or even cause complete loss of vision in one eye, and in some cases both.
With thrombosis of the branches, symptoms can manifest as:
- dark spots;
- fog in the eyes;
- distortion of vision;
- sensation of pain when blinking, as if sand were in the eyes.
However, more often, for example, if the center of the retina is not affected, vision is preserved and the disease can only be detected during examination. Therefore, it is so important to visit an ophthalmologist periodically, especially for patients at risk.
Varieties
- according to the degree of changes in the retina;
- by stages of development.
Degrees
In the first case, the pathology is divided into:
- non-ischemic - a slightly pronounced lesion of the retina, which practically does not affect vision;
- ischemic thrombosis - a serious violation of blood flow, severe damage to the vessels of the retina, extensive hemorrhages, while visual acuity is significantly reduced, there is a high risk of its complete loss.
The degree of ischemia directly affects the level of vision.
Stages of development
This pathology in its development is characterized by several stages:
- Prethrombotic state - characterized by the presence of uneven, dilated, tortuous veins, filiform hemorrhages, the central region of the retina swells. As a rule, the patient at this stage does not feel the presence of the disease, not numerous blurred vision is considered the result of malaise.
- Thrombosis itself is characterized by the appearance of hemorrhages on almost the entire surface of the retina, visual acuity drops noticeably, sensations of a veil and flies appear more often.
- Post-thrombotic state (retinopathy) - chronic thrombosis that appears within a few months. The fundus of the eye has chronic hemorrhages, solid exudates, there is the presence of newly formed vessels, which are absent in the normal state. The central zone has an edematous state.
The disease may recur.
Diagnostics
Symptoms of thrombosis, especially in the initial stages, are almost impossible to determine without diagnosis. Recognition of the disease, for highly qualified specialists, is not difficult, using diagnostic techniques:
- Perimetry;
- Visometry;
- biomicroscopy;
- Ophthalmoscopy;
- Laboratory tests;
- ECG, blood pressure measurements, retinal OCT;
- Angiography of retinal vessels.
The prognosis of the disease with the correct, timely treatment prescribed by the attending physician is usually favorable. Various complications (optic nerve atrophy, glaucoma, retinal dystrophy, and so on) are possible only in case of improper treatment.
Treatment
The main task for thrombosis is to detect the disease in time and start treating it as quickly as possible.
Medications
The use of medicines is aimed at the following actions:
- dissolution of hemorrhages;
- restoration of blood circulation;
- normalization of retinal nutrition;
- reduction in puffiness.
The following means are used:
- Antihypertensive (hypotensive) - reduce blood pressure, reduce swelling of the retina ( intravenous injections"Dibazola", "Papaverina", oral tablets - "Lizoril", eye drops - "Arutimol", "Timolol");
- Fibrinolytic agents - promote the resorption of blood clots, restore blood circulation (daily eye injections of Plasminogen, Fibrinolysin, 0.5 milliliters for two weeks);
- Antithrombotic (anticoagulant) agents - are used after a course of fibrinolytics, to prevent blockages of the vessel. Direct anticoagulant "Heparin" is used in the complex of injection intramuscularly and into the lower eyelid area, the course is a week;
- Antiplatelet agents - to prevent the recurrence of the disease: tablets "Aspirin", "Plavix";
- Hormonal agents - serve to relieve inflammation and swelling. It is administered within a week by injections into the lower eyelid of preparations containing the active substance dexamethasone;
- Vitamins - groups C and B.
Treatment at home
It is important to understand that to fully cure eye thrombosis folk remedies impossible. They serve rather to prevent this disease. At the first suspicion, be sure to contact a qualified specialist.
This includes the following options:
Drops
- Take twenty grams of grass, for example: cumin, cornflower flowers or plantain leaves, insist on two hundred grams of boiling water, strain. Bury five times a day during the entire course of treatment.
- Take clover, wood lice, squeeze the juice and bury it.
Possible contraindications for individual intolerance to the components.
Compresses
Compresses are made from tea leaves, cucumber juice, and herbal infusions. Twenty grams of any ingredient is poured with boiling water, insisted for an hour. The mixture in gauze is placed on the eyelids, kept from half an hour to fifty minutes. The procedure is carried out for two weeks, then after a break of fourteen days, the course is repeated.
Infusions, decoctions
It is good to use infusions from the following plants:
- hawthorn flowers;
- sage;
- mint leaves;
- lemon balm;
- elecampane root and others.
They can be brewed as tea, or infuse a decoction in a thermos, or prepare a vodka tincture for ten days.
Gymnastics and massage
There are many options for eye gymnastics, here are some of them;
- With tension, open and close your eyes (five times); look right, left, up, down (five times).
- Blink vigorously for two minutes.
- Massage with light pressure on the eyeball for two seconds. Repeat up to ten times.
laser operation
Laser treatment (laser coagulation) has a great effect, it is used after therapeutic drug treatment, if the disease is ischemic in nature and the use of pharmaceuticals does not have noticeable results.
The intervention is based on the effect of a laser on a thrombus, with the aim of resolving it and, as a result, normalizing blood flow to the retina.
Prevention
In order to fully treat such a disease, it is necessary not only to use medications, laser surgery, but also to comply with therapeutic rules:
- reduction of loads;
- adherence to a diet that normalizes blood pressure.
The diet for the prevention of thrombosis consists of:
- at least two liters of fluid per day;
- a large number of vegetables and fruits;
- seafood, fish;
- low fat dairy products.
And also mandatory introduction to the diet:
- dates;
- soy products;
- beef liver;
- nuts;
- legumes;
- cereal;
- asparagus;
- nettle leaves and mint;
- watermelon;
- lettuce;
- spinach;
- blueberries.
It is necessary to exclude from the diet all fatty, fried, pastries, chocolate, coffee, alcohol.
Foods indicated for consumption do not need to be consumed all at once, but they must be present in the daily diet to prevent thrombosis. Subject to all the doctor's recommendations, the prognosis in the treatment and prevention of recurrence is always positive.
Source: www.glazeexpert.ru
Thrombosis of vessels and central retinal vein
Article publication date: 09/16/2018
Date of article update: 05/30/2019
Thrombosis of the vessels and the central retinal vein (CVR) is a dangerous pathological condition characterized by blockage of the central retinal vessel and its branches with blood clots. The result of the disease is a violation of blood circulation.
This pathology is diagnosed in many people, is a common cause of visual loss and disability.
The mechanism of development of pathology
Most often in humans, thrombosis of the central retinal vein and its individual branches is determined. The condition is characterized by a sharp violation of the normal blood flow through the ophthalmic veins and vessels.
If there is a blockage of the central vein, then there is a violation of the outflow of blood. It begins to accumulate in the vessels, which contributes to their deformation. The vascular walls become denser, which leads to a slowdown in blood flow. Gradually, a thrombus forms, which disrupts normal blood circulation.
Prolonged stagnation of blood leads to the release of its liquid part into the tissues around the vessel. There is an increase in pressure inside the eye, it is possible to develop hemorrhage and swelling. One possible consequence is macular edema, swelling of the central area of the retina.
In such a case, the condition is dangerous, the full restoration of vision remains in question.
In violation of the blood supply to the eye, ischemia of the optic nerve is often diagnosed, characterized by a sharp decrease in visual function, monocular blindness. The disease occurs more often in men, can lead to complete loss of vision.
Occlusion of the central retinal artery (CAS) and its branches is a serious danger due to the rapid development of unpleasant symptoms and irreversible consequences.
Types of thrombosis
Depending on the degree of damage to the retinal veins, two types of thrombosis are distinguished:
- Ischemic. With this form, most of the vessels in the eyeball are affected. A serious retinal hemorrhage is diagnosed, visual function is seriously reduced. Perhaps the development of irreversible consequences in the absence of timely treatment started.
- Not ischemic. Damage to a small area of vessels is noted, there is no hemorrhage, visual impairment is minimal and imperceptible to the patient.
In medicine, there is also the concept of complete and incomplete CVD thrombosis. The first group includes the ischemic form, the second - non-ischemic. The degree of ischemia directly affects the quality of human vision.
Reasons for development
This pathological condition develops as a result of various health problems of the patient.
There is a division of the most common causes according to the age of the patient:
There are also factors provoking the development of the disease:
- Increased body weight.
- Passive lifestyle.
- Alcohol abuse.
- Lack of vitamins in the body.
These factors are not able to independently provoke the development of thrombosis, but their combination increases the likelihood of its occurrence several times. This disease affects women and men equally.
Clinical picture
Thrombosis develops gradually. With partial occlusion, a person does not notice bright signs, the change in vision is minimal. The disease is often diagnosed by chance, on examination by a doctor.
A sick person may experience:
- A slight decrease in visual function.
- Peripheral hemorrhages.
- Paleness of the arteries.
- Areas of excess blood content are poorly distinguishable.
The ischemic form of thrombosis is characterized by the presence of more pronounced signs:
- Massive hemorrhages.
- Severe swelling.
- Excess accumulations of blood are very noticeable.
- Perceptible loss of vision.
- Poor pupillary response to light.
- Marked narrowing of the ophthalmic artery.
There are several stages in the course of thrombosis. Each of them is characterized by the development of different symptoms.
- The first stage is called prethrombosis. At this stage, there is stagnation of venous blood. The veins become wider, darken, tortuosity of the vessels appears. The center of the retina becomes edematous. At the first stage, a person may have clouding before his eyes, such a phenomenon is not perceived as a symptom of the disease.
- The second stage is thrombosis. It is characterized by a serious violation of blood circulation, the occurrence of hemorrhages in the retina and other parts of the eyeball. The boundaries of the optic nerve are poorly visible or not noticeable at all. There is macular edema, visual function is seriously impaired. The patient notes the presence of a veil before the eyes, the loss of visual boundaries. In the absence of adequate treatment, complete or incomplete thrombosis develops, pathological changes in the retina are noted.
- Post-thrombotic retinopathy is the third stage of the disease. The return of vision in humans occurs in slow motion. Unnatural formations of capillaries are diagnosed. There are residual hemorrhages in the fundus. During the recovery period, new blood vessels may form in places where they should not be.
Unfortunately, recurrence of the disease is possible in the absence of proper treatment.
Diagnostics
An experienced ophthalmologist can easily determine the degree of thrombosis. Diagnosis of the disease consists in questioning the patient and conducting specific examinations. The doctor finds out when the changes in visual functions began, what medications the patient takes, whether there are certain diseases in a person.
After conducting a survey and collecting information, studies are assigned using special techniques:
- Visometry. The method involves the study of visual acuity. With an ischemic form of thrombosis, the severity exceeds 0.1, with a non-ischemic form, it is below this indicator.
- Tonometry. During the study, the pressure in the eyeball is measured. Indicators are taken during the day. In a diseased organ, the numbers will be 2-3 mm Hg. Art. lower than in healthy.
- Perimetry. A method to help determine the narrowing of the field of view (cattle). With thrombosis, a similar phenomenon is observed in the area of the affected retina. The density of scotoma varies with different masses of hemorrhage and the presence of ischemic foci.
- Microperimetry. The method is used to determine the reaction to light of certain parts of the retina, which allows you to accurately identify the area of the lesion.
- Biomicroscopy. Allows you to see the signs of thrombosis: grinding of the anterior chamber of the eye, suspension of blood in the vitreous body, the absence of a friendly reaction of the pupils when illuminating the diseased eye.
- Optical coherence tomography. A study using a scanning beam helps to determine the structure, size of puffiness and features of the course of the disease. The method is used to evaluate the effectiveness of treatment.
- Fluorescent angiography (FAG). An effective technique that determines the type of thromboembolism, the degree of the pathological process, the area of the lesion, the period of onset of the disease. The method is often used at the first examination, it helps to determine the presence of thrombosis, if other methods have not helped.
After confirming the diagnosis, a suitable treatment is prescribed, aimed at eliminating the causes and symptoms of thrombosis, restoring visual function.
Self-determination of the disease at an early stage is impossible.
Symptoms are minimal, people often do not pay attention to a slight visual impairment. Intense signs are noted with a serious course of the disease, when a person already sees poorly.
Preventive ophthalmological examination is required at least once every 6 months. Regular visits to a medical specialist will help not to miss the onset of the disease and choose the right therapy in time.
Principles of treatment
Treatment for thrombosis depends on the severity of the disease. With uncomplicated types, the use of drugs is sufficient.
Complicated forms of thrombosis will require surgical intervention. The choice of treatment method remains with the doctor.
Conservative treatment
The use of medications helps to restore normal blood circulation in the eyeball and visual functions.
The doctor will select medications based on the degree of thrombosis and the patient's condition. Before treatment, the patient is obliged to inform the doctor about the medications taken.
Medicines used in therapy:
- Medications that lower blood pressure. It can be tablets - Nefedipine, Fenigidin. A solution of the drug Dibazol is administered through a vein, Lasix is used for intramuscular injection. Timolol will help reduce pressure in the eyes.
- It is possible to normalize blood flow with the use of fibrinolytic drugs. Plasminogen is injected into the subocular space for two weeks.
- To avoid recurrence of the disease, the patient may be prescribed Acetylsalicylic acid. Reception is carried out under the supervision of a physician to monitor blood clotting.
- Special hormonal preparations are used to reduce swelling and inflammation. Often, Dexamethasone is used for this purpose - it is injected under the eyeball, or in the form of droppers.
- In the presence of pain, analgesics are used.
- Complexes of vitamins are necessarily prescribed, the main attention is paid to ascorbic acid and B vitamins.
All medicines are prescribed by a doctor. Self-selection of medicines can lead to an aggravation of the process and serious negative consequences.
Surgical methods
Even after successful medical treatment, the patient is recommended to undergo laser photocoagulation of the retina. The operation is performed under local anesthesia on an outpatient basis. Its duration is no more than half an hour.
It is performed by a qualified ophthalmologist. During surgery, the thrombus is exposed to a laser, as a result of which it resolves. The result is the restoration of normal blood flow in the vessels of the eyeball.
The operation has some contraindications:
- Retinal disinsertion.
- Presence of a cataract.
- Hemorrhages are diagnosed in the fundus of the eye.
- Reduced transparency of the media of the eye.
Possible consequences
In 10% of all cases of vascular thrombosis, complete loss of vision is possible. This complication often occurs as a result of ischemia of the entire central vein and atrophy of the optic nerve.
Insufficient blood supply leads to other complications after thrombosis:
- Atrophic changes in the nerve.
- Recurrent macular edema.
- secondary glaucoma.
The appearance of a scotoma is not excluded - an area of the retina of the eyeball with an altered or lost visual function.
Forecast
With proper and timely treatment, vision can be restored completely. Incomplete recovery or loss is diagnosed in 10% of all cases of the disease.
For quick recovery after thrombosis of the vessels of the eye, it is recommended to limit physical activity, not to make sudden movements, cover your eyes with sunglasses, and keep pressure under control.
It is necessary to stop watching TV for a long time and working at the computer.
Prevention of recurrent thrombosis
It is possible to avoid recurrence of the disease if preventive measures are observed:
- Monitor pressure readings.
- Control of glucose levels in diabetes mellitus, taking prescribed medications.
- Diseases of the endocrine system require careful attention and treatment.
- Be sure to visit an ophthalmologist every six months.
For prevention, it is permissible to perform some exercises that help improve vision.
Compresses from tea leaves, herbal infusions, cucumber juice have a good effect on the condition of the eyes. In the infusion of any element, gauze is moistened and put on the eyelids for half an hour. Repeat this procedure for 14 days, take a break for the same amount of time and perform again. It is recommended to use infusions of hawthorn flowers, mint leaves, lemon balm, sage, brewed in the form of tea.
Source: infoserdce.com
Retinal thrombosis - methods of diagnosis and control
Alas, now ophthalmologists often state retinal thrombosis. Moreover, this phenomenon has become much younger over the past 5 years - the vessels of the eyes are in a “deplorable” state not only in the elderly. First of all, this condition should be feared by those suffering from diabetes and hypertension, as well as people with glaucoma (increased intraocular pressure).
Causes
Retinal vascular thrombosis is always a consequence of a long-standing chronic pathology of the eye and / or systemic therapeutic diseases.
Risk factors and precursor diseases of retinal thrombosis:
- Atherosclerosis . The deposition of "harmful" lipids in the inner membrane (intima) of the vessels leads to damage to their walls. In response to this, inflammation occurs, which provokes the migration of coagulation factors to the site of damage and increased thrombus formation.
- Diabetes. This disease not only exacerbates the course of atherosclerosis, but also contributes to fragility and pathological tortuosity of blood vessels. There is even a term "diabetic retinopathy" - pathological changes in the vessels of the retina as a result of damage by structurally altered glycosylated (saturated sugars) proteins.
- Arterial hypertension . People with high pressure retinal vascular thrombosis should be especially feared. Due to hypertension, the smallest vessels are damaged, the blood supply is disturbed and the formation of blood clots is accelerated.
- Vasculitis - from Latin, the term literally translates as "inflammation of the vessels." Arises as allergic reaction or as a result of diseases of the connective tissue and blood ( hemorrhagic vasculitis, systemic lupus erythematosus, scleroderma, etc.).
- Bulging eyes due to prolonged and persistent thyrotoxicosis . An excess of thyroid hormones affects the periorbital tissue - it begins to grow. The eyeball literally "bulges" outward. The vessels do not keep up with it - they burst and thrombose.
- Tumors . They can grow both from the tissue of the eye and metastasize from other organs. Sometimes a particle of the tumor that has entered the vessel blocks its lumen. Read more about neoplasms of the eyelids and the eyeball →
Stages and types of retinal thrombosis
Thrombosis of the central retinal vein (CRV) can be of two varieties:
- thrombosis of the central vein, scientifically - central occlusion;
- thrombosis of one or more branches of the central vein - peripheral occlusion.
Such a division is necessary to evaluate the following parameters:
- Areas of defeat . In CVR thrombosis, a large part of the retina is damaged, and in the presence of a thrombus in a small venule, only a small area may be affected.
- The severity of possible consequences and the urgency of hospitalization . Thrombosis of the central vein is dangerous with a significant loss of vision and requires immediate hospitalization. Thrombosis of the peripheral retinal veins with early diagnosis and a small area of damage can be treated even on an outpatient basis.
- Volume of ophthalmic care . Treatment with central occlusion will be more prompt and voluminous than with peripheral occlusion.
Stages of the thrombotic process in the retina
The development of the disease proceeds in several stages:
- Prethrombosis . It is characterized by the expansion and tortuosity of the veins, single point hemorrhages. At this stage, there are no clinical manifestations yet, but periodic blurring before the eyes may appear.
- Thrombosis directly . Numerous linear hemorrhages are visible in the fundus, macular edema on the retina, which is responsible for color perception, fuzzy boundaries of the optic nerve head. There is a sharp fall in visual acuity and a persistent "veil" before the eyes.
- Post-thrombotic changes . On the fundus, traces of hemorrhages and newly formed vessels with thin walls are visible. Visual acuity is restored slowly.
Clinical symptoms and diagnosis of retinal thrombosis
Symptoms largely depend on the location of the thrombus and the degree of narrowing of the vessel (occlusion).
If there is thrombosis of the central vein of the retina, at least 3/4 of the retina is damaged: there will be large multiple hemorrhages, a rapid deterioration in vision and a distortion of color perception.
If thrombosis of a branch of the central retinal vein (a small branching vessel) has occurred, visual acuity falls slowly and is often not regarded as an alarming symptom. Blurry black spots or "fog" may appear in the field of view in front of the gaze.
Complete occlusion (occlusion of the vein lumen by 95% or more) has severe clinical symptoms. Fortunately, it is rare. Partial occlusion may not be clearly manifested. The manifestation of signs of thrombosis begins with a narrowing of the lumen of the vessel by 70 percent or more.
Thrombosis of the central retinal artery is always an urgent (emergency) condition that requires prompt qualified assistance! If with venous occlusion there is a chance to save vision, then with occlusion of the CAC, complete blindness threatens.
Diagnostics
A 100% specific sign of thrombotic changes in the retina during examination of the fundus through a magnifying glass is the appearance of a “crushed tomato”.
Also, with visometry, reduced visual acuity is diagnosed - a person cannot see the lines of letters and notes that he began to see worse than the day before.
Angiography with fluorescent contrast agent will help to make a definitive diagnosis and accurately indicate the location of the thrombus.
Treatment
Treatment is carried out in 4 stages:
- Restoration of blood flow in a thrombosed vessel.
- Reduced retinal edema.
- Dissolution and elimination of the resulting hemorrhages (if they are small in area).
- Improvement of microcirculation in the retina.
Therapy Methods
For the treatment of retinal thrombosis, an integrated approach is used:
- A thrombus can dissolve Fibrinolysin or Plasminogen. They are injected with a syringe under the eye. The only caveat: no more than 2 hours should pass from the onset of clinical manifestations of thrombosis.
- Heparin in the form of injections, Warfarin or Clopidogrel - are used to prevent further thrombosis and reduce blood clotting in small vessels.
- Trental is able to improve blood circulation and protect the walls of blood vessels from hypoxia. It is administered intravenously 2 times a day.
- Retinal edema is treated by introducing solutions of glucocorticosteroids (Prednisolone, Hydrocortisone) into the tissue around the eye. With severe soreness in the eye, anti-inflammatory drugs are prescribed intravenously.
folk therapy
In addition to traditional therapy, there are many remedies traditional medicine. But they are used only for preventive purposes. To maintain the elasticity of the walls of blood vessels, a decoction of nettle, tincture of sage, mint in all varieties (tincture, tea, juice) is suitable. Helps improve vision forest honey.
Excellent help in the prevention of eye diseases drops made from freshly squeezed clover or cornflower juice. Take 1 tablespoon of chopped herbs in a glass of boiling water. The mixture is infused for 2 days, then filtered. You need to drip 2 drops in each eye at least 4 times a day.
Natural remedies, of course, are good, but not for emergency help. They can slow down the rate of development of pathological changes. But in the presence of complications or severe neglect of the process, only traditional, scientifically proven methods can save.
Since the complications of a blood clot in the retina are at least a decrease in vision, the maximum is atrophy of the optic nerve and complete blindness, it is important to recognize the symptoms in time and provide qualified assistance. But it is easier to prevent negative consequences.
Prevention measures
Retinal thrombosis is really preventable. It is only necessary to undergo annual examinations and follow the doctor's prescriptions. Ways to prevent retinal vein thrombosis depend on the presence of a specific risk factor and comorbidity.
- At hypertension funds are needed to normalize blood pressure. There are many of them, an individual combination is selected for each patient. Concerning action of concrete preparations it is necessary to consult at the cardiologist.
- With all types of diabetes mellitus, the main task is to achieve a permanent normal level blood glucose. This can be achieved by diet, adequate physical activity and carefully selected medications. In type 1 diabetes, you need to set the dosage of insulin, in type 2 diabetes - the type and frequency of use of hypoglycemic drugs.
- Any eye disease requires increased attention. In no case should you start glaucoma. Not only does it threaten with thrombosis of the vessels of the eye, it also leads to total absence lateral vision. People with various types of retinopathy (diabetic or hypertensive) should be checked by an ophthalmologist once every six months.
- Correction of hormone levels. With excessive work of the thyroid gland, drugs that reduce the level of thyroxine are needed. Women are not recommended to "get carried away" with oral contraceptives - they increase the risk of blood clots.
- Prevention of increased aggregation ("clumping") of platelets - take Aspirin (TromboASS or Plavix) daily, 1 tablet a day. This is especially true for those who suffer from cardiovascular diseases.
Vision is a special sense organ, without which a person loses the ability to self-service and a normal social life. Patients with eye diseases should understand that ocular thrombosis leads to irreversible changes. No operation will return or “resurrect” retinal neurons that died as a result of oxygen starvation. It is better to start prevention of retinal thrombosis right now.
Thrombosis of the central vein of the retina is an acute condition in which the vessel is partially or completely blocked. Why does pathology occur? How does it manifest itself? How is it diagnosed and can it be cured? This is discussed later in the article.
What it is
Thrombosis of the CVV is a violation of the patency of the blood vessel. The disease progresses rapidly, more often it develops secondary against the background of existing complications of other diseases.
A blockage in a certain area of the visual apparatus provokes backflow of blood into the capillaries and an increase in blood pressure in patients.
The degree of reduction in the quality of the visible in full depends on which part of the vein is affected. If the lateral vein is clogged, doctors slowly but manage to partially or completely restore the functions of the visual apparatus.
In case of blockage of the central - the prognosis is the most unfavorable.
The body is atrophied. The retina is exposed degenerative changes.
More often, CVD develops in older people, provokes a violation of the circulatory process, a decrease in organ functions.
At the first appearance unpleasant symptoms It is worth contacting doctors, undergoing diagnostics and the proposed treatment.
Classification
The disease is divided into types:
- non-ischemic, in which the occlusion is partial, there is no hemorrhage and only a small part of the blood flow is affected;
- ischemic with complete occlusion, extensive hemorrhage and large lesions.
The disease proceeds in stages:
- prethrombotic state. The veins gradually expand, there is a slight stagnation.
- The blood circulation is disturbed, the vascular walls are tense, a yellow spot appears on the CV and severe hemorrhage. The optic disc acquires fuzzy boundaries.
- The most difficult stage, when the ischemic form of the disease begins to progress.
Why there are risk groups
Development may precede:
- diabetes;
- hypertension;
- atherosclerosis;
- influenza, otitis with infection of the paranasal sinuses, oral cavity;
- jumps in blood pressure;
- high intraocular pressure or exertion of pressure on the eyeball from the outside, for example, by a tumor-like body.
The risk group consists of people:
- leading a passive lifestyle;
- obese, cardiovascular diseases, dysfunction of the endocrine glands.
Causes a violation of occlusion arterial hypertension, glaucoma, cataracts with stable indicators of high blood pressure in the eyes.
Thrombosis of the eye - blockage of the vein of the upper temporal or lower branch of the vessel. This is the main reason for the violation.
How does it develop
Blockage of the organ is characterized by a transient course. If central occlusion is involved in the pathology, then 2/3 of the CVS is immediately affected.
Massive hemorrhages begin to appear. Vision and color perception can deteriorate in a matter of hours.
In the case of involvement in the process of occlusion on the periphery, the sharpness of the picture decreases slightly. However, patients begin to appear dark spots and fogs, blurry objects.
With partial occlusion in the early pores, symptoms may be completely absent and appear only with a clear narrowing of the lumen by 80-90%.
Vision with the development of the disease deteriorates slowly. This is the only early symptom that is difficult to track down.
Only as the progression progresses, the general well-being of patients deteriorates sharply.
There are no special complaints in patients at the stage of prethrombosis, when the view is only periodically clouded, the severity decreases.
At the peak of the progression of the disease, the macular area begins to swell. The boundaries of the optic nerve head become indistinct. The vitreous body is subject to hemorrhage.
In patients, visual fields partially fall out, dark circles appear before the eyes.
Reference! Symptoms become noticeable at the stage of progression, when the destructive process of CVV reaches a certain level. If the macula area is not involved in the pathology, the signs may for a long time be absent altogether. The disease is detected by a specialist ophthalmologist during a routine examination.
The dangerous thing is that people often ignore a slight decline in vision and do not seek medical attention. Meanwhile, with incomplete thrombosis, visual functions gradually fade away, are disturbed.
Degenerative processes can become irreversible.
What is dangerous
If treatment is not carried out in a timely manner, then with a blood clot in the eye, the consequences are:
- atrophy of the optic nerve;
- glaucoma;
- macular fibrosis with the formation of a membrane against the background of collagen accumulation, which reduces the quality of the picture.
The disease takes a relapsing course with severe macular edema, pathological modification of the fundus. At first glance, harmless swelling, puffiness and the periodic appearance of dark circles result in serious consequences.
Degenerative processes begin to develop. Possible manifestations of iridocyclitis, uveitis.
If the functioning of the blood vessels is impaired, partial or complete loss of vision may occur.
The note! Thrombosis of the central retinal vein and its branches in almost all cases is considered an emergency condition, when the decision on treatment should be made immediately. This will increase the chances of preserving the functions of the organ in case of venous constriction, and will avoid complete blindness in case of damage to the central artery.
Signs of the disease
Symptoms fully depend on the degree of occlusion or the location of the thrombus. With thrombosis, almost the 3rd part of the retina is involved in the pathology.
Common manifestations of the disease:
- blurry black spots, fog before the eyes;
- distortion of the perception of colors, visibility and outlines of objects;
- lacrimation;
- photophobia.
In most cases, at an early stage, patients do not complain about poor eyesight.
The main symptoms of retinal vascular thrombosis are clearly expressed with complete occlusion, 96-98% occlusion of the lumen.
Although this is a rare occurrence. Usually seen partial occlusion with a narrowing of the lumen by 60-70%.
When and who to contact
An ophthalmologist is in charge of diagnostic measures and prescribing treatment. In his absence, you can first of all visit a therapist who, according to indications, will redirect you for a consultation with an endocrinologist, neuropathologist, cardiologist.
It is necessary to consult a doctor if there is:
- partial loss of field of view;
- the appearance of black flies or circles at night, in the morning;
- frequent dizziness, headaches;
- squinting;
- impaired visibility of objects in front of you;
- extensive hemorrhages;
- decrease in visual acuity.
As people age, blood vessels inevitably wear out.
Stress and mental disorders only aggravate the situation: they provoke their narrowing and spasms, fragility and a decrease in their elasticity, thrombosis.
Diagnostics
An experienced doctor quickly and easily makes a diagnosis as soon as he conducts visual inspection fundus with a Goldman lens.
In case of doubt, it redirects to the following ophthalmic procedures:
- Visometry to identify the degree of deviation from the norm.
- Perimetry in order to recognize the boundaries of the field of view of that space, if you focus your eyes on one point.
- Ophthalmoscopy to determine vascular changes, the degree of hemorrhage and general condition.
- Biomicroscopy for visualization of the vitreous body, determining the degree of its clouding.
- Fluorescein angiography for an accurate diagnosis.
Be sure to state blood pressure indicators, i.e. an EKG is performed.
Treatment Methods
To understand how to treat eye thrombosis, one hundred answers - in stages. Physicians take steps to: 
- restoration of blood flow in the injured vascular area;
- reduction of edema;
- elimination of hemorrhages;
- normalization of blood microcirculation in the area of the circulatory system.
Atrophic processes develop rapidly, therefore, after diagnosis, it should be carried out immediately conservative therapy, to:
- contribute to the resorption of hemorrhages on the eyelids;
- nourish and improve the trophism of the main components of the visual apparatus;
- remove puffiness.
Medically
Prescribed medications:
- preparations for dissolving a blood clot;
- coagulants of direct action;
- hormonal drugs to relieve inflammation and swelling of the CVS;
- antiplatelet agents that improve blood circulation;
- vitamins, mineral supplements to improve immunity.
Violation requires an integrated approach to therapy.
If hypoxia of the vascular wall occurs, drugs with intravenous drip or glucocorticosteroids with the introduction of edema are prescribed.
To relieve inflammation and pain, injections of anti-inflammatory drugs are indicated.
Folk methods
Treatment with folk remedies for eye thrombosis will help to significantly improve blood circulation, lower blood pressure. Preparing infusions, decoctions, teas from medicinal herbs, plants. To prevent hemorrhage, to strengthen the walls help honey, perga.
If macular edema continues to increase after the treatment, then the only right decision is to perform laser coagulation with separation of the central zone from the affected one.
Forecasts
If you start to treat the disease in a timely manner, then the prognosis is positive. To consolidate the result, doctors perform laser coagulation of the retina 2 months after drug treatment. This makes it possible to reduce the likelihood of relapse.
It is especially difficult for people at risk. With hypertension and diabetes, it is important to monitor blood pressure and blood glucose levels. Periodically visit doctors for examination.
Pathology develops at lightning speed. It is impossible to prevent its development, therefore, preventive measures are not provided.
The violation causes irreversible changes: it reduces the quality of the visible, provokes atrophy of the optic nerve and complete blindness. If retinal neurons begin to experience oxygen starvation- it is unlikely that it will be possible to correct the situation with medicines or even surgery.
The outcome of the development of the disease is fully influenced by time. Only timely diagnosis and proper treatment will help patients avoid the development of cataracts, partial or complete loss of vision.
Informative video: Retinal vein thrombosis