Like a cobblestone pavement. Peripheral dystrophy of the retina. Methods of treatment of different types

It is on the periphery of the retina that dystrophic processes often develop.

Peripheral retinal dystrophy - an invisible danger

The peripheral zone of the retina is practically invisible during the usual standard examination of the fundus. But it is on the periphery of the retina that dystrophic (degenerative) processes often develop, which are dangerous because they can lead to ruptures and retinal detachment.

Changes in the periphery of the fundus - peripheral retinal dystrophy - can occur both in nearsighted and farsighted people, and in people with normal vision.

Possible causes of peripheral retinal dystrophy

The causes of peripheral dystrophic changes in the retina are not fully understood. The occurrence of dystrophy is possible at any age, with the same probability in men and women.

There are many possible predisposing factors: hereditary, myopia of any degree, inflammatory eye diseases, craniocerebral and injuries of the organ of vision. Common diseases: hypertension, atherosclerosis, diabetes, intoxication, previous infections.

The leading role in the occurrence of the disease is given to impaired blood supply to the peripheral parts of the retina. The deterioration of blood flow leads to metabolic disorders in the retina and to the appearance of local functionally altered areas in which the retina is thinned. Under the influence of physical exertion, work associated with lifting to a height or diving under water, acceleration, weight transfer, vibration, ruptures may occur in dystrophically altered areas.

However, it has been proven that in people with myopia, peripheral degenerative changes in the retina are much more common, tk. with myopia, the length of the eye increases, resulting in stretching of its membranes and thinning of the retina at the periphery.

PRHD and PVRD - what's the difference?

Peripheral retinal dystrophies are divided into peripheral chorioretinal (PCRD), when only the retina and choroid are affected, and peripheral vitreochororetinal dystrophies (PVCRD) - with involvement in the degenerative process of the vitreous body. There are other classifications of peripheral dystrophies that are used by ophthalmologists, for example, according to the localization of dystrophies or the degree of danger of retinal detachment.

Some types of peripheral retinal dystrophy

Lattice dystrophy - most often detected in patients with retinal detachment. A family-hereditary predisposition to this type of dystrophies is assumed with a higher frequency of occurrence in men. As a rule, it is found in both eyes. Most often localized in the upper outer quadrant of the fundus equatorially or anteriorly from the equator of the eye.

When examining the fundus of the eye, lattice degeneration looks like a series of narrow white, as it were, fleecy stripes that form figures resembling a lattice or a rope ladder. This is what obliterated retinal vessels look like.

Between these altered vessels, pinkish-red foci of retinal thinning, cysts and retinal breaks occur. Characteristic changes in pigmentation in the form of darker or lighter spots, pigmentation along the vessels. The vitreous body is, as it were, fixed to the edges of the dystrophy, i.e. “tractions” are formed - strands that pull the retina and easily lead to breaks.

Dystrophy of the "snail track" type. On the retina, whitish, slightly gleaming, streaky inclusions with many small thinnings and perforated defects are found. Degenerative foci merge and form ribbon-like zones, which in appearance resemble a trace from a snail. Most often located in the upper outer quadrant. As a result of such dystrophy, large round gaps can form.

Hoarfrost dystrophy is a hereditary disease of the periphery of the retina. Fundus changes are usually bilateral and symmetrical. On the periphery of the retina there are large yellowish-white inclusions in the form of "snow flakes" that protrude above the surface of the retina and are usually located near thickened partially obliterated vessels, there may be age spots.

Hoarfrost degeneration progresses over a long period of time and does not lead to ruptures as often as cribriform and cochlear marks.

Cobblestone degeneration is usually located far on the periphery. Separate white foci are visible, slightly elongated, near which small clumps of pigment are sometimes determined. It is more often found in the lower parts of the fundus, although it can be determined along the entire perimeter.

Racemose (small cystic) retinal dystrophy is located on the extreme periphery of the fundus. Small cysts can merge to form larger ones. With falls, blunt injuries, ruptures of cysts are possible, which can lead to the formation of perforated ruptures. When examining the fundus of the eye, the cysts look like multiple round or oval bright red formations.

Retinoschisis - retinal detachment - can be congenital or acquired. More often it is a hereditary pathology - a malformation of the retina. Congenital forms of retinoschisis include congenital retinal cysts, X-chromosomal juvenile retinoschisis, when patients, in addition to peripheral changes, often have dystrophic processes in the central zone of the retina, leading to decreased vision. Acquired dystrophic retinoschisis most often occurs with myopia, as well as in the elderly and senile age.

If there are also changes in the vitreous body, then often tractions (strands, adhesions) are formed between the changed vitreous body and the retina. These spikes, joining at one end to the thinned area of ​​the retina, greatly increase the risk of ruptures and subsequent retinal detachment.

Retinal breaks

By appearance, retinal breaks are divided into perforated, valvular and by the type of dialysis.
Perforated breaks most often occur as a result of lattice and racemose dystrophy, the hole in the retina gapes.

A rupture is called valvular when a portion of the retina covers the site of the rupture. Valvular tears are usually the result of vitreoretinal traction, which "pulls" the retina along with it. When the gap is formed, the area of ​​vitreoretinal traction will be the top of the valve.

Dialysis is a linear break in the retina along the dentate line, where the retina attaches to the choroid. In most cases, dialysis is associated with blunt trauma to the eye.

The gap in the fundus looks like bright red, clearly defined foci of various shapes, through which the pattern of the choroid is visible. Retinal breaks are especially noticeable on a gray background of detachment.

Diagnosis of peripheral dystrophy and retinal breaks

Peripheral retinal dystrophies are dangerous because they are practically asymptomatic. Most often they are found by chance during the inspection. In the presence of risk factors, the detection of dystrophy may be the result of a thorough targeted examination. There may be complaints about the appearance of lightning, flashes, the sudden appearance of more or less floating flies, which may already indicate a retinal tear.

A complete diagnosis of peripheral dystrophy and "silent" breaks (without retinal detachment) is possible when examining the fundus under conditions of maximum medical pupil dilation using a special three-mirror Goldman lens, which allows you to see the most extreme areas of the retina.

If necessary, compression of the sclera (sclerocompression) is used - the doctor, as it were, pushes the retina from the periphery to the center, as a result of which some peripheral areas inaccessible for inspection become visible.

To date, there are also special digital devices that can be used to obtain a color image of the periphery of the retina and, in the presence of zones of dystrophy and ruptures, to estimate their size relative to the area of ​​the entire fundus.

Treatment of peripheral dystrophy and retinal tears

If peripheral dystrophy and retinal breaks are detected, treatment is carried out, the purpose of which is the prevention of retinal detachment.

Perform preventive laser coagulation of the retina in the area of ​​dystrophic changes or delimiting laser coagulation around an existing gap. With the help of a special laser, the retina is affected along the edge of the dystrophic focus or rupture, as a result of which the retina is "glued" to the underlying membranes of the eye at the points of exposure to laser radiation.

Laser coagulation is performed on an outpatient basis and is well tolerated by patients. It should be borne in mind that the process of adhesion formation takes some time, therefore, after laser coagulation, it is recommended to observe a sparing regimen that excludes heavy physical labor, climbing to a height, diving under water, activities associated with acceleration, vibration and sudden movements (running, parachuting , aerobics, etc.).

Prevention

Speaking about prevention, first of all, they mean the prevention of ruptures and retinal detachment. The main way to prevent these complications is the timely diagnosis of peripheral retinal dystrophy in patients at risk, followed by regular monitoring and, if necessary, preventive laser coagulation.

The prevention of formidable complications depends entirely on the discipline of patients and attention to their own health.

Patients with existing retinal pathology and patients at risk should be examined 1 to 2 times a year. During pregnancy, it is necessary to examine the fundus of the eye at least twice on a wide pupil - at the beginning and at the end of pregnancy. After childbirth, an examination by an ophthalmologist is also recommended.

Prevention of the dystrophic processes themselves on the periphery of the retina is possible in representatives of the risk group - these are myopic, patients with a hereditary predisposition, children born as a result of a difficult course of pregnancy and childbirth, patients with arterial hypertension, diabetes mellitus, vasculitis and other diseases in which deterioration is observed. peripheral circulation.

Peripheral retinal dystrophy- This is a pathological process characterized by the slow destruction of tissues and deterioration of vision up to its complete loss. It is in this zone that dystrophic changes most often occur, and it is this zone that is not visible during a standard ophthalmological examination.

According to statistics, up to 5% of people who do not have a history of vision problems suffer from peripheral vision, up to 8% of patients with hyperopia and up to 40% of patients diagnosed with myopia.

Types of peripheral retinal dystrophy

The phrase peripheral dystrophy is a collective term that combines many diseases.

The following are its main varieties:

Lattice dystrophy- represented by consecutively arranged white stripes, forming a pattern similar to the image of the grid. This picture is visible with a careful examination of the fundus. The pattern is formed from vessels through which blood no longer passes, between them are formed, tending to rupture. Lattice-type dystrophy occurs against the background of retinal detachment in more than 60% of cases, and often has a bilateral character.

Dystrophy, the damage of which proceeds according to the type of snail track. On examination, whitish, somewhat gleaming perforated defects are visible, it is because of this that this type of disease got its name. At the same time, they merge into ribbons and resemble the trace of a snail. Often large gaps form as a result of this type of dystrophy. In most cases, it is observed in people with myopic disease, it is less common than lattice dystrophy.

Hoarfrost dystrophy is inherited, the changes are bilateral and symmetrical. This type of dystrophy got its name due to the fact that inclusions are formed on the retina, resembling snow flakes, somewhat protruding above its surface.

Dystrophy by the type of cobblestone pavement characterized by the formation of deeply located white annular defects having an oblong shape. Their surface is even, in 205 cases it is observed in patients with myopia.

Retinoschisis - in most cases, this defect is hereditary and is characterized by retinal detachment. Sometimes it occurs in myopia and in old age.

Small cystic dystrophy - characterized by the formation of cysts that have the ability to merge, their color is red, their shape is round. When they break, perforated defects are formed.

Symptoms of peripheral retinal dystrophy

Regardless of the type of peripheral dystrophy, patients complain of similar symptoms:

Visual impairment. Sometimes it occurs in only one eye, sometimes in both.

Restriction of the field of view.

The presence of fog before the eyes.

Distorted color perception.

Rapid fatigue of the organ of vision.

The presence of flies or bright flashes before the eyes. This symptom is intermittent.

Image distortion, the picture looks like a person is trying to see through a thick layer of water.

Violation of the perception of the shape of a real object and its color - metamorphopsia.

Decreased vision in poor light or at dusk.

Symptoms can occur both in combination and separately. They get worse as the disease progresses. The danger of peripheral dystrophy lies in the fact that at the initial stages the disease does not manifest itself in any way, but develops asymptomatically. The first signs may begin to disturb a person when, for a year, the detachment reaches the central sections.

Causes of peripheral retinal dystrophy

Among the causes of peripheral dystrophy are the following:

The hereditary factor, it has been proven that dystrophy occurs more often in those people whose loved ones suffered from a similar problem.

Myopia, this is due to the fact that the length of the eye increases, its membranes stretch and become thinner at the periphery.

Inflammatory eye diseases.

Eye injuries of various origins, including craniocerebral.

infectious diseases.

Carrying weights, diving under water, climbing to heights, any extreme physical exertion on the body.

body intoxication.

Chronic diseases.

The disease does not depend on age and gender, it occurs with the same frequency in men, women, children and pensioners.

Treatment of peripheral retinal dystrophy

Before proceeding with the treatment of peripheral dystrophy, it is necessary to correctly diagnose it. The difficulty lies in the fact that the symptoms at the initial stage of the development of the disease practically do not manifest themselves in any way, and during a routine examination, the periphery zone is inaccessible to an ophthalmologist. Therefore, a thorough and systematic examination is necessary, in the presence of risk factors.

Laser coagulation. Treatment of peripheral retinal dystrophy primarily consists of surgery. To do this, use the method of laser coagulation of blood vessels, which consists in delimiting the zone damaged by dystrophy. Laser coagulation can also be carried out for prophylactic purposes in order to prevent the development of dystrophy. This is not a traumatic operation that does not require a rehabilitation stage and a person in a hospital. After it is completed, it is advisable for the patient to prescribe medication and physiotherapy courses.

For preventive measures refers, first of all, to regular visits to an ophthalmologist, especially by people at risk. Peripheral dystrophy is dangerous for its complications, which is why its early diagnosis and timely treatment are so important. It is important to remember that treating peripheral dystrophy is laborious, but preventing the disease is much easier. Therefore, a preventive visit to an ophthalmologist is so important, because any, even modern treatment, is not able to restore vision by 100%, and the goal of surgical intervention will be to stop the gaps and stabilize the level of vision that a person has for the period of treatment.

Delimiting peripheral laser coagulation of the retina.

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

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

The peripheral zone of the retina is practically invisible during a routine examination of the fundus. Visualization of these departments requires pupillary dilatation (mydriasis, cycloplegia). It is there that degenerative changes develop, which can lead to ruptures and retinal detachment.

Peripheral vitreochorioretinal dystrophy (PVCRD)- a disease that can be caused by many reasons: inflammatory eye diseases, craniocerebral and eye injuries, hypertension, atherosclerosis, diabetes, intoxication, past infections, hereditary factors, an increase in the size of the anterior-posterior size of the eyeball.

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

Under the influence of a) physical exertion, and especially work associated with lifting, carrying weights, vibration, lifting to a height or diving under water, acceleration, and b) psycho-emotional stress, increased visual load - breaks occur in the weakest areas of the retina. The appearance of ruptures is facilitated by changes in the vitreous that appear in the form of adhesions (vitreoretinal adhesions). These spikes, joining at one end to a weak area of ​​the retina, and at the other to the vitreous body, more often than other causes, contribute to the occurrence of retinal breaks. The presence of even very small holes on the retina, close to each other, is a threat of their fusion and the formation of a large perforated defect. Especially dangerous is the combination of ruptures and stretching of the retina in myopia (nearsightedness).

The main types of peripheral retinal dystrophies:

• lattice dystrophy;
• dystrophy of the "snail track" type;
• frost-like dystrophy;
• cobblestone degeneration;
• cystic retinal dystrophy;
• retinoschisis - retinal detachment.

Retinal breaks.

By type, retinal breaks are divided into:

• perforated;
• valve;
• type of dialysis.

Retinal disinsertion.

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

Diagnostics.

A complete diagnosis of peripheral dystrophies and retinal ruptures is difficult and is possible only when examining the fundus by an ophthalmic surgeon under conditions of maximum medical dilation of the pupil.

Treatment of dystrophies and ruptures.

When peripheral dystrophies and retinal breaks are detected, treatment is carried out, the purpose of which is to prevent detachment. Perform delimiting peripheral laser photocoagulation of the retina, resulting in "sticking", and within 2-4 weeks, the fusion of the retina with the underlying membranes of the eye at the points of exposure to laser radiation. Restrictive peripheral laser photocoagulation performed on an outpatient basis and is well tolerated by patients. The essence of the operation is to treat the thinned areas of the retina with a laser. With the help of laser radiation, the so-called “soldering” of the retina is performed in weak places and adhesions of the retina with underlying tissues are formed around the breaks. The operation is performed on an outpatient basis, under local drip anesthesia. Before treatment, the pupil is dilated with special drops, then anesthetic drops are instilled, and the patient is placed behind the device, pressing his forehead and chin against a special stop. A special contact lens is attached to the eye, through which light and a laser beam are directed into the eye. On the same day, the patient returns home.

It must be taken into account that the process of formation of adhesions takes some time, therefore, after laser coagulation, it is recommended to observe a sparing regimen.

Prevention.

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

Specialists of the Ophthalmological Center for Laser Microsurgery of the Medina Clinic are fluent in both the method of restrictive peripheral laser coagulation of the retina and other methods of laser interventions for eye pathology.

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

Peripheral retinal dystrophy is a hidden danger. This area of ​​the retina is not visible during a routine examination of the fundus, but it is here that pathological processes occur, which further lead to ruptures and retinal detachment. This dangerous disease can occur in any person, regardless of gender and age.

Peripheral vitreochorioretinal dystrophy (PVCRD) occurs in people not only with myopia and hypermetropia, but also with normal vision. The disease is almost asymptomatic, up to retinal detachment.

The main causes of PVRD currently include hereditary factors, as well as eye injuries and craniocerebral injuries, atherosclerosis, diabetes mellitus, hypertension and other diseases.

Especially often PVRD is detected in people with myopia. With myopia (myopia), the length of the eye is increased, and all its membranes, including the retina, are stretched and thinned. Thinning of the retina, especially in the peripheral parts, leads to a deterioration in blood flow, metabolic disorders and the formation of foci of dystrophy.

The dystrophic focus is a sharply thinned area of ​​the retina. In most cases, such changes affect not only the retina, but also the vitreous body adjacent to it and the choroid.

Under the influence of injuries, physical exertion (especially work related to lifting and carrying weights, vibration, lifting to a height or diving under water, acceleration), stress, as well as increased visual load, breaks occur in weak areas of the retina, further leading to detachment retina. This is largely facilitated by changes in the vitreous body that appear in the form of vitreoretinal adhesions. These adhesions, joining at one end to the dystrophic focus, and at the other to the vitreous body, more often than other causes contribute to retinal breaks.

Especially dangerous is the combination of ruptures and stretching of the retina in myopia.

The main types of peripheral retinal dystrophies

Lattice dystrophy

Most often detected in patients with retinal detachment. There is a hereditary predisposition to this type of dystrophy. As a rule, it is found in both eyes. Examining the fundus of the eye, the doctor sees a lot of empty vessels, forming bizarre figures in the form of a lattice, between which cysts and ruptures form. Pigmentation in this zone is broken, along the edges of the focus is fixed to the vitreous body with strands, which can easily break the retina both in the dystrophy zone and next to it.

Dystrophy of the "snail track" type

The dystrophy zone has an elongated shape in the form of an uneven whitish shiny ribbon with multiple small gaps. It looks like a snail's footprint. Often leads to the formation of large retinal breaks.

Hoarfrost dystrophy

Hereditary form of dystrophy. Changes are most often symmetrical in both eyes. When viewed, they look like snow flakes located next to empty vessels.

Cobblestone degeneration

It looks like a lot of light rounded foci on the periphery of the retina, sometimes with clumps of pigment. Rarely leads to the formation of ruptures and retinal detachment.

Small cystic retinal dystrophy

On the fundus, multiple small rounded or oval reddish cysts are determined. The cysts often coalesce and may form retinal tears.

Retinoschisis - retinal detachment

As a rule, this is a hereditary pathology - a malformation of the retina. Acquired dystrophic retinoschisis usually occurs with hypermetropia and myopia, as well as in the elderly and senile age.

Retinal breaks

By type, retinal breaks are divided into:

• perforated;
• valve;
• type of dialysis.

perforated breaks most often occur as a result of lattice and small cystic dystrophy, a hole gapes in the retina. A rupture is called valvular when a portion of the retina partially covers the site of the rupture. valve ruptures appear as a result of vitreoretinal traction, which pulls and tears the retina. When a rupture is formed, the area of ​​vitreoretinal traction will be the top of the valve. Dialysis is a linear tear of the retina along the dentate line - the place of attachment of the retina to the choroid. In most cases, dialysis is associated with blunt trauma to the eye.

Retinal disinsertion

Through the hole formed in the retina, intraocular fluid enters under the retina, exfoliating it. The retina that has lagged behind its usual place ceases to function, i.e. ceases to perceive light as an irritant. Patients with retinal detachment describe this fact as the appearance of a black "curtain" in front of the eye, through which nothing can be seen. The dimensions of the “curtain” that interferes with viewing depend on the area of ​​the detached retina. As a rule, part of the peripheral vision disappears first. Central vision at the first moment is preserved, as well as a sufficiently high visual acuity. But this is not for long. As the detachment spreads, the area of ​​the interfering “curtain” also increases. As soon as the retinal detachment reaches the central regions, visual acuity drops from 100% to 2–3%, i.e. such a person with a sore eye is able to see only the movement of objects near the face. This is provided by a partially preserved or partially adjacent retina in other areas. If the retinal detachment is total, complete darkness sets in for this eye.

Diagnostics. Treatment of dystrophies and ruptures. Prevention

A complete diagnosis of peripheral dystrophies and retinal ruptures is difficult and is possible only when the fundus is examined by an experienced ophthalmologist under conditions of maximum medical pupil dilation using a special three-mirror Goldman lens, which allows you to see the most extreme areas of the retina.

When peripheral dystrophies and retinal breaks are detected, treatment is carried out, the purpose of which is to prevent detachment. Laser coagulation of the retina is performed, as a result of which the retina first sticks together, and then, within 7-10 days, fuses with the underlying membranes of the eye at the points of exposure to laser radiation. Laser coagulation is performed on an outpatient basis and is well tolerated by patients. It must be taken into account that the process of formation of adhesions takes some time, therefore, after laser coagulation, it is recommended to observe a sparing regimen.

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

There can be many reasons for visual impairment. Experts call a variety of eye diseases. Retinal degeneration (dystrophy) is a very common cause of visual impairment. There are no sensory nerve endings in the retina. Because of this, the disease can proceed painlessly.

Definition

Retinal degeneration most often affects the elderly. Retinal disease in children is very rare. It manifests itself in the form of pigmented and dotted white degeneration, in the form of a yellow spot (Best's disease). These varieties of the disease are congenital and hereditary.

With age, changes occur in the retina of the eye. Various slags can be deposited between the shell of the eye and the vascular. They begin to accumulate, and as a result, yellow or white “garbage” is formed - druze.

During degeneration, the most important cells begin to die. This disease is called "yellow spot".

Treatment with folk remedies

Retinal degeneration can be similar to various other abnormalities in the body. Medical treatment should not be ignored. Traditional medicine is an auxiliary element that consolidates the treatment.

Be sure to diversify your diet. Eat more seaweed, cinnamon and honey.

1. Mix water and goat milk in equal proportions. This solution should be dripped into the eyes two to three drops a day. Apply a tight bandage over your eyes and rest for a few minutes. Do not move your eyes or open them.
2. Prepare the next drink. Coniferous needles - five tablespoons, dried rose hips - two tablespoons, onion peel - two tablespoons. Mix the whole mixture well and grind. Pour a liter of water and boil on fire for no more than 15 minutes. The broth is filtered and infused for another day. Apply for a month half an hour before meals.
3. Take five tablespoons of nettle, one tablespoon of lily of the valley. Pour one glass of water and leave for ten hours in a dark place. Then add a teaspoon of soda and make a compress for the eyes from the resulting broth.

Prevention

All forms are caused either by diseases of the organs of vision or the body as a whole. Most often, people who have myopia of medium or high degree suffer. It is impossible to prevent the disease, but it can be detected and controlled in time.

Prevention is that you need to be examined by an ophthalmologist twice a year.

It is advisable not to smoke, not to abuse alcohol and a variety of drugs. Eat right, and it is best to add more vitamins to your diet.

• Vitamin A. These are carrots, sunflower seeds, potatoes, seafood, fish liver.
• Thiamine, vitamin Bi. This includes brewer's yeast, honey, green peas, nuts, wheat.
• Vitamin C, ascorbic acid. These are leafy vegetables, sweet peppers, spinach, black currants.
• Potassium (honey and vinegar).
• Vitamin B12. Beets, blueberries, parsley, apricots, prunes, dates.

Macular retinal degeneration

There are two forms of macular degeneration:

1. Astrophic.
2. Exudative.

These two forms differ from each other in that during exudative degeneration, the cells begin to exfoliate due to the fluid coming from the vessels. Cells slough off the underlying membranes, and as a result, hemorrhage may occur. Edema may form at the site.

In the astrophic form, the "yellow spot" is affected by the pigment. There are no scars, swelling or fluid. In this case, both eyes are always affected.

signs

With macular degeneration of the retina, vision gradually deteriorates and decreases. The disease is painless, so it is very difficult to detect the disease at an early stage. But when one eye is affected, the main symptom is seeing fine lines as wavy. There are times when vision is sharply reduced, but does not lead to complete blindness.

For any distortion of straight lines, you should immediately consult a doctor. Other symptoms include blurry images and trouble reading books, newspapers, etc.

The reasons

The main reason is old age. After the age of 50, the risk of developing such a disease increases several times; by the age of 75, a third of older people suffer from retinal degeneration.

The second reason is the hereditary line. An interesting fact is that dark-skinned people suffer from the disease less often than Europeans.

The third reason is the lack (deficiency) of vitamins and microelements. For example, vitamins C, E, lutein carotenoids, zinc and antioxidants.

Diagnosis and treatment

It is impossible to independently identify the disease at an early stage. You can detect the disease only with regular visits to the ophthalmologist. The doctor will examine and identify the beginning changes. This is the only way to prevent the development of macular degeneration of the retina.

Modern medicine does not have many ways to treat this disease, but if the deviations were replaced at an early stage, then laser correction can be done. If cataract maturation occurs, then doctors replace the lens.

age-related macular degeneration

This disease is most common in the elderly. The Caucasian population is especially affected.

• The causes of AMD are as follows:
• genetic predisposition;
• smoking;
• age;
• obesity;
• cardiovascular diseases;
• anamnesis;
• hypertension;
• low intake of fatty acids and green leafy vegetables.

There are two forms of the disease. The most common is dry. Non-exudative and astrophic. Any AMD disease begins with it. The dry form affects about 85 percent of people.

In the dry form, changes occur in the pigment epithelium, where the foci appear as dark dots. The epithelium performs a very important function. It maintains the normal state and functioning of cones and rods. The accumulation of various toxins from rods and cones leads to the formation of yellow spots. In the case of advanced disease, chorioretinal atrophy occurs.

Read also: - a disease in which the central part of the retina is affected - the macula.

The second form is wet. It is neovascular and exudative. This disease develops in about 25 percent of people. With this form, a disease called choroidal neovascularization begins to develop. This is when new abnormal blood vessels develop under the retina. Hemorrhage or swelling of the optic nerve can lead to detachment of the retinal pigment epithelium. If the disease is not treated for a long time, then a disc-shaped scar forms under the macula.

Diagnostics

Specialists use one of the diagnostic methods:

1. Ophthalmoscopy. Allows you to identify both forms of the disease. Use the Amsler grid.
2. Color fundus photography and fluorescein angiography. If doctors assume a wet form of the disease, then these two diagnostics are carried out. Angiography reveals choroidal neovascularization and geographic atrophy.
3. Optical coherence tomography. Helps to assess the effectiveness of ongoing therapy and to identify intraretinal or subretinal fluid at an early stage.

Treatment

1. With dry AMD or one-sided wet form, special nutritional supplements are needed.
2. Anti-VEGF drugs.
3. In the wet form, laser treatment is applied.
4. Various support measures.

Peripheral degeneration

Peripheral retinal degeneration is a common disease in modern medicine. From 1991 to 2010, the number of cases increased by 19%. The probability of developing with normal vision is 4%. The disease can manifest itself at any age.

If we touch on the topic of peripheral degeneration, then this is already a more dangerous phenomenon. After all, it is asymptomatic.

Diagnosing peripheral disease can be difficult because fundus changes are not always pronounced. It is difficult to explore the area in front of the equator of the eye. This type very often leads to retinal detachment.

The reasons

Peripheral degeneration develops in people suffering from myopic or hypermetropic type of refraction. Especially at risk are people who suffer from myopia. There are also other causes of the disease:

1. Traumatic injuries. For example, a severe traumatic brain injury or damage to the bone walls of the orbit.
2. Violation of the blood supply. Changes in blood flow can lead to trophic disorders and thinning of the inner lining of the eyeball.
3. various inflammatory diseases.
4. iatrogenic effect. There are changes in the inner lining of the eye. This happens after vitreoretinal surgery or when the effect of laser photocoagulation has been exceeded.

Who is at risk?

People who suffer from myopia are most susceptible to the disease. In myopic people, thinning and tension of the retina occurs. This leads to dystrophy.

This includes the elderly, especially over 65 years of age. At this age, the main cause of a sharp decrease in vision is peripheral dystrophy.

Also included in this group are the following:

• Suffering from diabetes.
• Atherosclerosis.
• arterial hypertension.

Classification

Experts classify pathology into several types. It is trellised, frost-like and racemose. Separate variants of changes may resemble a "snail track" or "cobblestone pavement".

Forms of the disease:

1. Peripheral vitreochorioretinal (PVCRD). It is characterized by damage to the vitreous body, retina and choroid.
2. Peripheral chorioretinal (PCRD). Pathologies of the retina and choroid.

Vitreochorioretinal dystrophy is divided by localization:

1. Equatorial. The most common retinal lesion.
2. Paraoral. Dystrophic changes occur at the dentate line.
3. Mixed. The shape is associated with the greatest risk of rupture due to the presence of diffuse changes over the entire surface of the retina.

Diagnostics

During a routine examination of the fundus, the peripheral region is inaccessible. In most cases, the diagnosis of this area is possible only with the maximum possible medical expansion of the pupil; a three-mirror Goldman lens is used for examination.

In order to identify the disease and prescribe treatment, the patient can perform the following studies:

1. Ophthalmoscopy. In this case, studies of the optic disc, retina and choroid are carried out. It uses rays of light that are reflected from the structures of the fundus. There are two types of ophthalmoscopy: direct and reverse.
2. Perimetry. This method will help to identify the concentric narrowing of the visual fields. If the doctor detects the onset of the disease, then the patient will be assigned a quantitative perimetry.
3. Visometry. It is considered the easiest way to determine visual acuity. It is carried out everywhere: in various educational institutions, in the army, during examinations for ophthalmic diseases, etc.
4. Refractometry. One of the modern methods where medical equipment is used is a refractometer. At the moment, there is advanced equipment - a computer automatic refractometer. With the help of such a study, the development of refractive errors is detected, as well as diagnosing myopia, hyperopia or astigmatism.
5. . Allows you to detect pathologies at the earliest stages. Ultrasound is used to diagnose changes in the vitreous body, to assess the size of the longitudinal axis of the eye.

Treatment

Before prescribing treatment, the specialist assesses the nature of the pathology. To eliminate the disease use:

1. conservative therapy. In the treatment, medications of the groups of antiplatelet agents, angioprotectors, antihypoxants are used. Bioactive additives, vitamins C and B are also used here.
2. Surgical intervention. The treatment uses laser coagulation of blood vessels in areas of increased thinning. The operation is carried out on an outpatient basis. After the operation, conservative therapy is prescribed, including taking various drugs.

Pigmentary degeneration of the retina

Pigmentary degeneration (abiotrophy) is a hereditary disease of the inner lining of the eye. The retinal rods begin to break down. This disease is very rare. If a person falls ill and does not take any action, then blindness occurs.

The disease was described in 1857 by D. Donders and named "retinitis pigmentosa". And five years later, a hereditary disease was established.

The reasons

The most sensitive area of ​​the eye is made up of cells. These are rods and cones. They are so called because the appearance resembles such a shape. The cones are located in the central part. They are responsible for sharp and color vision. The rods occupied all the space, filling the retina. They are responsible for, as well as for visual acuity in poor lighting.

During damage to individual genes that are responsible for the nutrition and functioning of the eye, the outer layer of the retina is destroyed. It all starts in the periphery and in a few years spreads throughout the retina.

Both eyes are affected early on. The first signs are visible in childhood, the main thing is to consult a doctor in time. If the disease is not treated, then by the age of twenty, patients lose their ability to work.

There are other developments of the disease: only one eye, a separate sector of the retina is affected, a later disease occurs. Such people are at risk of developing glaucoma, cataracts, swelling of the central zone of the retina.

Symptoms

Hemeralopia or in other words "night blindness". Occurs due to damage to the retinal rods. People who suffer from this disease are poorly oriented in places with poor lighting. If a person notices that he can hardly navigate in the dark, then this is the first sign of the disease.

The progression of the disease begins with damage to the rods of the retina. It starts from the periphery and gradually approaches the central part. In the later stages, the patient's sharp and color vision decreases. This happens due to the fact that the cones of the central part are affected. If the disease progresses, then complete blindness may occur.

Diagnostics

It is possible to identify the disease only at the earliest stages and only at a young age. The disease can be detected if the child begins to orientate poorly at night or at dusk.

The doctor examines the visual acuity and the reaction of light. There is an examination of the fundus, since it is there that the change in the retina occurs. The diagnosis is also refined with the help of electrophysiological studies. This method will help to better assess the functioning of the retina. Doctors evaluate dark adaptation and orientation in a dark room.

If the diagnosis has been established or suspicions have been identified, then an examination of the patient's relatives should be carried out.

Treatment

To stop the progression of the disease, the patient is prescribed various vitamins and medications. They improve blood circulation and nourish the retina.

In the form of injections, drugs such as:

• Mildronate.
• Emoxylin.

In the form of drops, the following medications are prescribed:

• Taufon.
• Emoxylin.

To stop the development of pathology, doctors use physiotherapy methods. The most effective device that is used at home is Sidorenko glasses.

Science is developing, there are news about new methods of treatment. For example, this includes gene therapy. It helps repair damaged genes. In addition, there are electronic implants that help blind people move freely and navigate in space.

In some patients, the progression of the disease can be slowed down. For this, vitamin A is used weekly. People who have completely lost their sight restore their visual sensation with the help of a computer chip.

Before starting treatment, you need to consider the cost, as well as the reputation of the medical center. The most important thing is to pay attention to the work of specialists and their training. Familiarize yourself with local equipment and medical staff. All these steps will help to achieve a good result.

Conclusion

It is impossible to get rid of the disease once and for all. It is only possible to identify it in time, slow down the development and progression. The prognosis for a full recovery is not the most pleasant, so you need to block the disease in the early stages. And in order to maintain vision, you need to undergo an examination by a doctor every year and carry out preventive actions.