Retinal dystrophy: a review of modern treatment methods. Retinal dystrophy: symptoms, diagnosis and treatment. Peripheral retinal dystrophy
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Retinal dystrophy is a collective concept. It unites a large number of diseases that are characterized by a progressive decrease in visual functions caused by degenerative processes of the retina.
Over the past few decades, retinal dystrophy has become main reason blindness and, as a consequence, disability of the population.
Classification of the disease
All dystrophies can be divided into two large groups: acquired (secondary) and congenital (primary). In turn, secondary ones are divided into three more groups depending on the location of the defects: central, peripheral and generalized.
To date, scientists have described the following types retinal dystrophy:
Causes
30 to 40% of cases of retinal dystrophy develop in people suffering from myopia
It has been proven that from 30 to 40% of cases of retinal dystrophy develop in people suffering from (myopia). About 8% of cases of dystrophy occur against the background of farsightedness.
The causes of retinal dystrophy can be divided into two categories:
- Causes of the eye: injuries, surgeries, farsightedness and myopia, inflammatory eye diseases.
- Presence of diseases of other organ systems: diabetes, dyslipidemia (impaired fat and cholesterol metabolism) and atherosclerosis, hypertonic disease, poisoning, alcohol abuse, smoking, lack of vitamins or their complete absence in the diet, chronic diseases blood vessels and heart, etc.
Symptoms and manifestations
At first, retinal dystrophy may not manifest itself in any way. These may be isolated episodes of flies flashing before the eyes or floating spots. As a rule, people do not attach much importance to this and do not seek help.
At first, retinal dystrophy may not manifest itself in any way - visit an ophthalmologist regularly
In the future, as dystrophy progresses, the clinical picture becomes much brighter. Visual acuity begins to decline. Moreover, for some this manifests itself somewhat atypically: a person does not notice a decrease in vision, but while reading or writing he needs especially bright lighting.
The following symptoms of retinal dystrophy appear:
If even one symptom appears, you should urgently seek help from an ophthalmologist.
Thanks to the progress of medicine, retinal dystrophy is quite treatable in the initial stages and does not end in blindness. Concerning neglected cases, then the prognosis is not favorable.
Central retinal dystrophy
The pathological process represents one of the groups of blood microcirculation disorders in the vessels of the retina. The peculiarity of the disease is that it affects exclusively its central part (macula). Hence the second name – macular degeneration.
Based on ongoing processes and clinical manifestations The following varieties are distinguished: central dystrophy :
Peripheral retinal dystrophy
A group of disorders that occur in the periphery of the retina. It is dangerous due to its complications and difficulty of diagnosis. It develops both in people with normal visual acuity and in people with impairments (myopia).
Changes in peripheral nutrition worsen metabolic processes and provokes the formation of thinned areas of the retina. The chorioretinal type of pathology affects only the retina and the vascular layer, and the vitreochorioretinal type of peripheral retinal dystrophy affects both vitreous.
Ophthalmologists divide peripheral dystrophy into the following types:
The peripheral type of pathology is accompanied by deterioration of vision, limitation of the visual field, fatigue, a feeling of the presence of spots or flashes before the eyes. The clinical picture may consist of one or more simultaneous manifestations.
Danger similar condition is that initial stages the diseases are asymptomatic and the patient turns to an ophthalmologist already in advanced stages of the disease, accompanied by retinal tears.
Retinal dystrophy in children
In most cases, degenerative disorders of the visual analyzer in children are hereditary. Vascular pathology in the macula area manifests itself in several anomalies. For example, Stargardt disease, which has an autosomal recessive inheritance principle (both parents of the child have a “sick” gene in their set of chromosomes).
The disease affects both eyes and begins to progress after the 5th age. The prognosis is unfavorable, since it is impossible to cure such dystrophy, and over time the optic nerve can completely atrophy.
Best's disease is also a congenital condition. In the center macular spot A cystic formation appears, reducing the level of central visual acuity.
Juvenile retinoschisis is an X-linked disease characterized by dystrophic changes with subsequent degradation of the vitreous body. It affects boys, girls become carriers of the “sick” gene. The clinical picture is manifested by nystagmus (involuntary eye movements) and strabismus.
Retinitis pigmentosa is a severe pathology that is a combination of several hereditary diseases. Peak progression occurs at the age of ten.
Retinal dystrophy in pregnant women
A pregnant woman must attend consultations with an ophthalmologist. The first visit usually occurs at the very beginning of pregnancy, when future mom becomes registered.
The first visit to the ophthalmologist is at the beginning of pregnancy, the second is towards the end of pregnancy
During the examination, the doctor carefully examines the vessels of the fundus to identify angiopathy and other pathologies of the retina. The second visit to the ophthalmologist occurs towards the end of pregnancy. Such simple measures help prevent a formidable complication of childbirth - retinal detachment.
If a woman is myopic, then she is examined by an ophthalmologist at least once a month.
If a pregnant woman has retinal dystrophy, then childbirth must be carried out by cesarean section. This is due to the fact that retinal dystrophy can subsequently cause retinal ruptures and detachment.In the third trimester of pregnancy, a physiological decline occurs blood pressure, conditioned hormonal changes and preparing the body for childbirth. As a result of decreased blood flow, the amount of nutrients delivered to the retina. This factor can also provoke the development of dystrophic processes.
Considering all of the above, we can conclude that regular monitoring of the expectant mother by an ophthalmologist is an integral part of pregnancy management.
Diagnostics
A simple vision test can help identify the disease.
Usually there are no problems with diagnosing retinal dystrophy. Retinal changes are clearly visible with conventional ophthalmoscopy. A simple vision test helps to identify the disease (with dystrophy, visual acuity is significantly reduced).
As a diagnostic, the simplest and accessible method research is . It can be carried out both at an appointment with an ophthalmologist and at home for the purpose of self-monitoring.
It should be noted that Regular Amsler testing is recommended for all people over 50 years of age. This is due to the fact that secondary retinal dystrophy develops more often in the older age group.
Treatment
How to treat retinal dystrophy? Unfortunately, on this moment not a single method has been created that could cure retinal dystrophy. Modern treatment aimed at stopping the progression of the disease. That is, in its essence it is symptomatic and does not in any way affect the root cause.
In ophthalmology, surgical, physiotherapeutic, medicinal and laser methods are used to correct retinal dystrophy. Let's look at each in more detail.
Taking medications
These drugs are taken in courses several times a year. The list of medications and rules for taking them are agreed with the ophthalmologist. Treatment is selected individually depending on each specific case.
Physiotherapy
It has a good effect on the eye and is often used in the complex treatment of retinal dystrophy. Courses are conducted on the recommendation of the attending physician and include the following procedures:
Surgical intervention
This type of intervention is carried out when laser therapy and medications have not brought results.
It is carried out only according to strict indications established by an ophthalmologist. Typically, this type of intervention is carried out when laser therapy and medications have not brought the expected results. All operations can be divided into two types:
- Vasoreconstructive: aimed at restoration normal operation vascular bed. Involves the use of transplants.
- Revascularizing: aimed at eliminating pathological proliferation of blood vessels on the retina.
All interventions are carried out in an ophthalmology hospital.
Laser treatment of retinal dystrophy
It is the most popular method for correcting retinal dystrophic processes
It is the most popular method for correcting retinal dystrophic processes. This is quite reasonable, since laser ray effectively affects the affected areas of retinal tissue and does not in any way affect healthy tissue eyes.
Laser therapy cannot completely eliminate the pathology. It is used to relieve the progression of symptoms and prevent retinal detachment. The treatment method is aimed at obtaining the following results:
The laser heats the surface of the retina, connecting it to the vascular fundus. The specialist controls the procedure using a special device - a stereoscope. The main contraindication to coagulation is an insufficient level of transparency eyeball, cornea and lens.
Laser therapy leaves small scars at the “cauterization” site, however, this is better than complete loss of vision as the disease progresses.
Treatment with folk remedies
The use of folk remedies at home for retinal dystrophy is incomplete treatment. They can be used in combination with traditional therapeutic measures. Good effect provides the use of immunomodulator herbs (echinacea, motherwort, eleutherococcus), which help strengthen the body’s immune forces and activate metabolism.
Decoctions and infusions of some medicinal plants taken orally or used as eye drops. Remedies are prepared from chamomile, chicory, eyebright, sweet clover, pine cones, juniper. Several effective recipes:
Heredity
Heredity can manifest itself in the form of a predisposition to a disease or the development congenital pathology. Congenital genomic mutations are the cause of any type of dystrophy.
Diseases often have an autosomal recessive type of inheritance, that is, with healthy parents, some of the children are born sick. This occurs due to the fact that both parents are carriers of a “sick” autosomal recessive gene in their chromosome set.
Prevention
Preventative measures for retinal dystrophy include the following:
Retinal dystrophy is serious illness which leads to significant vision loss. It often develops in people with a history of diabetes, hypertension, atherosclerosis, and obesity. Yes, excess weight and smoking are also factors influencing the development of retinal dystrophy. Hereditary factors, transferred viruses, stress and vitamin deficiency also contribute to the occurrence of visual impairment and the development of one or another type of this disease.
Retina - thinnest shell, consisting of nerve cells. It covers the entire eyeball from the inside. Light-sensitive cells in the retinal tissue convert light impulses into electrical impulses. Then, along the optic nerve and optic tract, electrical signals enter the human brain, where they are deciphered and transformed into visual images that we see before our eyes.
Causes of retinal dystrophy
The development of pathology can be triggered by many factors. Basically, dystrophy occurs:
- in old age, as a consequence of aging processes in the body
- by hereditary predisposition
- for hypertension, atherosclerosis and other vascular diseases
- as a complication of diabetes
- for vitamin deficiencies and poor nutrition
- if you are overweight
- from harmful influence smoking
- as a result of stress and nervous shock
- after a viral illness
- as a result harmful effects ultraviolet radiation
Up to 40% of various types of this retinal pathology are observed in myopic people. With farsightedness, dystrophy is observed only in 8% of cases, from 2 to 5% occur in people with normal vision.
All causes of the disease can be classified into local and general.
The first include:
- genetic predisposition;
- eye injury;
- myopia;
- inflammatory and infectious eye pathologies
From common reasons highlight:
- diabetes
- atherosclerosis, hypertension
- various types of intoxication
Symptoms of dystrophy
Dystrophy may have various symptoms, depending on the form of the disorder, but basically, several general signs of the disease can be named. So, you should be concerned if you have:
- Visual acuity decreases
- Decreased or lost peripheral vision
- Disorientation at dusk
- Dark spots appear before the eyes
- The clarity of the outlines of objects is lost
- Visible images are distorted
- Straight lines appear crooked
- Letters fall out when reading
Retinal dystrophy is a general concept that includes various shapes diseases that have different characteristics, symptoms and effects on vision.
Types of retinal dystrophy
All types of retinal dystrophy have general signs, which consist in the progression of visual dysfunction and degenerative-dystrophic changes in the retinal fiber. It is worth highlighting several main types of retinal dystrophy. First of all, retinal dystrophy is divided into:
- congenital
- acquired
Congenital dystrophy is a genetically determined, inherited disease. The most common form of congenital dystrophy is pigmentary dystrophy retina of the eye. All congenital dystrophies are incurable, steadily progress and lead to significant irreversible vision loss.
Acquired dystrophies can be divided into:
- central
- peripheral
Central retinal dystrophy (macular degeneration)
It affects the central fovea of the retina, that is, the area that is responsible for the most accurate vision and discrimination of small details. It is characterized by impaired central vision, while peripheral vision remains normal. It often affects the eyes of those who suffer from myopia. With central retinal dystrophy, serious problems with driving, writing, reading and drawing.
Age-related macular degeneration is the most common cause of vision loss in older people in developed countries. The progression of the disease can be stopped if treatment is started in time. Age-related macular degeneration can cause significant vision loss, but it never leads to complete blindness.
Peripheral dystrophy
It affects the periphery of the retina, that is, the area that does not participate in vision. It is not accompanied by deterioration of vision, but is dangerous because it can lead to the development of such a serious complication as retinal detachment. This form mainly occurs in nearsighted people. Sometimes the presence of peripheral dystrophy may be indicated by the appearance of floaters in front of the eye. In this case, you need to urgently consult a doctor for a thorough examination of the periphery of the retina with mandatory pupil dilation. If peripheral retinal dystrophy or tear is detected, then urgent laser treatment will be necessary to prevent retinal detachment.
Video - Professor M.E. Konovalov talks about macular degeneration of the retina
Watch from 30 minutes of the program "Live Great" with Elena Malysheva (issue dated 10/08/2010).
Treatment of retinal dystrophy
Modern medicine has a sufficient number of methods aimed at treating retinal dystrophy. With their help, you can improve vision and stop the progression of the disease. The goal of treatment is to reduce the likelihood of complications that could lead to permanent vision loss. The prognosis and course of the disease depend on how it is carried out. Timely consultation with a doctor increases the patient’s chances of restoring vision. But, nevertheless, only a few manage to regain their former sharpness, since in most cases retinal dystrophy is caused by age-related changes.
If the patient comes to the clinic for initial stage illness, he is prescribed drugs containing lutein, necessary for normal functioning retina. It is also recommended to exclude bad habits, if present, and protect your eyes from ultraviolet radiation. Vitamins will support vision, preventing the eyes from becoming overly tired due to visual stress. For wet stages of dystrophy, it is recommended to administer special drugs into the vitreous body of the eye to relieve swelling of the central zone of the retina.
Timely and correct treatment will help you maintain good vision for many years!
Course of conservative treatment
Optical coherence tomography(OST-diagnostics)
| Name of service | Price OST + consultation with a laser surgeon, rub. | Discounted price for patients of the Center, rub. |
|---|---|---|
| Primary diagnosis of retinal diseases (1 eye) | ||
| Primary diagnosis of retinal diseases (2 eyes) | ||
| Dynamic observation for retinal diseases (1 eye) | ||
| Dynamic observation for retinal diseases (2 eyes) | ||
| Diagnosis of diseases of the anterior segment of the eye (cornea) (1 eye) | ||
| Diagnosis of diseases of the anterior segment of the eye (cornea) (2 eyes) | ||
| Cost of recording results on CD |
Laser eye treatment ( The price for the operation is indicated for one eye.)
Dispensary observation of patients with diabetic retinopathy and age-related macular degeneration
Surgical treatment of retinal detachment
To see what is included in the price of the service, hover your mouse over the price column.
The price for the operation is indicated for one eye.
Retinal dystrophy is degenerative change fabrics retina. Depending on the location, central and peripheral forms of the disease are distinguished. In this article we will look at central (macular) degeneration.
There are two types of retinal macular degeneration - wet and dry form, let's look at them.
Macular degeneration of the retina - “dry form”
Age-related macular degeneration(AMD) or involutional central dystrophy, senile macular degeneration. This is the name of a degenerative disease of our retina, which leads to decreased central vision.
The main cause of the disease is the irreversible aging process of the entire human body, including its eye organs. Also, retinal dystrophy can be a consequence of trauma, inflammatory or infectious diseases, developed myopia, and sometimes this affects Negative influence heredity.
Smoking, diseases of cardio-vascular system, radiation can provoke the development of the disease.
The first symptoms that indicate retinal dystrophy are:
- Curvature of contours and blurring of objects.
- Difficulty reading due to noticeable “breaking” of letters.
- The brightness of images decreases.
- At later stages, a kind of transparent spot appears in the central part of the visual field.
If such changes are detected, it is extremely important not to hesitate to contact an ophthalmologist in order to diagnose the disease promptly and correctly. The initial stages of the disease can be treated much more effectively than advanced retinal dystrophy.
On early stages In cases of the “dry” form of this disease, doctors usually use drug treatment to improve the functional state and nutrition of the retina.
Depending on the type of disease, retinal dystrophy is subject to laser correction or surgery. Laser procedures are painless and only special eye drops are used as anesthesia. As a result of this operation, accumulated waste is removed from the affected area of the retina. Usually one procedure is enough, but in special cases the doctor may prescribe it again.
Surgical treatment is often aimed at preserving visual functions in patients with dystrophic processes of the fundus. Modern method surgical correction hemodynamics(separately or together with a conservative course of treatment) consists of using special drugs injected into the vitreous body of the eye and thereby reducing swelling in the central part of the retina. This operation is also performed using local anesthesia.
Retinal dystrophy treatment and course of surgery
Collagen implant(width – 6 mm, length – 20 mm) is impregnated with an antioxidant or vasodilator drug and inserted through an incision in the conjunctiva into the sub-Tenon’s space (inferonasal or inferotemporal quadrant, 8 mm from the limbus) without suturing. During 10 postoperative days, instillations are carried out against the occurrence of inflammation.
Results:
The collagen sponge "Xenoplast" is introduced into the sub-Tenon's space to dilate blood vessels due to the developing aseptic inflammation in the surrounding tissues of the microvasculature. This stimulates the growth of connective tissue along with newly formed vessels.
After 1-2 months from the day of the operation, formation of the sponge occurs at the site of insertion. granulation tissue. After 2-3 months, the sponge completely resolves, and the degree of vascularization of the newly formed episcleral tissue remains quite high.
Improving blood flow in the choroid, which is involved in the blood supply to the retina and disc optic nerve is a factor that leads to an increase in acuity by 61.4%, as well as a 75.3% expansion of the visual field.
The operation, during which retinal dystrophy is corrected, can be performed repeatedly, but not more often than after 2 months from the date of the previous one.
Indications:
Correction of visual acuity up to 0.4 D:
- In the presence of retinal pigmentary abiotrophy
- In the presence of a dry form of chorioretinal central retinal dystrophy
Not all patients diagnosed with retinal dystrophy can be recommended for surgical intervention. Therefore, it is necessary to know in advance about the available contraindications:
- Age over 75 years
- Vision with acuity below 0.02 D
- Severe uncompensated somatic diseases(collagenoses, stage III hypertension, cancer, etc.)
- Diabetes
Also, retinal dystrophy cannot be treated during the period when any inflammatory processes, including those related to eye diseases.
Macular degeneration "wet form"
Now one of the most effective methods treatment of macular degeneration“wet” forms are considered to be the introduction of Lucentis (an inhibitor of the growth of newly formed vessels) into the vitreous body. This leads to a slowdown in the progression of central vision decline, as well as to the restoration (partial) of visual acuity in approximately 25-40% of patients who applied, and its stabilization in 95%. 0.05ml (0.5 mg).
Retinal dystrophy is corrected in several stages: the first three injections with a frequency of 1 r/month are performed sequentially for three months. After this, treatment with Lucentis is stopped, a stabilization phase begins, and visual acuity is checked at least once a month. An interval of 1 month is required between two doses of the administered drug. Treatment of the disease “Retinal Dystrophy” with Lucentis should only be carried out by an ophthalmologist, observing aseptic conditions.
Photodynamic therapy
Another most effective healing technique, used to treat central retinal dystrophy of the “wet” form during the formation of a neovascular subretinal membrane. Treatment is carried out as follows: the photosensitizer Visudin (a special substance that accumulates under the retina in the neovascular pathological membrane) is injected into the patient’s vein. After this, the central zone of the retina, which is absorbed by this photosensitizer, is irradiated by a laser (by a specialist with a specified wavelength). The neovascular pathological membrane is destroyed under the retina, as a result of which the disease retinal dystrophy is partially cured. For a lasting effect, 3 sessions are required photodynamic therapy, the interval between which is 2-3 months.
Barrage of the macular region
This operation is performed to treat certain forms of central “wet” retinal dystrophy. Laser coagulants are applied in a circle near the central zone of the retina. Typically, after this procedure, retinal edema resolves, with partial or full restoration visual functions.
Like any other disease, retinal dystrophy is easier to prevent than to treat. Therefore, compliance with simple preventive measures, helps reduce the likelihood of developing the disease. Namely: healthy image life, balanced diet, with essential microelements and vitamins, the obligatory presence of moderate physical activity, systematic visits to an ophthalmologist (once or twice a year is enough, in the absence of complaints) and mandatory treatment of chronic diseases.
Retinal dystrophy is pathological process, often leading to vision loss.
Causes of retinal dystrophy
They can be congenital or secondary (acquired), central in localization (located in the macular area) or peripheral.
Hereditary retinal dystrophies:
1. Generalized
- pigmentary (tapetoretinal) degeneration,
- Leber's congenital amaurosis,
- congenital nyctalopia (lack of night vision)
- cone dysfunction syndrome, in which color perception is impaired or complete color blindness is present
2. Peripheral
- X-chromosomal juvenile retinoschisis
- Wagner's disease
- Goldman-Favre disease
3. Central
- Stargardt disease (yellow-spotted dystrophy)
- Best's disease (yolk degeneration)
- age-related macular degeneration
Secondary ones arise due to various injuries and eye diseases (myopia, glaucoma, etc.)
Symptoms of retinal dystrophy
At retinal pigmentary degeneration the pigment epithelium and photoreceptor cells are affected. The first signs appear early childhood. Characteristic specific symptoms: pigmented lesions (bone bodies), atrophic optic disc and narrowed arterioles.
At Leber's congenital amaurosis Blindness occurs from birth or children lose vision before age 10. Features: lack of central vision, nystagmus, keratoconus, strabismus, etc. Throughout fundus Various degenerative lesions are identified (white and pigmented salt and pepper type, bone bodies), the optic disc is pale, the vessels are narrowed.
X-chromosomal juvenile retinoschisis refers to hereditary vitreochorioretinal dystrophies. In this case, retinal dissection occurs, cysts form on the periphery, into which hemorrhages can occur. In the vitreous body there is hemophthalmos, strands that can lead to retinal detachment.
Wagner's disease manifested by myopia, reshinoschisis, pigmentary dystrophy and preretinal membranes with a transparent vitreous body.
Goldman-Favre disease– hereditary dystrophy has a progressive course, the main manifestations of which are bone bodies, retinoschisis and vitreous degeneration.
Stargardt's disease affects the macular area. Characteristic sign on the fundus there is a “bull’s eye” in the central zone, that is, a dark area with a light ring, surrounded by rounded hyperemia. Symptoms include decreased visual acuity by age 20, impaired color vision and spatial contrast sensitivity.
Best's vitelline dystrophy– a yellowish focus forms in the macular area, resembling the yolk of an egg. At the age of approximately 10-15 years, decreased vision, distortion of the shape of objects, and “fog” before the eyes appear. Both eyes are affected to varying degrees.
Age-related (involutional, senile) central retinal dystrophy- one of the most common reasons decreased vision in people over 50 years of age with a hereditary predisposition.
There are 2 forms:
Non-exudative – characterized by pigment redistribution, drusen, and areas of retinal dystrophy. The lesions can merge, resembling a “geographic map” picture. Drusen are located under the pigment epithelium and have a yellowish-white color; they may proliferate into the vitreous body. There are soft (with unclear boundaries), hard (with clear boundaries) and calcified. The course of the non-exudative form is benign, develops slowly
Exudative – in its development it goes through several stages: exudative detachment pigment epithelium, exudative detachment of the neuroepithelium, neovascularization, exudative-hemorrhagic detachment, reparative stage. Quickly leads to blindness.
Risk factors for developing age-related macular degeneration: Blue eyes And White skin, diet low in vitamins and minerals, increased cholesterol levels, smoking, arterial hypertension, hypermetropia, cataracts, previous eye surgeries.
The main complaints of patients with retinal dystrophies: decreased visual acuity often in both eyes, narrowing of the visual field or the appearance of scotomas, nyctalopia ( poor eyesight in the dark), metamorphopsia, impaired color perception.
If any of the above symptoms appear, you should contact a specialist who will diagnose correct diagnosis and prescribe treatment.
Examination for retinal dystrophy
For diagnosis it is necessary to conduct the following studies:
Visometry – visual acuity from normal (in the initial stage) to complete blindness. Cannot be corrected;
- perimetry – narrowing of the field of view, from the appearance of scotomas to tubular vision;
- Amsler test is the simplest subjective way to diagnose macular degeneration. The patient is asked to close one eye and look at a point in the center of the Amsler grid at arm's length, then slowly zoom in on the test without taking his eyes off the center. Normally, the lines are not distorted
Amsler test: 1. norm 2. Pathology
Refractometry – for diagnosing refractive errors (retinal degeneration is possible with high myopia);
- biomicroscopy allows to identify concomitant pathologies;
- ophthalmoscopy is performed after drug dilation of the pupil, preferably with a Goldmann lens for a more detailed examination of the retina, in particular the periphery. At various types The doctor sees dystrophy different picture fundus;
- definition color vision– tables of Rabkin and others;
- electroretinography – indicators are reduced or not recorded in most hereditary dystrophies;
- adaptometry - study of dark adaptation - reduction or absence of dark vision when cones are damaged;
- fluorescein angiography to determine areas where laser coagulation of the retina is necessary;
- optical coherence tomography of the retina
HRT (Heidelberg retinotomography);
- Ultrasound of the eye;
- general clinical tests;
- consultation with a therapist, pediatrician, geneticist and other specialists according to indications.
Treatment of retinal dystrophy
Depending on the clinical picture and type of dystrophy, treatment is prescribed. Treatment is almost always symptomatic, since all degenerations, except secondary ones, are hereditary or predisposed.
The following treatment methods are used: conservative, laser, surgical (vitreoretinal surgery, scleroplasty for detachment, etc.)
Drug treatment:
Disaggregants (Ticlopidine, Clopidogrel, acetylsalicylic acid) - taken orally or parenterally;
- vasodilators and angioprotectors(No-shpa, Papaverine, Complamin, Ascorutin);
- antisclerotic agents Prescribed mainly to elderly people - methionine, simvastatin, atorvastatin, clofibrate, etc.;
- combined vitamin preparations
(Okuwait-lutein, Blueberry-forte, etc.), as well as intramuscular B vitamins;
- means that improve microcirculation(pentoxifylline parabulbar or intravenous)
- polypeptides from the retina of large cattle(Retinalamin) parabulbar daily for 10 days. The sub-Tenon space is injected once every six months;
- biogenic stimulants
– aloe, FIBS, encad (used intramuscularly or subconjunctivally for the treatment of taperetinal dystrophy);
- apply taufon drops, emoxipine drops topically, 1 drop 3 times a day, constantly or at the discretion of the doctor.
At exudative form age-related macular degeneration, dexamethasone 1 ml is administered parabulbarly, as well as furosemide intravenously. For hemorrhages, heparin, etamsylate, aminocaproic acid, and prourokinase are used. In case of severe edema, triamcinolone is injected into the sub-Tenon's space. Routes of administration, dosage and duration of treatment depend on each specific case.
Physiotherapy also effective for retinal dystrophies: electrophoresis with heparin, no-spa, nicotinic acid, etc., magnetic therapy, and stimulation of the retina with low-energy laser radiation are used.
Most effective method treatment is considered laser coagulation retina, in which damaged areas are demarcated from healthy tissue, thereby stopping the development of the disease.
For the formation of vitreoretinal adhesions and neovascular membranes, it is recommended vitrectomy.
Hereditary retinal dystrophies have an unfavorable prognosis and almost always lead to blindness.
For age-related macular degeneration it is indicated hospital treatment 2 times a year, and it is also recommended to wear sunglasses and quit smoking.
Ophthalmologist Letyuk T.Z.
The retina is the main section of the visual apparatus, its main function is the perception of light impulses and recording images environment and transmitting this information to the brain for subsequent processing. Retinal dystrophy is a disease in which the tissue of the eyeball gradually dies. For the disease, retinal dystrophy, treatment may differ, depending on the severity and type of process, as well as the reason for which it arose.
When diagnosed with retinal dystrophy, treatment is a very complex and lengthy process aimed at strengthening blood vessels eye muscles and retina, improvement of metabolic processes in the tissues of the visual apparatus, inhibition of dystrophic processes and prolongation of the period of remission.
Today, medication, surgery and laser methods are used.
Drug therapy consists of taking the following drugs:
- angioprotectors and vasodilators. Drugs that strengthen and dilate blood vessels. These are Ascorutin, No-shpa, Complamin, Papaverine;
- antiaggregants – medicines, preventing thrombus formation ( Acetylsalicylic acid, Ticlodipine or Clopidogrel);
- if the patient has atherosclerosis, getodelimic drugs are used that help lower cholesterol (Atrovostarin, Methionine, Simvastatin);
- B vitamins;
- means for improving microcirculation, which are injected directly into the eye (Pentoxifylline);
- intravenous administration of photosensitizers;
- Lucentis – prevents the growth of pathological blood vessels. Used when age form diseases.
For the disease, retinal dystrophy is treated with physiotherapeutic methods, which is carried out in parallel with drug therapy gives good results. These are electrophoresis, magnetic therapy, laser irradiation, photostimulation.
If conservative methods did not bring the expected effect, and retinal dystrophy progresses, apply surgery. Today, laser intervention is most often used. For the disease retinal dystrophy, laser treatment involves cauterizing abnormal blood vessels. This operation prevents further development of the disease, but as a result, a scar remains and vision in this area is not restored.
Retinal dystrophy - is treatment possible at home?
When a patient is diagnosed with retinal dystrophy, treatment at home is, first of all, organizing the correct balanced nutrition, rich in vitamins and microelements, observing a rest regime and timely examinations by a doctor. In case of retinal dystrophy, treatment at home can also be carried out using folk recipes.
Retinal dystrophy: treatment with popular folk remedies:
- goat milk, diluted in equal proportions with water, is instilled 1 drop at a time. After this, you need to give your eyes a rest for at least half an hour;
- pour 50 g of garlic into one liter of vodka. Leave for 2 weeks in a warm place in a tightly sealed container, shake occasionally. Take the strained mixture 3 times a day, 15 drops. The course lasts 2 months. After a ten-day break, taking the tincture is resumed;
- 1 tbsp. l. caraway seeds are poured into a glass of boiling water. The mixture is kept in a water bath for 10 minutes, then a tablespoon of cornflower flowers is added and infused for about 5 minutes. Apply 2 drops twice a day;
- if retinal dystrophy is detected, then treatment at home can be carried out using celandine. For this, 1 tsp. celandine is poured with 0.5 cups of boiling water. The mixture is boiled for several seconds, then settled. Strain the cooled broth and place in the refrigerator. Apply 3 drops three times a day for a month. Then take a 30-day break and resume treatment.
It is important to remember that with a disease such as retinal dystrophy, treatment with folk remedies should in no case be considered as independent therapy. It can only be used as an auxiliary method.
Retinal pigmentary dystrophy: treatment methods
Pigmentary dystrophy is hereditary disease, as a result of which the patient develops a narrowing of the visual field and its deterioration in the dark. When diagnosed with retinal pigmentary dystrophy, treatment consists of taking vasodilators, vitamin therapy, and unloading the eye muscles. In severe cases that are not amenable to such therapy, surgical intervention is resorted to.
For the disease pigmentary dystrophy of the retina, treatment is usually carried out with the following drugs:
- Coplamin 0.15 g, orally 2–3 times a day;
- Nihexin 0.25 g, 2-3 times a day, course duration - one month;
- 1% solution of nicotinic acid, 0.5–1 ml intramuscularly for 15 days;
- intramuscular injections of vitamin B;
- subcutaneous administration of aloe, 1 ml for a month.
If a patient has retinal pigmentary dystrophy, treatment with folk remedies can temporarily alleviate the condition.
Surgical treatment involves transplanting fibers of the external rectus and oblique muscles into the suprachoroidal space to form new blood vessels.
Macular retinal dystrophy - treatment and modern medicines
With this form, the macula is affected - the central area responsible for color and detailed vision. The most common form is the dry form, in which visual functions fade away gradually. When diagnosed with dry retinal dystrophy, treatment consists of the use of antioxidant agents, and they must be taken on an ongoing basis, especially for persons over 50 years of age.
The wet form develops very quickly and blood cells and fluid accumulate under the retina, killing the light-sensitive cells in the retina. For the disease wet retinal dystrophy, treatment is carried out using medications or laser surgery.
Macular retinal dystrophy treatment medications, the most effective today:
- When diagnosed with macular degeneration of the retina, treatment is carried out using dietary supplements. Anthocyanin Forte is a dietary supplement with a powerful antioxidant effect. Designed to protect blood vessels;
- vitamin B;
- Lucentis - its action is aimed at preventing the formation of new pathological vessels;
- Lutein forte is a drug that, accumulating in the macula, prevents tissue destruction and clouding of the lens;
- Mildronate – improves metabolic processes of the visual apparatus;
- Okuwait lutein – improves metabolic processes, protects the retina from damage from sunlight and free radicals;
- Retinalamin – stimulates the process of restoration of damaged tissues, improves metabolism;
- for the disease macular degeneration of the retina, treatment is effective eye drops Emoxipin. They improve blood circulation and normalize metabolic processes.
It is very important to understand that it is unacceptable to self-diagnose and prescribe treatment. You should always see a doctor.
Treatment of central retinal dystrophy (video) is most often carried out according to the following scheme:
- No-spa 0.04 g three times a day for a month;
- intramuscular injection of a 1% solution of nicotinic acid;
- Nihexin 0.25 g 3 times a day, course of therapy – 2–3 months;
- 1% solution of Tropaphen, 0.5–1 ml for 20 days;
- injection of a 0.5–1.5% sodium nitrate solution under the skin of the temple. Up to 50 injections are required;
- for macula retinal dystrophy, treatment with vitamins A, B, C, E, P, PP by intramuscular administration;
- intramuscular injection of 50 mg of Cocarboxylase (15-20 procedures);
- Nerobol 0.005 g, twice a day for a month;
- conjunctival injections of 0.2% ATP solution, 0.2 ml (10–15 injections);
- Thrombolitin injections.
In case of age-related retinal dystrophy, treatment can also be carried out by instillation of Dexamethasone and intravenous administration of Furasemide.
When diagnosed with macular retinal dystrophy, treatment with folk remedies can be carried out as follows:
- Spread the washed wheat evenly in a flat container, periodically wetting the grains. After the wheat has sprouted, it is thoroughly washed and ground through a meat grinder. Ten tablespoons of this mass are poured with water and taken on an empty stomach after it swells. Store in the refrigerator for no longer than four days;
- 50 g of mumiyo is dissolved in 10 ml of freshly squeezed aloe juice. Store in the refrigerator. The mixture should be warmed to room temperature and drop 1 drop twice a day. The duration of treatment is 10 days, after which a month-long break is taken and the course is resumed;
- 6 tbsp. l. Pour 0.5 liters of pine needles. water. Boil for 15 minutes, leave for 8–10 hours. Drink in small portions throughout the day.
Unfortunately, when diagnosed with macular retinal dystrophy, medication treatment does not always bring long-term positive results. When diagnosed with macular retinal dystrophy, surgical treatment is used quite often.
Corneal dystrophy: treatment methods
This disease is hereditary. Wears double sided, inflammatory nature. It often progresses, causing clouding of the cornea.
When diagnosed with corneal dystrophy, treatment is symptomatic. Most often, drugs are used that improve the nutrition of the cornea, as well as vitamin ointments (Vita-pos, Actovegin) or drops (Taufon, Emoxipin, Balarpan). If the patient has corneal dystrophy, then treatment with physiotherapeutic methods is also used. Preference is given to electrophoresis and laser irradiation of the cornea.
Unfortunately, conservative methods only slow down the progression of the disease. In case of significant and rapid deterioration of vision, resort to surgical method– keratoplasty, which involves partial or complete replacement of the damaged area of the cornea.
If you have vision problems, do not put off visiting a doctor. If diagnosed with retinal dystrophy and corneal dystrophy, treatment is possible. And the sooner it starts, the higher the chances of a full life.
