retinal dystrophy. Age-related macular degeneration Peripheral retinal dystrophy ICb code 10

The etiology of retinal abiotrophy varies depending on the specific type of disease. The general mechanism is a mutation of a specific gene or genes that encode specific proteins involved in the life of the retina. At the same time, the pathogenesis of most forms is not well understood.
The cause of the most common form of retinal abiotrophy - pigmentary dystrophy - can be more than 150 variants of mutations in several dozen genes, most of which are inherited in an autosomal dominant manner. Almost a quarter of all cases of retinitis pigmentosa are caused by various mutations in the opsin protein gene. In the CRB1 photoreceptor protein gene, the mutation has a recessive inheritance pattern, and in the RP2 and RPGR genes, it is X-linked. There is a rarest form of retinal pigment abiotrophy with a mutation in mitochondrial DNA and, therefore, inheritance from mother to offspring. Despite the huge number of different variants of the primary disorder in retinitis pigmentosa, the pathogenesis of the disease is generally the same - there is a violation of the utilization of used rods, as a result of which they become a source of toxins in the retina. Due to the fact that the concentration of rods increases towards the periphery of the retina, pathological changes begin there, the formation of new photosensitive cells slows down, which leads to a decrease in photosensitivity.
White-dotted retinal abiotrophy is associated with mutations in one of four genes - RHO, PRPH2, RDH5 or RLBP1, with the most common form due to changes in the PRPH2 gene encoding the peripherin protein. The disease is inherited in an autosomal recessive manner. It is assumed that peripherin is involved in the stabilization of photoreceptor membranes, mainly rods, therefore, disturbances in its structure make them less stable and lead to their destruction. White dot abiotrophy of the retina has a progressive course, with the first violations (which are visible when examining the fundus in the form of white dots) are formed on the periphery of the retina.
Yellow-spotted retinal abiotrophy (Stargardt's disease) is also caused by mutations in several genes. The most common form of yellow-spotted retinal degeneration is associated with a violation of the structure of the ABCA4 protein, which performs transport and energy functions in photoreceptor membranes. This form of the disease is inherited in an autosomal recessive manner. A change in the structure of the ABCA4 transmembrane protein leads to the accumulation of toxic metabolites in the retina (in particular, lipofuscin), which causes degeneration of the photosensitive layer. Another variant of Stargardt's disease with autosomal dominant inheritance is due to a change in the structure of the ELOVL4 protein, which controls the formation of long-chain fatty acids in the tissues of the eye. In this case, the degeneration of photoreceptors is associated with impaired synthesis of some components of their membranes. Another type of yellow-spotted retinal abiotrophy is associated with a mutation in the PROM1 gene. The pathogenesis of disorders in this case has not been thoroughly studied.
Best retinal abiotrophy is caused by mutations in the BEST1 gene, the transcription product of which is the bestrophin protein, which belongs to the class of anion channels. Inheritance is autosomal dominant, the pathogenesis of dystrophy is unknown.
Congenital stationary night blindness is a generalized retinal abiotrophy with a predominant lesion of the rods, it is also accompanied by other disorders of the organ of vision - strabismus, cataracts. There are complete and incomplete forms of congenital stationary night blindness, both are inherited by an X-linked mechanism. The full type is caused by a mutation of the NYX gene, which encodes a protein that provides the transfer of excitation from rods to bipolar cells. As a result, the transmission of information from photoreceptors is disturbed, hemeralopia occurs with an almost complete absence of vision in the dark, while sharpness and color perception usually do not suffer. The incomplete form is due to a mutation in the CACNA1F gene, the product of which is a similar protein, but it is present in both rods and cones. In this case, however, the transmission of the impulse is not completely blocked, so twilight vision is only weakened, but sharpness and color perception also suffer.

Retinal pigment abiotrophy is a severe hereditary eye disease. Pathology is characterized by degeneration and destruction of the receptors responsible for the perception of light. Another name for the disease is retinitis pigmentosa. This is one of the most dangerous ophthalmic diseases. To date, medicine does not have sufficiently effective methods of treating such a pathology. The disease progresses and leads to blindness. Can vision loss be avoided? We will consider this question further.

The reasons

The cause of retinal pigment abiotrophy is genetic disorders. The disease is transmitted in several ways:

• autosomal dominant;
• autosomal recessive;
• X-linked recessive.

This means that the pathology can be inherited in the following ways:

• from one or two sick parents;
• the disease can manifest itself in the second or third generation;
• the disease can occur in men who are related to each other by blood.

It is observed in both sexes. However, this disease affects men much more often than women. This is due to the fact that pathology is often inherited in a recessive X-linked way.

The immediate cause of pigmented retinal abiotrophy is a violation in the genes responsible for the nutrition and blood supply of photoreceptors. As a result, these structures of the eye undergo degenerative changes.

Pathogenesis

The retina contains special neurons that are sensitive to light. They are called photoreceptors. There are 2 types of such structures:

1. cones. These receptors are essential for daytime vision as they are only sensitive to direct light exposure. They are responsible for visual acuity in good lighting conditions. The defeat of these structures leads to blindness even in the daytime.
2. Sticks. We need these photoreceptors in order to see and distinguish objects in low light conditions (for example, in the evening and at night). They are more sensitive to light than cones. Damage to the rods leads to a deterioration in twilight vision.

With pigmentary retinal abiotrophy, dystrophic changes first occur in the rods. They start from the periphery, and then reach the center of the eye. In the later stages of the disease, the cones are affected. First, a person's night vision deteriorates, and subsequently the patient begins to distinguish objects poorly even during the day. The disease leads to complete blindness.

International Classification of Diseases

According to ICD-10, retinal pigment abiotrophy belongs to the group of diseases united under the code H35 (Other diseases of the retina). The full pathology code is H35.5. This group includes all hereditary retinal dystrophies, in particular, retinitis pigmentosa.

Symptoms

The first sign of the disease is blurred vision in low light. It becomes difficult for a person to distinguish objects in the evening. it early symptom pathology, which can occur long before pronounced signs of visual impairment.

Very often, patients associate this manifestation with "night blindness" (avitaminosis A). However, in this case, this is a consequence of damage to the rods of the retina. The patient develops severe eye fatigue, headache attacks and a sensation of flashes of light before the eyes.

Then the patient's peripheral vision deteriorates. This is due to the fact that damage to the rods begins from the periphery. A person sees the world around him as if through a pipe. The more rods undergo pathological changes, the more the field of view narrows. In this case, the patient's perception of colors worsens.

This stage of pathology can last for decades. At first, the patient's peripheral vision is slightly reduced. But as the disease progresses, a person can perceive objects only in a small area in the center of the eye.

Late in the disease, cone damage begins. Daytime vision also deteriorates sharply. Gradually, the person becomes completely blind.

Pigmentary abiotrophy of the retina of both eyes is often noted. In this case, the first signs of the disease are observed in childhood, and by the age of 20 the patient may lose his sight. If a person has only one eye or part of the retina affected, the disease develops more slowly.

Complications

This pathology is steadily progressing and leads to complete loss of vision. Blindness is the most dangerous consequence this pathology.

If the first signs of the disease occur in adulthood, then retinitis pigmentosa can provoke glaucoma and cataracts. In addition, the pathology is often complicated by macular degeneration of the retina. This disease is accompanied by atrophy yellow spot eye.

Pathology can lead to malignant tumor(melanoma) of the retina. This complication is observed in rare cases, but it is very dangerous. Melanoma requires surgery to remove the eye.

Forms of the disease

The progression of pathology largely depends on the type of inheritance of the disease. Ophthalmologists distinguish the following forms of retinal pigment abiotrophy:

1. Autosomal dominant. This pathology is characterized by slow progression. However, the disease can be complicated by cataracts.
2. Early autosomal recessive. The first signs of the disease appear in childhood. The pathology progresses rapidly, the patient is rapidly losing sight.
3. Late autosomal recessive. Initial symptoms pathologies occur at the age of about 30 years. The disease is accompanied by a serious loss of vision, but progresses slowly.
4. Linked to the X chromosome. This form of pathology is the most difficult. Loss of vision develops very quickly.

Diagnostics

Retinitis pigmentosa is treated by an ophthalmologist. The patient is prescribed the following examinations:

1. Dark adaptation test. With the help of a special device, the sensitivity of the eye to bright and dim light is recorded.
2. Measurement of fields of view. With the help of the Goldman perimeter, the boundaries of lateral vision are determined.
3. Examination of the fundus. In pathology, specific deposits, changes in the optic nerve head and vasoconstriction are noticeable on the retina.
4. Contrast sensitivity test. The patient is shown cards with letters or numbers different colors on a black background. With retinitis pigmentosa, the patient usually has difficulty distinguishing blue shades.
5. Electroretinography. With the help of a special device, the functional state of the retina is studied when exposed to light.

Genetic analysis helps to establish the etiology of the disease. However, such a test is not carried out in all laboratories. This is a complex and extensive study. Indeed, many genes are responsible for the nutrition and blood supply of the retina. Identifying mutations in each of them is a rather laborious task.

Conservative treatment

effective methods treatment of retinal pigment abiotrophy has not been developed. It is impossible to stop the process of destruction of photoreceptors. Modern ophthalmology can only slow down the development of the disease.

The patient is prescribed drugs with retinol (vitamin A). This helps to somewhat slow down the process of deterioration of twilight vision.

Conservative treatment retinal pigment abiotrophy also includes the use of biogenic stimulants to improve the blood supply to the eye tissues. These are drops "Taufon", "Retinalamin" and a drug for injection into the eye area "Mildronate".

Strengthening the sclera with biomaterial

At present, Russian scientists have developed the Alloplant biomaterial. With retinal pigment abiotrophy, it is used to restore the normal blood supply to the eye tissues. This is a biological tissue that is injected into the eye. As a result, the sclera is strengthened and the nutrition of photoreceptors is improved. The material takes root well and helps to significantly slow down the development of the disease.

Treatment abroad

Patients often ask questions about the treatment of retinitis pigmentosa in Germany. This is one of the countries where latest methods therapy for this disease. At the initial stage, detailed genetic diagnostics are carried out in German clinics. It is necessary to identify the type of mutation in each gene. Then, using electroretinography, the degree of damage to the rods and cones is determined.

Depending on the results of the diagnosis, treatment is prescribed. If the disease is not associated with a mutation in the ABCA4 gene, then patients are prescribed high doses of vitamin A. drug therapy supplement with sessions of staying in a pressure chamber filled with oxygen.

Innovative methods of treatment of retinal pigmentary abiotrophy are applied. If the degree of damage to the eye reaches the stage of loss of vision in a patient, then an operation is performed to transplant an artificial retina. This graft is a prosthesis pierced with multiple electrodes. They mimic the photoreceptors of the eye. The electrodes send impulses to the brain through the optic nerve.

Of course, such a prosthesis cannot completely replace the real retina. After all, it contains only thousands of electrodes, while the human eye is equipped with millions of photoreceptors. However, after implantation, a person can distinguish the contours of objects, as well as bright white and dark tones.

Gene therapy with retinal stem cells is being carried out. This method of treatment is still experimental. Scientists suggest that such therapy promotes the regeneration of photoreceptors. However, before treatment, it is necessary to conduct a thorough examination of the patient and make a trial implantation, since stem cells are not indicated for all patients.

Forecast

The prognosis of the disease is unfavorable. It is impossible to stop pathological changes in the retina. Modern ophthalmology can only slow down the process of vision loss.

As already mentioned, the rate of development of the disease may depend on various reasons. Retinitis pigmentosa progresses rapidly, transmitted through the X chromosome, as well as an early autosomal recessive form. If the patient has a lesion of only one eye or part of the retina, then the pathological process develops slowly.

Prevention

To date, no methods have been developed for the prevention of retinitis pigmentosa. This pathology is hereditary, and affect gene disorders modern medicine can not. Therefore, it is important to identify the first signs of pathology in time.

If the patient's twilight vision has worsened, then such a symptom should not be attributed to beriberi. This could be a sign of more dangerous disease. In case of any deterioration in vision, you should immediately contact an ophthalmologist. This will help slow down the development of retinitis pigmentosa.

In the center of the retina is the macula, the light-sensitive element. Macular degeneration - This is an eye disease that occurs due to the pathology of blood vessels, a violation of their nutrition. Due to these reasons, damage to central vision occurs.

Macular degeneration is considered an age-related disease that most often causes blindness in people over 50 years of age.

ICD-10 code

ICD-10 disease code - H35 / 3 - degeneration of the macula and posterior pole.

Forms

There are dry and wet forms of the disease. The division is based on the presence or absence of newly formed vessels in the eye.

Dry Form:

Diagnosed in 90% of cases. Occurs due to age-related changes, in which the tissue becomes thinner, and pigment is deposited in it.

The disease goes through three stages. At the first time, several drusen (yellowish deposits) of a small size are found in the patient, the symptoms of the disease are not felt.

At the second stage of a small size, the drusen increase, in some cases a single large one is found. Spot appears in the center field of view an eye that prevents a person from seeing well, he constantly feels a lack of light.

At the third stage, the spot increases, reading, fine work are much more difficult.

Wet Form:

It is characterized by the appearance of newly formed vessels in which hemorrhages occur. This damages photosensitive cells. They die off over time and as a result, a person sees spots in the center of the field of view.

Due to the fragility of the newly formed vessels, it seems to the patient that the lines are curved, although in fact they are straight. Fragile vessels act on visual cells, creating an optical effect - a distortion of the shape of objects.

Consequences of micro-hemorrhages: due to the resulting fluid, scar tissue appears in this place, which leads to loss of vision.

Symptoms

Characteristic symptoms depend on the stage of the disease.

Main features :

• there is a feeling of lack of lighting;
• almost complete lack of vision in the twilight;
• straight lines are refracted;
• spots appear before the eyes;
• fragments fall out of the field of view when viewed directly.

Symptoms may appear in one or both eyes.

Why degenerative changes develop, scientists have not been able to identify. According to numerous studies, we can only talk about the factors contributing to the emergence and development of the disease:

1. First of all, the elderly suffer, the risk of the disease increases significantly after 70 years;
2. Wrong lifestyle - errors in nutrition, the use of strong alcoholic beverages, smoking, lack of movement;
3. Hereditary factor - if parents were sick, the risk almost doubles;
4. Health problems - diabetes, atherosclerosis, heart attack, stroke, myopia.

The cause of macular degeneration may be cytomegalovirus- an infectious disease caused by the herpes virus. Healthy man does not notice its presence, but it is dangerous for people with immunodeficiency.

Treatment

If macular degeneration is diagnosed, you can seek help from specialized medical institutions. One of the best is the clinic named after Academician S.N. Fedorov "Eye Microsurgery" - it is recognized worldwide as one of the leading centers in the field of ophthalmology. For many years, treatment in the Fedorov clinic has been carried out using the most modern equipment and the latest technologies.

Depending on some factors - the age of the patient, the duration and form of the disease - conservative therapy does not always bring visible relief. In this case, resort to surgical treatment.

Methods for the treatment of macular degeneration:

1. Preparations Avastin, Lucentis, Makujen. They are administered intravitreally (inside the eye) to stop the growth of blood vessels. Do this procedure in stationary conditions using a fine needle. Course - 3 injections with a break of one month. A large number of patients experience improvement in vision.
2. Intravenously administered medicine Verteporfin. Its action is activated by laser surgery. Photodynamic therapy improves visual functions, but after some time the effect of the drug weakens and a second procedure is required.
3. — the laser impact occurs on the newly formed vessels and on the retina. It is used in the progressive form of the disease. After such an operation, there is no improvement in vision.
4. Means that strengthen the walls of blood vessels: Vitamins E, A, group B.
5. Drugs to reduce swelling.

Prevention

1. What foods do doctors recommend for age-related macular degeneration? - It has been proven that people who consume large quantities of vegetables and fruits, berries (blueberries are the most useful) are less susceptible to the disease. Greens, carrots, spinach, cabbage, tomatoes, apples - they must be constantly present in the daily diet. Fat intake should be optimized. Eat fish and seafood at least twice a week.
2. See your ophthalmologist regularly. After the age of 60, it is recommended to visit a doctor at least once a year.
3. Adhere to eye hygiene:you can not read, write, do other things in rooms with insufficient lighting;
4. Avoid eye strain;
5. Protect your eyes during hazardous work (for example, welding), from ultraviolet rays. Sunglasses should be of a high degree of protection.
6. Take vitamins and minerals.
7. Do not smoke or stay in smoky areas.

When a person is helpless, the quality of his life goes down. To be active and independent, you need to take care of your health, especially your eyes. Active lifestyle, feasible physical exercises, rejection bad habits help to delay vision loss for many years.

Video:

RCHD (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical protocols MH RK - 2013

Peripheral retinal degenerations (H35.4)

Ophthalmology

general information

Short description

Approved by the minutes of the meeting
Expert Commission on Health Development of the Ministry of Health of the Republic of Kazakhstan

No. 23 dated 12/12/2013

Peripheral chorioretinal degeneration- chorioretinal changes in the periphery of the fundus, when only the retina and choroid are involved in the process. It can occur both in nearsighted and farsighted people, and in people with emmetropic refraction.

I. INTRODUCTION

Protocol name: Peripheral chorioretinal degeneration

Protocol code:

Code (codes) according to ICD-10:

H35.4 Peripheral chorioretinal degeneration

Abbreviations used in the protocol:

PCRD - peripheral chorioretinal degeneration

optic disc - optic disc

VEP - visual cortical evoked potentials

ELISA - linked immunosorbent assay

ECG - electrocardiography

HIV human immunodeficiency virus

ERG - electroretinogram

Protocol development date- 2013

Protocol Users- an ophthalmologist at a polyclinic and a hospital.

Classification

Clinical classification

By type they are divided into:

1. Lattice dystrophy is the most common cause of retinal detachment. There is a familial predisposition to this species dystrophies 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.

2. 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 appearance reminiscent of a snail's footprint. Most often located in the upper outer quadrant. As a result of such dystrophy, large round gaps can form.

3. Hoarfrost dystrophy is an inherited 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, may be dark spots. Hoarfrost degeneration progresses over a long period of time and does not lead to ruptures as often as ethmoid and snail print.

4. Cobblestone degeneration located, as a rule, 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.

5. Cystic (small cystic) retinal dystrophy 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. On examination eye day cysts look like multiple round or oval bright red formations.

6. Retinoschisis — retinal dissection- Can be congenital or acquired. More often it hereditary pathology- 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.

mixed forms- combination various kinds degenerations.

Peripheral chorioretinal degenerations can lead to 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 cystic 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 tear of the retina along the dentate line - the site of attachment of the retina to the choroid. In most cases, dialysis is associated with blunt trauma to the eye.

The gaps in the fundus look 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.

Diagnostics

II. METHODS, APPROACHES AND PROCEDURES FOR DIAGNOSIS AND TREATMENT

List of basic and additional diagnostic measures

The list of mandatory diagnostic measures before planned hospitalization for drug and laser treatment:

1. Consultation with an ophthalmologist

2. Visometry

3. Biomicroscopy

4. Ophthalmoscopy

5. Tonometry

6. Cycloscopy

7. Perimetry

8. Echobiometry

9. Lacrimal lavage

10. ENT, dentist, therapist

11. Consultation of narrow specialists (phthisiatrician, cardiologist, endocrinologist, epidemiological environment, etc.) in the presence of concomitant pathology.

12. Clinical and laboratory studies: general analysis blood, general urinalysis, blood sugar test, fecal test for helminth eggs, fluorography, ECG, coagulogram, blood clotting test, microreaction, HIV blood, biochemical blood test (ALT, AST, electrolytes, bilirubin, creatinine, urea), ELISA of blood for markers of hepatitis.

List of main diagnostic measures:

1. Consultation with an ophthalmologist

2. Visometry

3. Biomicroscopy

4. Ophthalmoscopy

5. Tonometry

6. Cycloscopy

7. Perimetry

8. Echobiometry

9. Keratorefractometry

List of additional diagnostic measures:

1. Doppler ultrasound to detect the degree of blood flow reduction in the vessels of the eye

2. A, B scan to determine the anterior-posterior and transverse size of the eyeball and to exclude retinal detachment

3. Electrophysiological studies - ERG and VEP for differential diagnosis with other diseases

Diagnostic criteria

Complaints and anamnesis

Peripheral chorioretinal degenerations 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. Complaints about the appearance of lightning, flashes, the sudden appearance of more or less floating flies, which may already indicate a retinal tear. Burdened hereditary anamnesis in relation to myopia.

Physical examination

Level blood pressure(to prevent the occurrence of hemorrhages during laser interventions)

Laboratory research: not informative.

Instrumental Research:

Visometry: decreased visual acuity

- Biomicroscopy: destruction of the vitreous body of varying severity

- Ophthalmoscopy: degenerative changes in the retina in the central zone in the presence of myopia various degrees:

Stage 1: initial changes in the optic disc in the form of a scleral ring, the formation of cones up to ¼ DD, less often large sizes, with a normal ophthalmoscopic picture of the macula in normal and redless light

Stage 2: initial disturbances in the pigmentation of the fundus, changes in the shape and color of the optic disc, cones of various sizes, often up to 1/2 DD, the disappearance of foveolar reflexes. With no red

Ophthalmoscopy yellow spot of orange-yellow color, normal shape, without reflexes.

Stage 3: pronounced violations of the pigmentation of the fundus, an increase in the spaces between the vessels of the choroid, large cones - up to 1.0 DD. In normal light, the macular area is of the "parquet" type or darkly pigmented. In redless light, a deformed yellow spot with light yellow foci or white patches on an orange-yellow background is determined.

Stage 4: depigmentation, cones more than 1 DD, true staphyloma. A yellow spot in ordinary light resembles a tissue eaten by a moth. Atrophic foci outside the macular region are possible. In redless light, the yellow spot is discolored, sharply deformed and resembles a light yellow blot.

Stage 5: extensive cone more than 1 DD, true staphyloma. In the macular region, an atrophic focus, sometimes merging with the cone. In redless light, yellow color is absent or is determined in the form of separate islands. In the absence of myopia, there will be no changes in the central zone.

- Tonometry: increase in IOP above the tolerable level;

- Perimetry: narrowing of the peripheral boundaries of the visual field,

- Cycloscopy:

I. Chorioretinal changes in the equator.

1. Lattice dystrophy.

2. Pathological hyperpigmentation

3. Retinal breaks with valves and caps.

II. Chorioretinal changes in the dentate line

1. Cystic dystrophy

2. Retinoschisis

3. Chorioretinal atrophy

III. mixed forms

Echobiometry: determination of the transverse and longitudinal size of the eye

Indications for expert advice:

In the presence of concomitant general pathology, a conclusion of the relevant specialist is necessary that there are no contraindications to surgical laser treatment. Without fail, the conclusion of an otorhinolaryngologist and a dentist for the absence of chronic foci of infection.

Differential Diagnosis

Differential Diagnosis in the presence of myopia, it is carried out between peripheral chorioretinal degeneration of myopic genesis and peripheral pigmentary degeneration.

Treatment abroad

Get treatment in Korea, Israel, Germany, USA

Get advice on medical tourism

Treatment

Treatment Goals

Stabilization degenerative changes on the retina and visual acuity, prevention of retinal detachment

Treatment tactics

Non-drug treatment:
- mode - general,
- diet - table No. 15.10, enriched with vitamins and minerals,
- appointment of light procedures,
- physiotherapy with a helium-neon laser No. 5-7 with a stimulating purpose (according to indications).
- Limitation of physical activity
- Spectacle correction

A) gymnastics according to Avetisov-Mats

C) gymnastics according to Dashevsky

D) electrical stimulation

E) computer programs "Relax", "Eye"

E) Amblyocor

Medical treatment

Mydriatics and cycloplegics:
tropicamide 0.5; 1% - for pupil dilation 2 drops 2 times a day

Atropine sulfate 1% 2 drops x 2 times a day

Trophic therapy:
Sodium chloride - dilution of drugs 200.0 ml.

Vinpocetine - improvement of tissue trophism 1 tab. 3 times a day for 1 month; 2.0 - 4.0 ml. in / in the physical. solution No. 10

Cinnarizine - improvement of tissue trophism 1 tab - 3 times a day for 1 month

Retinoprotectors(mildronate, retinolamine 1 tab. 3 times a day for 1 month; 0.5 p / b No. 10.

Cerebrolysin - lymphotropic drug 2.0 ml. intramuscularly; 0.5 ml. parabulbarno

Emoksipin - antioxidant 0.5 ml. parabulbar; 2.0 intramuscularly No. 10, or drip 1 drop 4 times a day, contact eye films No. 10.

Retinol acetate / palminate + Tocopherol acetate - antioxidant 1 tab. 2 times a day.

Vasodilator drugs:

Angioprotective drugs

Cyanocobalamin - vitamin therapy 1.0 ml. intramuscularly

Pyridoxine hydrochloride - vitamin therapy 1.0 ml. intramuscularly.

Ascorbic acid - vasoconstrictor -5% - 2.0 ml №10 i/m

Taurine 0.5 ml p / b No. 10;

Surgery (on an outpatient basis)

Laser coagulation of zones of peripheral degeneration

Preventive actions

Antibacterial and anti-inflammatory therapy for the prevention of postoperative inflammatory complications

Limitation of physical activity

Further management:

Within 7-10 days after laser intervention, instillation of anti-inflammatory and antibacterial drugs

Ophthalmoscopy and cycloscopy 2 times a year

Treatment effectiveness indicators:
- stabilization of visual functions,
- stabilization and delimitation of degenerative foci and retinal breaks.

Hospitalization

Indications for hospitalization
- deterioration of visual functions,
- progression of degenerative conditions on the periphery of the fundus.

Type of hospitalization - planned.

Information

Sources and literature

1. Minutes of the meetings of the Expert Commission on Health Development of the Ministry of Health of the Republic of Kazakhstan, 2013
   1. 1. Jack J. Kansky [et al.]. Fundus diseases /; ed. S.E. Avetisova. - M.: MED-press-inform, 2008. - 424 p. 2. L.V. Dravica [i dr.]. Condition of the fellow eye in patients with unilateral retinal detachment // Ars Medica. - 2010. - No. 13(33). - S. 162-164. 3. American Academy of Ophthalmology. - 2008. - Mode of access: http://one.aao.org/CE/PracticeGuidelines/PPP.aspx. - Date of access: 08/10/2011. 4. M. Bonnet, P. Aracil, F. Carneau. Nongmatogenous retinal detachment after prophylactic argon laser photocoagulation / / Graefes Arch Clin Exp Ophthalmol. - 1987. - No. 225. - P. 5-8. 5. Brinton, D.A. Retinal Detail: Principles and Practice-3rd edition.- Oxford University Press in cooperation with the American Academy of Ophthalmology, 2009. - 258 p. 6. Byer, N.E. Lattice degeneration of the retina // Surv Ophthalmol. - 1979. - Vol. 23. - No. 4.-P. 213-248. 7. Byer, N.E. Long-term natural history of lattice degeneration of the retina // Ophthalmology. - 1989.-Vol. 96. - No. 9. - P. 1396-1401. 8. Byer, N.E. Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment // Ophthalmology. - 1994. - Vol. 1 0 1 .-No. 9 .-P. 1503-1514. 9. Byer, N.E. The long-term natural history of senile retinoschisis with implications for management / / Ophthalmology. - 1986. - Vol. 93. - No. 9. - P. 1127-1137. 10. Byer, N.E. The natural history of asymptomatic retinal breaks // 10. Ophthalmology. - 1982. - Vol. 89. - No. 9. - P. 1033-1039. 11. Byer, N.E. What happens to untreated asymptomatic retinal breaks, and are they affected by posterior vitreous detachment? / / Ophthalmology. - 1998. - Vol. 105. - No. 6. - P. 1045-1050. 12. M.C. Sharma. Determination of the incidence and clinical characteristics of subsequent retinal tears following treatment of the acute posterior vitreous detachment-related initial retinal tears / / Am J Ophthalmol. - 2004. - No. 138. - C. 280-284. 13.D.S. Chauhan. Failure of prophylactic retinopexy in fellow eyes w ithout a posterior vitreous detachment // Arch Ophthalmol. - 2006. - No. 124. - C. 968-971. 14.M.R. Dayan. Flashes and floaters as predictors of vitreoretinal 15. pathology: is follow-up necessary for posterior vitreous detachment? // eye. - 1996. - No. 10. - C. 456-458. 16.J.C. Folk, E.L. Arrindell. The fellow eye of patients with phakic lattice retinal detachment // Ophthalmology. - 1989. - No. 96. - P. 72-79. 17. R. Sarrafizadeh. Incidence of retinal detachment and visual outcome in eyes presenting with posterior vitreous separation and dense fundus-obscuring vitreous hemorrhage // Ophthalmology. - 2 0 0 1 .-V ol. 108, No. 10. - P. 2273-2278. 18. Kreis, A.. W. Aylward, J. G. Wolfensberger, T. J . Prophylaxis for retinal detachment Evidence or Eminence Based? // Retina. - 2007. - No. 27. - P. 468-472. 19. Lewis, H. Peripheral retinal degenerations and the risk of retinal detachment // Am J. Ophthalmol. - 2003. - No. 136. - P. 155-160. 20. Schroeder W, Baden H. Retinal detachment despite preventive coagulation // Ophthalmologe. - 1996. - No. 93. - P. 144-148. 21. Singh, AJ. Seemongal-Dass R.R. Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment / / Eye. - 2 0 0 1 .-No. 1 5 .-P. 152-154. 22.R.E. coffee. Symptomatic posterior vitreous detachment and the incidence of delayed retinal breaks: case series and meta-analysis // Am J 23. Ophthalmol. - 2007. - No. 144. - C. 409-413. 24. 22. K.A. overdam. Symptoms predictive for the later development of retinal breaks // Arch. Ophthalmol. - 2001.-No. 119.-C. 1483-1486. 25. 23. Williamson, T.N. Vitreoretinal Surgery / T.N. Williamson. - Berlin Heidelberg: Springer-Verlag, 26. 2008. - 227 p.
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Angioid streaks of the macula

Drusen (degenerative) macula

Senile macular degeneration (atrophic) (exudative)

If necessary, identify the drug that caused the lesion, use an additional code external causes(class XX).

retinal degeneration:

• lattice
• microcystic
• palisade
• resembling a cobblestone pavement
• reticular

Excludes: with retinal tear (H33.3)

Dystrophy:

• retinal (albipunctate) (pigmented) (yolk-like)
• tapetoretinal
• vitreoretinal

Central serous chorioretinopathy

Detachment of the retinal pigment epithelium

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is accepted as a unified normative document to account for morbidity, the reasons for the population's appeals to medical institutions of all departments, and the causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Diabetic angiopathy of the retina and lower extremities: ICD-10 code, symptoms and treatment methods

Angiopathy is a violation of the efficiency of the vessels of the eyeball, which manifests itself in the form of a deterioration in the tone of the vessels of the retina and the capillary bed of the fundus.

As a result of this disease, there is a decrease in the blood supply to the organ and nervous regulation. It seems strange that such a dangerous and serious illness does not have an ICD-10 code.

But this does not mean the safety of the disease. It, like similar diseases, requires close attention from ophthalmologists. This article provides detailed information about such a pathology as diabetic angiopathy, according to ICD-10.

What's this?

Angiopathy of the retina is not an independent disease, but just a manifestation of certain ailments that affect the blood vessels of the entire human body. The condition manifests itself in a pathological change in the blood vessels due to a significant violation of the nervous regulation.

Angiopathy of the retina

Fortunately, enough attention is paid to the disease, since it can lead to undesirable consequences for the whole organism. The most dangerous of them is the loss of vision. This common disease is diagnosed not only in babies, but also in people of a more mature age.

It usually occurs in men and women over 30 years of age. There is a certain classification of ailments that affect the development of this pathological condition.

Depending on them, retinal angiopathy is of the following types:

1. diabetic. In this case, the damage to the blood vessels occurs due to the neglect of the state of diabetes mellitus of both types. In this case, damage is noted not only to the capillaries of the eyes, but also to the blood vessels of the whole organism. This phenomenon leads to a significant slowdown in blood flow, as well as clogging of arteries, veins and capillaries. As a result, the nutrition of the eyes deteriorates, and visual function gradually decreases;
2. hypotonic. Low blood pressure can lead to a deterioration in the tone of the small blood vessels of the eyeballs. Also, their overflow with blood and a decrease in blood supply are noted. A little later, blood clots may appear. With this type of disease, a person feels a strong pulsation in the vessels of the eyes;
3. hypertonic. If a patient has hypertension, the ailment in question often occurs. It manifests itself in the form of branching and dilation of veins, frequent hemorrhages in the cavity of the eyeball and clouding of its structure. With successful treatment of hypertension, retinal angiopathy of both eyes will pass by itself;
4. traumatic. This form of the disease can develop in the presence of serious injuries of the spine, brain injuries and compression of the sternum. The development of angiopathy may be due to squeezing of large and small blood vessels in the area cervical spine. Another reason for this phenomenon is sharp increase pressure inside the skull;
5. youthful. This variety is considered the most dangerous and undesirable, since the causes of its occurrence are still unknown. The most common symptoms of the phenomenon are the following: an inflammatory process in the blood vessels, as well as periodic hemorrhages, both in the retina and in the vitreous body. The formation of connective tissue on the retina is not excluded. Such alarming signs of the disease often lead to cataracts, glaucoma, retinal detachment and even blindness.

Short description

The most likely signs of angiopathy, in the presence of which you should visit a personal specialist:

• blurred vision;
• flashing stars or flies before the eyes;
• pain in the lower extremities;
• regular bleeding from the nose;
• progression of myopia;
• bleeding from the organs of the urinary system;
• stomach and intestinal bleeding;
• retinal dystrophy.

Among the reasons for the development of angiopathy are the following:

• serious injury to the cervical spine;
• violation of the integrity of the head in the back of the head;
• the presence of high intracranial pressure;
• cervical osteochondrosis;
• the presence of bad habits, for example, such as smoking;
• all kinds of blood diseases;
• advanced age;
• unfavorable working conditions;
• poisoning the body with various toxic substances;
• visible disorders of nervous regulation, which are responsible for the tone of the walls of blood vessels;
• high blood pressure;
• individual features of the structure of the walls of blood vessels.

This disease has two main forms: non-proliferative and proliferative. In the first form, the blood flow through the capillaries deteriorates or stops completely.

From damaged vessels, fluid, proteins and fats enter the surrounding tissue, which provoke a significant deterioration in vision. Swelling becomes inevitable a little later visual disc, which can subsequently cause the loss of the ability to see.

In the second type of disease, new weak blood vessels form on the surface of the retina.

Due to their high fragility, in case of accidental damage, miniature hemorrhages appear at the bottom of the eye, which can lead to inflammatory process in the surrounding tissues. Often scars form.

final stage given state retinal detachment becomes - this phenomenon is considered the most serious complication of diabetes mellitus. Among other things, an unexpected hemorrhage into the internal environment of the eye can provoke a sharp deterioration in vision. Few understand the seriousness of this pathological condition.

A progressive disease can provoke such undesirable consequences as:

• complete damage to the optic nerve;
• narrowing of the visual fields;
• blindness.

That is why all people suffering from pressure surges and carbohydrate metabolism disorders should periodically visit an ophthalmologist's office and follow all his recommendations. This will help keep you healthy.

ICD-10 code

To begin with, it should be recalled that the ICD-10 is the International (adopted by WHO for doctors of all categories and countries) classification of diseases in the tenth revision.

As noted earlier, diabetic angiopathy has no ICD-10 code. This is due to the fact that it is considered a consequence of such dangerous ailments as intracranial hypertension, infectious diseases blood, diabetes and so on.

And these are just some of all the possible causes of the appearance of significant circulatory disorders in the retina. The particular danger of this pathological condition lies in the fact that against the background of angiopathy, the development of more serious problems, for example, such as retinal dystrophy and myopia, is not excluded. It is important to note that in the absence of timely and competent treatment, this disorder can lead to complete atrophy of visual function.

The most characteristic is that this serious illness, including retinopathy, which appeared against the background of disturbances in work endocrine system, capable of hitting not one, but two eyes at the same time. This is what is distinctive feature during differential diagnosis. You can detect the disease during a routine examination by an ophthalmologist.

Treatment of the disease, in addition to conservative methods, includes surgical ones.

As a rule, it is laser therapy that is actively used. It allows you to eliminate the growth of blood vessels and prevent the likelihood of hemorrhage.

It should be noted that certain medications are also used to maximize the restoration of visual function, which not only improve blood circulation, but also prevent thrombosis and reduce vascular permeability.

In addition, special drops are prescribed that improve metabolic processes occurring in the internal environment of the eye. One of these drops is Taufon.

In the treatment, certain methods of physiotherapy are actively used. These include the following:

• magnetotherapy;
• acupuncture;
• laser treatment.

Experts recommend that you definitely do gymnastic exercises for the eyes. As for nutrition, it is necessary to provide your daily diet with various varieties of fish, dairy products, vegetables, fruits and berries.

Vitamin courses of treatment should be carried out once every 6 months. For this, it is recommended to use vitamins B, C, E, A. Therapy should last up to two weeks.

As additional measure it is desirable to use special nutritional supplements and herbal remedies based on blueberries and carrots. But, it should immediately be noted that these substances are not able to restore the functionality of the retina.

Another disease that can cause serious harm to health is diabetic vascular angiopathy. lower extremities, code according to ICD-10 which is E 10.5 and E 11.5.

Related videos

What is diabetic retinal angiopathy:

So, according to ICD-10, diabetic retinal angiopathy is not encoded in any way. Diabetic angiopathy of the lower extremities has an ICD-10 code and even two - E 10.5 and E 11.5. To maintain eye health, you should regularly be examined by an ophthalmologist who will monitor their condition.

If the slightest problems are found, the doctor will prescribe the appropriate therapy, which will help eliminate them completely. It is very important to constantly visit a specialist’s office in order to diagnose violations in a timely manner, since this is the only way to quickly and effectively get rid of them.

• Eliminates the causes of pressure violations
• Normalizes blood pressure within 10 minutes after taking

Why is retinal angiopathy dangerous today and how to treat it correctly?

The human eye is a rather vulnerable organ and deterioration in the quality of vision is not the only ailment that can befall a person. At the same time, some eye diseases are independent diseases, others are only symptoms of others. And in both cases, it is important to be able to recognize the problem and correctly proceed to solve it. After all, often in the absence of action, you can lose the opportunity to see well. Angiopathy does not always pose a serious threat to the health of the body, but its treatment is as necessary as the treatment of any eye disease.

Disease Definition

As a rule, angiopathy of the retina appears against the background of a disorder of the nervous system and is a pathological change. circulatory system with poor blood flow. Such a pathology is not an independent disease and appears against the background of a general deterioration in the state of the body's vessels caused by various diseases and abnormalities. Sometimes angiopathy can be accompanied by deterioration and complete loss of vision.

Causes

Angiopathy can develop due to many reasons and factors. Among the main ones:

• Increased intracranial pressure;
• Decrease in the tone of the walls of blood vessels;
• Diabetes;
• Various blood diseases;
• Age changes;
• Eye damage and injury.

The causes of the disease can also be divided according to its types.

• Hypertensive. Due to the development of hypertension, the body can lose the overall tone of the veins and blood vessels, at the same time, the movement of blood in the retina of the eyes is also disturbed. Blurred vision is observed, myopia progresses. Degeneration occurs in the tissues of the retina.
• Juvenile (Eales' disease). It is an inflammation of the blood vessels and can lead to the development of cataracts, glaucoma and retinal detachment.
• Hypotonic. Along with the expansion of veins and arteries, the vessels of the eyes also expand, their general tone is lost. As a result of this, blood clots can form, and the patient, in turn, feels a pulsation in the eye area.
• Traumatic. Angiopathy may appear due to vascular damage in the cervical spine. There may be narrowing of the blood vessels in the eyes and, as a result, hypoxia.
• Dystonic. Accompanied by the rapid development of myopia. The disease manifests itself against the background of a general dysfunction of the vessels of the body, hemorrhages in the eyeball are possible.
• Diabetic. Develops in the absence proper treatment diabetes mellitus. In this case, the blood vessels narrow and in connection with this, the blood begins to move more slowly.
• Background. It occurs against the background of the appearance of various diseases and the presence of hereditary abnormalities associated with the vascular system. Possible chronic circulatory disorders.
• Venous. Throughout the body, the veins lose their tone and shape, blockages and blood clots occur. Along with this, visual impairment and clouding in the eyes are possible.

Symptoms

The main symptoms of retinal angiopathy include:

• Deterioration in the quality of vision;
• Progressive retinal dystrophy;
• Myopia;
• Lightning in the eyes;
• Bleeding and hemorrhage;
• Tortuosity of vessels;
• Growth of defective capillaries.

With microangiopathy, there is a thinning of the walls of the capillaries, a deterioration in blood circulation. The development of macroangiopathy is accompanied by the degradation of large vessels, diabetic - clogging and blockage of their mucopolysaccharides.

Angiopathy and the individual causes of its appearance are diagnosed by an ophthalmologist with the help of ophthalmoscopy, as well as on the basis of data on general condition patient's health.

Possible Complications

Without timely intervention in angiopathy, reversible changes in the retina, tissue hypoxia and hemorrhages can be expected. The vessels of the retina are also directly affected. In turn, they are severely deformed and lose blood conductivity. In some cases, complete loss of vision is possible.

Complications can provoke various bad habits, high blood pressure, hereditary diseases blood vessels, obesity, high cholesterol.

Treatment

Retinal angiopathy is an unpleasant phenomenon, but treatable. With its proper construction, the state of the retina can return to normal. Only a qualified ophthalmologist can prescribe a course.

Self-medication can be detrimental in the case of angiopathy, since certain procedures and medications are prescribed for each cause.

Simultaneously with the treatment of angiopathy, the treatment of diseases is carried out, the consequence of which it was, therefore, it is often necessary to observe other doctors. It is important to follow the prescribed diet during this period.

In a medical way

In the treatment of the disease, it is first necessary to restore proper blood circulation. For this, as a rule, appoint:

The main set of medicines also includes vasoconstrictive agents (calcium dobesilate, Parmidine, etc.), as well as drugs that prevent platelets from sticking together (Aspirin, Ticlodipine, Dipyridamole, etc.). If necessary, it is possible to prescribe vitamins C, E, P and elements of group B.

Widely used and eye drops, such as Taufon, Emoksipi, Anthocyan forte.

During the treatment of work disorders vascular system you need to give up bad habits. If they were one of the causes of the development of the disease, they will have to be completely excluded from everyday life.

Surgical methods

If angiopathy has acquired a neglected form, surgical intervention may also be required. Photocoagulation is performed, which prevents retinal detachment, the formation of fibrous tissue and reduces the appearance of defective vessels, as well as treatment with a surgical laser. Physiotherapeutic methods are also widely used.

Night blindness - symptoms in humans, as well as treatment methods are described here.

Folk remedies

In the treatment of retinal diseases, the use of folk remedies is also acceptable, but only in combination with the main methods of therapy and only after consulting doctors.

Treatment folk remedies usually made with the help of infusions: rowan fruits, currant leaves, dill seeds and cumin.

Collection number 1. It is necessary to collect one hundred grams of yarrow, chamomile, St. John's wort, immortelle and birch buds. It is required to prepare the infusion based on the proportion: for one tablespoon of the collection, half a liter of boiling water. After infusion for twenty minutes, the mixture must be filtered and diluted with hot water in the amount of half a liter. Reception is carried out twice a day - in the morning and in the evening, one glass each. The course of treatment is carried out until the collection is completely used up.

Collection number 2. Fifteen grams of lemon balm and valerian must be mixed with fifty grams of yarrow. A quarter of a liter of boiling water is needed to brew every two teaspoons of the resulting mixture. The infusion must be kept for three hours, then heated in a water bath and filtered. This amount of herbal medicine must be distributed throughout the day. Treatment is carried out for three weeks.

Prevention

In order to prevent the occurrence and development of retinal vascular disease, it is necessary to follow the basic rules:

1. Timely treatment of diseases that cause retinal angiopathy.
2. Avoid serious physical overload.
3. Regular check-ups with an ophthalmologist.
4. News healthy lifestyle life and follow a proper diet.
5. To refuse from bad habits.
6. In the presence of hereditary diseases of cardio-vascular system follow the regimen and recommendations of the attending physician.

Levomycitin eye drops: instructions for use are described here.

Video

conclusions

Retinal angiopathy is not an independent disease, which can complicate the program of its treatment, depending on the identified causes. It is not recommended to allow complications and start the situation with its appearance, since this can lead to serious consequences, up to complete loss of vision. At the same time at right choice treatment of angiopathy and the underlying disease, it is possible to achieve a complete return of the previous healthy condition retina and return to normal.

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The information on the site is presented for informational purposes only, be sure to contact your ophthalmologist.

Retinal angiopathy: ICD-10 code, treatment, types

What it is?

Angiopathy is a condition of the retinal vessels, in which capillary blood circulation changes due to violations of their nervous innervation. This is due to the low filling of blood vessels or their prolonged spasm.

Medicine does not distinguish angiopathy as an independent disease, modern scientific approaches attribute it to one of the manifestations of the underlying disease. Such a symptom complex can be the result of metabolic or hormonal disorders, injuries and intoxications, as well as the result of such bad habits as smoking or drug addiction.

This condition, if detected and treated early, is reversible. Only in advanced cases, the disease leads to serious complications:

Stages of retinal angiopathy

Treatment of angiopathy is prescribed by an ophthalmologist after a thorough examination. The success of therapy directly depends on the procedures aimed at getting rid of the underlying disease.

ICD-10 code

According to the international typology of diseases, angiopathy does not have its own code, since it has not been assigned the status of an independent disease. Therefore, coding goes according to the pathology that caused the vascular imbalance in the retinal tissues.

These can be various diseases:

• traumatic injuries of the eyes, face, neck, head;
• high intracranial or arterial pressure;
• osteochondrosis, cervical spondylosis;
• diabetes;
• hypo- or beriberi;
• blood diseases;
• atherosclerosis, vasculitis;
• intoxication with microbial toxins or poisoning chemicals(radiation);
• strong physical and psycho-emotional stress, causing prolonged spasm of capillaries;
• presbyopia or dystrophy of tissues in the eye apparatus.

Angiopathies have their own classification:

1. Juvenile (Eales' disease), refers to rare pathologies with an unexplained etiology. The disease affects young people and manifests itself:

• inflammation of capillaries and veins and proliferation of connective fibers in the retina;
• hemorrhages in the tissue of the eye;

The prognosis of the disease is serious, as it can provoke retinal detachment and partial or complete loss vision, as well as the development of cataracts or glaucoma.

2. Hypertensive retinal angiopathy is caused by high blood pressure in patients, because of this, the vessels of the eyes are often in a constricted state, which prevents the normal blood supply to the retina, often occurs with pronounced changes in the fundus.

3. Traumatic angiopathy develops with injuries to the head, neck or chest. Here, mechanical compression of the veins and capillaries or an increase in intracranial pressure is possible. Pathology causes a temporary or prolonged loss of visual acuity, damage to the nerve plexuses that innervate the eyes, degenerative changes in the cells of the retina and vitreous body.

4. The hypotonic type of the disease is characterized by overflow of blood vessels and their pathological expansion, therefore, there is a risk of increased thrombus formation, hemorrhages in the eye tissue.

5. Diabetic angiopathy is a consequence of the progression of this disease. Incorrect cellular metabolism causes changes in the structure of blood vessels (their thinning or obesity), so the normal blood circulation through them is disturbed.

6. The age-related form of the disease occurs due to the aging of the body, worn-out vessels no longer cope with the loads, their tone decreases, and dystrophic changes appear.

Angiopathy of the retina in a child

Changes in the tone of the vessels of the eyes in children in infancy can be observed with a change in body position or hysterical crying. This is due to the immaturity of the circulatory and nervous systems of babies and is not a pathology. The painful condition of the eye vessels in children is indicated by a prolonged spasm of the veins and capillaries, diagnosed during examination in a hospital (maternity hospital, children's hospital) or in outpatient settings.

Cause angiospasm of the eyes in children can:

• in a decrease in visual acuity;
• in the appearance of flickering, white or dark spots before the eyes, “fiery flashes, lightning, flashes”;
• in increased eye fatigue when reading, watching TV or working on a PC;
• in the formation of a network of capillaries on the mucous membrane of the eye, in the reddening of the conjunctiva, in the detection of pinpoint hemorrhages;
• in a decrease in the fields of lateral vision;
• in a sensation of pulsation within the eyes;
• in pathological changes in the fundus (with an objective examination by a doctor).

Treatment

Therapy of angiopathy is carried out according to the background disease:

1. The diabetic form of the pathology requires strict adherence to the diet and (or) the systematic administration of insulin.
2. Hypertensive angiopathy of the retina of both eyes is treated primarily with drugs that reduce pressure and vasoconstrictor agents.
3. Traumatic angiopathy involves treatment in a surgical hospital, the use of special manipulations (tires, plastering) or operations.

To improve blood circulation in the eye vessels in all forms of angiopathy, the following can be prescribed:

Physiotherapy is usually added to medical methods:

General strengthening procedures for this condition include:

• adherence to a carbohydrate-free diet;
• walks in the open air;
• light physical activity (swimming, gymnastics);
• reduction of visual stress;
• the use of vitamins.

What is retinal angiopathy, and what is the disease code for microbial 10,

Angiopathy is a change in the state of the vessels of the retina, which can lead to the development of dystrophic changes (retinal dystrophy), myopia, atrophy ophthalmic nerve etc.

Angiopathy of the retinal vessels is not a disease and ophthalmologists often focus on this, but a condition that can occur against the background of other diseases. Pathological changes in the vessels appear with injuries and injuries, and are also observed in diabetes mellitus.

ICD-10 code

Angiopathy has no code for international classification because it is not considered an independent disease. The code is assigned to the disease that led to the development of the pathological condition.

What does retinal angiopathy look like?

Causes and classification

Angiopathy has several causes. Names in vessels arise against the background of:

1. Traumatic injury chest or cervical spine. Which leads to a violation of blood flow, the occurrence of hypoxia.
2. Arterial hypertension - simply put, high blood pressure. With an increase in blood pressure, small retinal capillaries cannot withstand the load and burst. Hemorrhages occur, which can lead to a decrease in visual acuity, the occurrence of changes in the vessels and their bed.
3. Arterial hypotension - low blood pressure, which has arisen against the background of a significant expansion of the veins and large vessels, leads to the formation of blood clots in the vessels of the retina.
4. Cervical osteochondrosis is a disease that leads to impaired blood flow to the brain, increased intracranial pressure.
5. Diabetes mellitus is a pathology of the endocrine system, characterized by an increase in blood sugar levels. In the absence of adequate therapy, diabetes mellitus leads to thickening of the membrane walls and affects the state of the vascular network of the retina.
6. Traumatic brain injury - leads to disruption of the brain, increased intracranial pressure, the development of hypoxia. In this case, angiopathy occurs as a result of an injury.
7. Pregnancy and the process of childbirth - changes in the vessels may appear during pregnancy or occur after a difficult birth. In this case, the condition is subject to correction, but only if the cause of the pathology has been established.
8. Autoimmune diseases and diseases of the hematopoietic system are nonspecific causes. Against the background of such diseases, changes in the vessels of the retina occur quite rarely.

But what is presbyopia angiopathy of the retina, and how it is treated, this information will help to understand.

On the video - a description of the disease:

There are several types of angiopathy, it happens:

• hypertensive - occurs when the level of blood pressure or intracranial pressure increases;
• hypotonic - develops against the background of low blood pressure and the formation of blood clots;
• diabetic - the main cause is diabetes mellitus or an increase in blood sugar levels (can be diagnosed in children of the first year of life or newborns);
• background - occurs against the background of changes in the state of the vessels of the retina, with a long course it is dangerous with complications;
• traumatic - a consequence of past injuries, injuries occurs when there is a violation of blood flow to the brain;
• youthful - appears in children during puberty. The exact cause of the occurrence has not been established. It is manifested by a sharp loss of visual acuity, develops rapidly and can cause glaucoma or retinal dystrophy.

Angiopathy of both eyes is diagnosed more often. But there are cases when the vessels are modified only in one eyeball. This may indicate a slow progression of the pathology.

Description of symptoms

Angiopathy has a number of specific signs that a person can notice, but leave without due attention. Attributing the condition to stress or fatigue.

In most cases, patients complain:

1. On the appearance of "flies" in the eyes.
2. Decreased visual acuity.
3. On the appearance of flashes or fog before the eyes.
4. For pain or colic in the eyeball.
5. For rapid fatigue of the organs of vision.
6. On the appearance of petechial hemorrhages or bursting, red vessels in the region of proteins.

It is necessary to pay attention to the decrease in visual acuity, the appearance of flies or lightning before the eyes. Temporary, but complete or partial loss of vision. When, when getting out of bed or with heavy physical activity there is a sharp clouding in the eyes, an acute attack of dizziness.

This indicates that a person has problems with the circulation of the brain, hypoxia or high intracranial pressure. Against the background of these pathologies, retinal angiopathy develops.

Symptoms may change, occur periodically (only with an increase in blood pressure), but these signs should not be ignored. When anxiety symptoms appear, you should consult a doctor as soon as possible.

Diagnostics

It does not differ in particular complexity, it is enough just to contact an ophthalmologist. The doctor will examine the vessels of the fundus.

To detect changes, it is enough to conduct only one examination, but if necessary, the doctor may recommend an ultrasound of the eyes. They also measure intraocular pressure, which helps to eliminate the likelihood of developing glaucoma. But how the diagnosis of retinal angiopathy in a child occurs, this information will help to understand.

Treatment

Therapy is aimed at eliminating the root cause of the pathological condition. If angiopathy occurs against the background arterial hypertension, the doctor writes out a referral to a cardiologist. The doctor prescribes drugs that can stabilize the level of blood pressure and reduce the risk of bleeding in the vessels of the retina and small capillaries.

If angiopathy is associated with diabetes, then treat the underlying disease and try to prevent the development of complications.

So, what drugs can an ophthalmologist prescribe:

• vasodilators (Cinnarizine, Vinpocetine, etc.);

Cinnarizine

Angiopathy can occur not only during pregnancy, but also after childbirth. In the event that the birth process was severe or protracted and led to retinal hemorrhage.

A woman may complain about:

1. The appearance of mist in the eyes.
2. Decreased visual acuity. But what exercises to increase visual acuity should be used first of all, the information on the link will help to understand.
3. Bright flashes (lightning). But why flashes like lightning appear in the eyes, and what can be done about such a problem is indicated here.

In this case, you need to consult an ophthalmologist. After discharge from the maternity hospital, it is urgent to consult a doctor, he will help correct the condition and avoid possible complications.

Angiopathy of the retina is an alarming sign that should not be ignored. If you experience unpleasant symptoms, you should consult an ophthalmologist. The doctor will carry out the necessary diagnostic procedures and prescribe appropriate treatment.

1. Svetlana

When examining my fundus, the oculist noted a slight expansion of the vessels, she did not particularly advise anything, except for Taufon and the like. Apparently, however, vascular pathology a specialist who is responsible for vascular diseases or diseases that caused these vascular problems is involved. Cardiologist first. Although we would very much like our doctors to have a broader specificity of knowledge, and an ophthalmologist, in particular, could better navigate the various causes of eye diseases.