Will vision survive? What is retinitis pigmentosa and its treatment. Characteristic signs, methods of diagnosis and treatment of retinal abiotrophy Pigmented retinal abiotrophy mkb 10

In which, due to violations of their nervous innervation, capillary circulation changes. 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 may be the result of metabolic or hormonal disorders, injuries and intoxications, as well as a consequence of such bad habits like smoking or drug addiction.

Most often, angiopathy is diagnosed in the adult population (over 30 years old), a small percentage falls on children's and youthful forms of pathology.

This state with timely detection and treatment is reversible. Only in advanced cases does the disease lead to serious complications:

development and atrophy and;
decrease in acuity and narrowing of the visual fields.

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 of its code does not have, 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 tissues.

These can be various diseases:

traumatic, face, neck, head;
high intracranial or arterial pressure;
osteochondrosis, spondylosis cervical;
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;
or degeneration of tissues in the eye apparatus.

Kinds

Angiopathies have their own classification:

1. Youthful(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 the retina and partial or complete loss of vision, as well as the development of or.

2. Angiopathy of the retina by hypertensive type due to high blood pressure in patientsbecause of this, the vessels of the eyes are often in a narrowed state, which prevents the normal blood supply to the retina, often proceeds 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. Pathology causes a temporary or prolonged loss of visual acuity, damage to the nerve plexuses that innervate the eyes, dystrophic changes in cells, and.

4. hypotonic the type of 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. Age form of the disease, occurs due to the aging of the body, worn-out vessels can no longer cope with the loads, their tone decreases, dystrophic changes appear.

There are cases when angiopathy proceeds according to a mixed type, i.e. their development causes a whole "bouquet" of internal diseases, for example, diabetes mellitus, coupled with atherosclerosis or arterial hypertension, which occurs against the background of obesity. In such cases, the course of the pathology is aggravated and requires more intensive drug therapy.

Angiopathy of the retina in a child

Changes in vascular tone of the eyes in children in infancy It can be observed with a change in body position or hysterical crying. This is due to the immaturity of the circulatory and nervous system 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.

The most common cause of angiopathy in both eyes in newborns is increased intracranial pressure. In older children it is injuries, metabolic disorders, systemic autoimmune diseases and hereditary pathologies.

Can cause angiospasm of the eyes in children :

Video:

Symptoms

Clinical signs of the disease appear :

in a decrease in visual acuity;
in the appearance of flashes, white or dark spots before the eyes, “fiery flashes, lightning, flashes”;
elevated 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;
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:

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

For improve circulation blood in the eye vessels in all forms of angiopathy can be prescribed:

- Arbiflex;
- Pentoxifylline;
- Trental;
- Vasonite.

To medical methods are usually added physiotherapy :

To restorative procedures in this state include:

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

Such a complex eye disease as retinal angiopathy does not have an ICD-10 code. And this does not mean that this pathology of the organs of vision does not deserve the close attention of ophthalmologists. What are the symptoms of this disease, and how is it treated?

Recall. that ICD-10 is the International (accepted by WHO for physicians of all categories and countries) classification of diseases in the tenth revision.

talking medical language, angiopathy is a vascular disorder of the eye, manifested in a violation of the tone of the vessels of the retina and the capillary bed of the fundus. Against the background of this pathology, there is a decrease in blood flow and nervous regulation. There is no separate classification of this condition in ICD-10, since it is the result of much more serious diseases. Most often, angiopathy occurs against the background of such diseases:

intracranial hypertension.
Damage to the cervical segments.
Osteochondrosis of the cervical spine.
Various blood infections.
Diabetes.
Abuse of smoking and alcoholic beverages.
congenital anomalies.

And these are just some of possible causes circulatory disorders of the retina. The danger of this pathology lies in the fact that against the background of angiopathy, more serious pathologies, such as retinal dystrophy and / or myopia, may occur. Moreover, in the absence of timely and adequate treatment, this violation in the trophism of the retina can lead to complete loss of vision.

It is characteristic that angiopathy, including diabetic retinopathy, affects both eyes simultaneously. This serves as a hallmark of the differential diagnosis. Angiopathy is detected during examination of the fundus by an ophthalmologist.

Etiology of the disease and common types of course

There is a vascular pathology of this type in adults and children. Therefore, it is difficult to determine the true cause of occurrence in a particular case. But still, the main provoking factor is considered to be any chronic diseases. The main factor causing angiopathy is the general pathology of the vessels of the body, in which there is a violation of the structure of the vascular wall, including in the vascular bed of the retina.

Very often there is such a lesion of the vessels of the retina in the last trimester of pregnancy or after childbirth, which took place with violations. For a child, such angiopathy does not pose any threat, but the mother should immediately begin the treatment prescribed by the ophthalmologist.

The types of flow can be listed as follows:

1. Hypertensive angiopathy of the retina. It begins with the onset of hypertension and its progression. Often under the influence high blood pressure there is a rupture of the capillary and hemorrhage in the retina. But with rapid detection and timely elimination, this does not pose a threat of loss of vision.
2. Hypotonic. The nature of the flow at reduced pressure is opposite to the first type. The danger of this condition lies in the threat of a blood clot in the capillaries and subsequent obstruction of the vessel.
3. Diabetic threatens extensive obstruction of the fundus vessels.
4. Traumatic angiopathy - this condition occurs when a traumatic lesion of the cervical or thoracic spine and subsequent increase in intracranial pressure to critical levels.
5. Juvenile angiopathy is the most poorly studied form of vascular eye disease. This form is accompanied by single or multiple hemorrhages in the vitreous body and/or retina. Often complicated by cataracts, glaucoma, or even complete loss of vision.

The elderly are at risk for developing macular degeneration of the retina. With age, central vision is affected big changes due to problems with circulatory system are progressing.

H35.3 Macular and posterior pole degeneration

Doctors and scientists have not fixed the causes of macular degeneration as an unconditional list. They are identified as a series of assumptions pointing to possible factors that could have served as an impetus for the formation dystrophic changes. Among them:

Age changes.
Heredity.
Smoking.
UV exposure.
Unbalanced diet.
The presence of excess weight.
Diseases of the cardiovascular system.

Macular degeneration occurs more often in women due to their longer life expectancy in relation to men. At the same time, those who crossed the threshold of 50 years are predisposed to this disease.

In children, macular degeneration rarely develops. It occurs in them if the parents had a predisposition to this disease. At the same time, vascular sclerosis develops at the genetic level, which becomes an impetus for dystrophic changes in the retina.

There are dry and wet forms of macular degeneration. Moreover, each of them has a certain set of characteristics and symptomatic manifestations.

Diagnosed in 90% of cases. Represents the first stage of macular degeneration in which new vessels did not have time to form. A characteristic manifestation of dry macular degeneration is the thinning of retinal tissues and the accumulation of pigments in its layers. yellow color(druze). The dry form of the disease has 3 stages of development:

The early stage is not manifested by a violation of visual functions. It can be identified by the formation of druze.
The intermediate stage is characterized by the merging of small drusen into medium-sized spots or into one large one. As a visual defect, a blurry silhouette appears before the eyes.
The pronounced stage implies an increase in the silhouette and its blackening. This suggests that light-sensitive cells are dying.

The dry form of macular degeneration causes vision loss if not treated early.

The wet form of the disease harms vision more than the dry form. This is due to the formation of new vessels (the process of neovascularization). They are very fragile, so they are often damaged, causing hemorrhages. They, in turn, lead to the death of cells that are sensitive to light, and the appearance of a blind spot in the field of view.

There are hidden and classic types of macular degeneration. In the latter case, dystrophic processes are more pronounced. In this case, vascular neoplasms appear more often. This is accompanied by the development of scar tissue.

If we talk about dry macular degeneration, then in the initial stages it does not cause pain and symptomatic manifestation. It is necessary to take seriously the appearance of such signs in order to identify the disease in time.:

It becomes difficult to navigate in the dark.
Vision starts to drop.
Visible text becomes harder to see.
Recognizing surrounding faces is more difficult.
The field of vision is blurred dark spot without pronounced contours.

The same symptoms are characteristic of wet macular degeneration. To them are added the distortion of the outlines of the visible image and the visual bending of straight lines.

Diagnosis of a disease involves clinical picture in accordance with the patient's complaints and research results. In this case, such methods of detection of the disease are used:

Examination of the eye with an alkaline lamp and an ophthalmoscope.
Definition of spiciness and field of view using various tests (including the Amsler test).
Fluorescent angiography.
CT scan.

As a result of the research, the stage of the disease and the localization of the lesion are revealed. Accordingly, the treatment is prescribed according to the data obtained.

Dry macular degeneration is treated conservatively. The purpose of the measures taken is to stop the formation of new blood vessels, thereby eliminating the further development of the disease. The risk of further vision loss is prevented by antioxidants and zinc supplements. In the dry form of the disease, the patient is prescribed medicines, which include vitamins A, C and E, copper and zinc. In addition, the ophthalmologist prescribes Lutein and Zeaxanthin. The same funds are used as a prophylaxis of macular degeneration.

A conservative method in the treatment of wet macular degeneration is ineffective. Therefore, preference is given to such procedures:

laser surgery. It is used if the newly formed vessels are located at a distance from the fossa yellow spot. Those that are characterized by fragility and bleeding are removed. They are destroyed by laser radiation, but healthy tissue can also be accidentally damaged. Laser treatment does not always help. In many cases, even after a second procedure, vision continues to deteriorate.
Photodynamic therapy more safe method compared to laser surgery. Represents intravenous administration Vizudin. Medicinal substances are attached to the walls of painful vessels and irradiate them with light radiation for 1.5 minutes without affecting healthy tissues. As a result, the rate of vision deterioration slows down. For 5 days after the procedure, you need to protect your eyes from bright sunlight and room lighting. The effect of photodynamics is unstable. After some time, a second procedure may be necessary.
Intraocular injections or anti-VEGF therapy. First, local anesthesia is performed. After that, Avastin, Lucentis, Macugen and other modern medicines are introduced into the eye cavity. Their action is to block the growth factor of new non-viable vessels. The procedure is carried out monthly. Doses of the drug are calculated for each patient separately.

Doctors talk about the treatment of macular degeneration in this way:

Only intraocular injections can improve vision. Other methods of treatment only stop the further development of dystrophic changes.

Since the cause of dystrophic changes can be not proper nutrition, treatment with folk remedies involves its correction. It is recommended to eat chickpeas and wheat germ. Eye drops from tincture of aloe juice and mumiyo at the same time help improve eyesight. It is worth remembering that folk remedies are auxiliary and are used along with the main treatment. Before using them, talk to your doctor about their effectiveness.

Here's what they say about disease prevention on the Internet:

Thus, to reduce the risk of macular degeneration, you need to follow these tips:

Protect your eyes from UV exposure. For this purpose, before going out, wear sunglasses.
Quit smoking and the risk of developing the disease will decrease by 5 times.
Eat more fish, fruits and vegetables.
Set limits on fatty foods.
Take vitamins as advised by your doctor.
Make it a rule to exercise every day.
Keep track of your weight.
Control your blood pressure and cholesterol levels.

An annual visit to the ophthalmologist will help to identify the disease in time.

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What is this disease?

Macular degeneration

Dry Form:

Wet Form:

Main features:

straight lines are refracted;

cytomegalovirus

Treatment

Video:

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???? ???????;
?????? ????????????? ??? ?????? ?????? ??????? ??? ??????? (???????????);
?????????????? (??? ????????? ?????? ????????? ?????? ????????? ????????????, ????????, ?????????? ?????????);
?????????????? ??????? ? ?????????????? ???????????? ???? 60?/??? 90D, ? ????? ????? ????? ? ????????? ?? (????? ??????????, ????????? ???.), ????? ?????????? ?????? ?????????????? ???????????? ????????????.

???????????????? ????????????

??? ?????? ??????????????? ????????? ?????? ?????? ??????????:

????????, ???????? ???????????? ??????????? ??????????, ? ????????? ?????????? ???? ? ??????????? ?????????? ???????????????? (??? ?????? ??????? ?????? ?????????? ??????? ?????????? ????????????, ???????????????? ???????);
?????????????????????? ???????????? (?????????-???, ??????????? ???, ???????-???, ?????????? ???, ??????????????? ???).

??? ????????? ? ???????????????? ????????????? ????????? ? ?????? ????????? ????????? ??????.

??????? ?????????????????????? ???????? ??? : ???????????? ? ????????? ????? ??????? ???????? ?????????? ????????? ?? ?????? ??????? ? ?????????? ?????????? ? ???????? ????, ?? ? ????????????? ?????????? ???????????, ??????????? ?? ???? ?? ?????.
??? ? ????????????? ?????? ?????????????? ??????????????? ????? ??? ???? ???????????, ??? ??? ????????? ?????? ?????????? ??????????? ????????? ? ??????? ???????? ??????????????? ???????? (???. 31-52).
????? ????

??????????????? ???????

??? ???????? ?????

?????????? (???????)

??????????? (????????)

??????? ?????? ???????? ???????

??????-????????

?????? ???? ?????

????????????? ?????????:

????????? ?????????????

??????? (???????????)

????????? ? ??????????.

?????? ?????????? ? ????.

???????? ?????????

??????????

????????? ?????

?????????? ???????

??????? ? ?????? ???????? ??????

????? ???? - ?????????? ???????????????, ??????? ?????.

??? ???????? ????? ???????? ???????????????? ???????? ?????????? ??????????? ???????????. ???????? ???????????? ?????? ??????? ? ???, ??? ??? ????????? ?????????? ??? ???? ????? ?????????????? ?????????????? ???????. ??????????????, ??????? ??????? ? ????????????? ????? ???? ??????? ???? ??? ???????????????? ????????????????? ????????????. ? ????????? ????? ? ????? ?????? ??? ?????????????????? ????????????? ?????????? ?? ???? ??????, ????????? ?????????? (???????) ? ??????????? (????????) ??????? ? ???????????. ? ????????? ??????? ??? ????????? ??? ?????????? ??? ??????? ??????? ? ??????????? ??????????????????.

?????????? (???????) - ????????? ???-???????? ????????, ?????????? ??????? ????????? ? ??????????? ??????????????? ??????? ????? VEGF (vascular endothelial growth factor). ???????????? ??????? ??????? 165????? ??????? ?????, ?????????? ???????????? ????? ???????????????? ??????? ? ?????????? ????????????? ?????????? ?????? - ???? ??????? ??????????? ????????????? ????? ???. ??????? ???????????? ??? ????????????????? ???????. ?????????? ?????? ?? ??????????? ???????????? - ??????????, ??? ????????, ???????????? ?????? ??????? ?????? ??? ??????? ?????????? ?????????? ???, ?? ????????? ? ??????????? ???????. ??? ?????????? ?????????? ???????????? ?????????? ??????? ??????????????? ? ????????? ????? (0.3; 1.0 ? 3.0 ??) ?????? 6??? ? ??????? 54?; ?????? ???????????? ??????? ?????? ?????????? ? ??????? ??????? ??????? ??? ??? ??????????? ?? ?????????????? ???.

? ???? ?? ????? - ??? ????????????? ??????????? ? ?????????? ? ?????? ???????? - ??????????? (????????) . ??????????? ? ?????????????? ??????????, ????????????? ??? ??????? ??????? ????? VEGF. ???????????????? ??????? ????????? ????????? one ??? ? four ???. ??? ?????????? ????????????????? ??????????? ???????????? (ANCHOR ? MARINA) ??????????? ??????? ??????????????? ? ???? 0.3? 0.5??. ? ??????????? ??????? ???? ??????? ?? ?????? ????????????, ?? ? ????????? ????????? ??????? ??????.

????? ????, ? ??????? ????????????? ?????????? ????????? ???????????? ????? ??????? ?????????, ???????????? ????????????, ? ???????????? (???????). ??? ??????? ? ????-VEGF ??????????? ??????? ????????? ??????????? ??? ??????? ??????????????? ????. ? ????????? ?????, ?????? ?????? ?? ????????? ??????? ????????? ??????????, ??????????????????? ?? ??? ??????? ????????????????????????? ????????? ??????? ????????????? ????????????? ? ???????????? ???????????? ? ????????????.

?????????? ??????????? ? ??? ???? ??????????? ??????? ? ??????? ??????? ??????????? ? ???????????????? ???????? ??????????????? ????????????????. ? ????????? ????? ?????????? ??????? ?????? ????????? ??????? ????????????? (???????-40). ??????? ?? ?? ??? ?? ???? ???? ???? ??????? ????????? ??????????????? ?off-label? (?? ???? ??? ???????????? ??????????), ????? ??????? ??????? ??????? ???????????????. ??????? ?????? ???????????????, ???? ????? ? ???? four ??. ? ????? ?? ??????? ???????????? ???? ???????, ??? ??????????? ???????????????? ??????? ????? ??????????????? ??????? ? ?????????? ??????? ????? ?????????, ?? ?? ?????? ?? ??????????? ????????????? ??????? ??????.

??????? ?????? ???????? ??????? ??????? ???????????????? ???????: ???????????????? ??????? ? ????????? ? ???????????????? ????????? ?????????????. ?????? ????????????? ?????? ??????? ??? ????????? ? ????????????? ???????????????? ???????????? ??????????????.

??? ???????? ????????????? ?????????? ?????? ??????????? ???????? ????????, ? ?????? ???????, ??????????????????? (????? 40% ???????), ?????????. ????? ????, ???????????? ????????? ? ????????? ?????? ? ????????? ????????? ??????? ?????? ????? ? ????, ??? ??????? ? ???? ?????? ???????? ??????? ??????????? ???????????. ?? ?????????, ??? ?? ???????? ????? ??????????? ????? ????????????????? ?????????? ???????????????? ???????? ???????????????? ? ??????????? ???????????.

?????????? ? ???????????? ???????, ????????????? ? ????? ?????? ??? ???, ?????? ????? ??????? ??????? ?????????????? ??????? ??????????? ????????????.
- ??? ?????? ????? ??? ????????? ????????? ??? ????????? ???????????? ??????????????, ?????? ??????? ?? ????????????? ??????? ?? ?????? ????, ??? ??? ?????? ??????????????? ?????????????? ??? ???????? ????????????????????? ??????? ???????? ??? ?????? ?????? ?????? ??? ????????. ??? ???? ????? ??? ????????? ????? ? ????????????? ???????.
- ??? ???????? ????? ??? ??? ?????????? ???? ????? ???????????? ??????????????????? ???????? ???????????????? ? ???????????? ??????. ????? ??????? ????? ????????? ?? ?????????? ???????????????.
- ????????????? ?????????????? ????? ????????????? ?????????? ? ?????? ?????????? ????????, ????????, ????????? ??????????????, ? ????????? ???????????? ???????? ???? ????? (????????????).
??????-???????? (???????? ?????? - 2 ??, ???????? ??????? ??????????????? ???? - 130 ??, ???????? - 100 ??, ???????? - 15 ??, ??????? ???-??????? - 1.3 ??, ???? - 5 ??, ???? - 0.5 ??, ????? - 15 ??, ?? ???? - fifty ??).

1 ???????? 1 ??? ? ???? (?? ???????? ????? ???? ????? ???? ????????? ?? 3 ???????? ? ????). ????????, ??? ???????? ???????? ?????-???????, ??? ?????? ????????? ???????????. ? ???????????????? ????? ??????????? ??????? ?? 2 ??? 2 ???? ? ???.

?????? ???? ????? (???????? ??????? ? ? 225 ??, ??????? ? - 36 ??, ?????-??????? ? 1,5 ??, ?????? ? 2,5??, ?????????? ? 0,5 ??, ???? (? ???? ???????? ????) - 1 ??, ???? (? ???? ?????? ?????) ? 5 ??) - ?? 1 ???????? 2 ???? ? ????. ???? ????????, ? ??????? ?? ??????, ??????????????? ? ????? ?????? ??? ??. ????????? ? ?????? ?????? ????????? ???????? ???????.

????? ???????, ??? ?????????, ?????????? ?????-???????, ?????? ????????? ??????????? ??-?? ????????? ?????????? ???????? ???? ?????.

????????? ??? ????????? ???????????? ??????????????:
- ?????????? ?? 5 ?? 3 ???? ? ???? ??????, ??????? ?? 2 ???;
- ?????????????? ?? 100 ?? 3 ???? ? ???? ??????, ??????? ?? 1 -2 ???;
- ?????? ????????????? ??????? ???????? ?? 1 ???????? 3 ???? ? ???? ??????, ??????? ?? 2 ???.
????????????? ?????????:
- ????????? ? ?????????? ??????? (????????, ????????? ?????) ?? 1 ???????? 2 ???? ? ???? ??????, ??????? ?? 2-3 ???;
- ??????? ????????? Spirulina platensis?? 2 ???????? 3???? ? ???? ??????, ??????? ?? one ???.
????????? ??? ?????????? ???? ????????:
- ???????????? ?? 0.5 ?? ? ???? ??????????????????? ???????? (10 ????????);
- ???????????? ?? 250 ?? 1 ??? ? ???? ????? ?? ??????? ?? ??? 3 ???, ????? ????? ??????????? ???????? ???? ????? ?????????.
????????? ????????????? ? ??????????? ???????? ???? ????? (?????????) ? ???? ??????????????????? ???????? (5 ?? 1 ??? ? ?????, ? ?????????? 0,5 ?? 0,5% ???????? ??? 0,9% ???????? ?????? ???????, ???? 10 ????????).

????????????? ??????????????? ????? ???????????????? ???????. ??? ? ????????????? ????? ??????????? (???????), ??????????? ??????????????.

??????? (???????????) - ???????????? ????????, ??????????? ? ?????????? ? ?????? ??? ??????? ????????? ? ????????????? ?????????????????? (???).

????????? ? ??????????. ?????????? ??????????? ?????? ? ????????? ? ??????????????? ???????????? ????????????? ??? ??? ????????????? ??? ??? ?????????????? ??????.

?????? ?????????? ? ????. ??? ? ????????? - 2-????????? ???????. ? ??????? 10 ??? ??????????? ?????? ???????. ????? 15 ??? ????? ?????? ???????? ??????? ?????????? ????????????? ??????? (689 ??) ? ??????? 83 ?.

???????? ????????? ???????? ?? ???, ??? ?? ???????? ??????????????? (?? ???? ???????????? ???????? ????????????) ????????, ??? ????????? ???????? ??????? ???????? ????????? ????? 680 ? 695 ??. ??????????? ? ????????????? ?????, ??? ???????????? ???????? ?? ?????? ????????? ? ????? ????????? ? ?????????? ????????????? ?????????? ???????????????? ??????? ?????????????? ????????. ????????? ????? ????????????????? ???????????? ??? ?????? ???????? ?????? ? ?????? ????? 689 ??, ??? ????????? ???????? ??????? ???????? ????????? ????? ?????, ??????? ? ????????? ?????. ????? ???????, ???????? ???????????? ?????????????? ?? ?????-??????, ?? ????????? ?????????? ????? ???????????????? ???????????. ??? ????????? ??????????? ????????? ????????? ??????????? ?????????? ????????? ????????, ???????????? ????????? ???????????????? ???????, ??? ???????? ? ???????? ? ??????????? ??????? ?????????????? ?????????????????. ????????? ?????????? ???????? ? ????????? ???? ????? ?????????? ???, ????? ??????? ????????? ??????? ? ????????????? ?????????????.

5-6 ??????? ???????????????? ??????? (?????? ???????? ?? ??? ??????????? ? ??????? 1-?? ???? ????? ?????? ???????). ?????? ????????? ?????? ? ??????????? ??? ???????? ?????? ????? 3 ???. ???? ???????? ????????????, ????????? ????????? ?????????????. ???? ?? ??????????????????? ??????? ? ????????? ??? ???????? ????????, ???????????? ???????????, ?? ??????? ???????????? ???????????? ???????????, ???????? ????????? ?????? ??? ????? 3 ???.

?????????? ?????????? ???????????? ????????, ??? ????? ??????? ????? ???? ????????????? ? ????????? ???????:
- ??? ????????????? ???????????? ?????????????? ?????????????? ????????, ??? ??????? ?????? 0,1 ? ???? (????? ???????? ?????????? ?? ????? 20% ???? ???????, ?????????? ???);
- ??? ???????????????? ???????????? ??? ??? ???????? ????????????? ???;
- ??? ??????????????? ?????????, ????????????? ???, ??? ??? ?????????? ??????????????? ??????????? ??? ?? ???????? ????? ?????????? ????????????? ????;
- ??? ???????? ??? ??? ???????? ????? ????? 4 ???????? ??? ???????????????? ???????: ?????? ??? ????? ?????? ??????? ?????? (????? ????, ???? ??????? ????? ????????? 5400 ???, ???????? ??????? ??????????, ??? ???? ??????? - ???????????? ?????????? ???????);
- ??? ????????? ??????? ???????????????? ????????? ??? ? ??? ???????, ????? ??????? ?????? ??? ??????? ?????? ????? ?????? ???? ????????? (?? ???? ??????????? ???????? ?????????? ??? ??????????? ??????).
3% ????????? ????? ??????????? ? ??????? ?????? ?????????? ??????? ??????? ?????? (? ??????? ?? 4 ?????? ????? ETDRS).

2 ??? ???????? ??????????? ?????? ????????? ????? ? ?????? ?????, ?????? ?????? ????.

? ????????? ????? ???????????????? ??????? ???? ????????? ? ??? ???????, ??? ????????? ???????????????? ???????? ?????????? ???????????.

?????????? ???????????????? ???????????? ???? ?????????? ? ?????? 90-? ????? ??? ??????? ??????? ?????????. ????? ??????? ?? ???????????????, ??? ??????? ??????? ???? ???????????? ????? ??????? (810 ??) ???????????? ? ????? ?????? ????? ?????? ??? ?????? ???????? ??????. ???????? ????????? ?????????????? ? ???????? ????????? ??? ? ?????????. ?????? ???????? ?????????????? ??????????? ??? ??????? ??? ??????? ???????. ????????, ??????????? ??????????? ??????????? ?? ????????????? ????????.

????????? ??? ?????????? ???????????????? ???????????? ? ??????? ??? ??? ??????? ?????????????? ?????????????? ???????? ? ??????????? ???????????? ???????????. ????? ???????, ???????????????? ???????????? ????? ????????? ? ??? ???????, ????? ? ??????? ??????????? ?? ???????? ?????????????? ??????? ?? ???????????????? ???????. ????? ????? ? ?????????? ? ???????????? ???????.

?????? ??? ????????????? ???????????????? ???????????? ???????? ?????? ??????????, ????????? ? ?????? ??????? ? ?????????????? ???????? ??????? (? ????? ??????????? ?????? ???? ????????????): ??????? ???????? ? ?????????? ????, ???????? ??????? ????????, ??????? ???, ?????????????? ????????????? ? ???????????? ????? ? ?????????. ???????? ????? ?????????, ???????????? ?????? ???????. ????????, ?????? ??????? ????? ?? ??????? ???????? ???????????????.

???????? ????????? ?????????? ?? ????? ? ????? ?????????????:
- ?????????????? ????????????? (?? ???????????? ?? ????? ??????????, ?????????? ????????????? ????????);
- ?????????? ??????? ???????? ?? ? ?????????:
- ???????????? ??????????? ?????????:
- ???????????? ?????????????? ????????;
- ????????????? ??? ?????????????? ?????????????? ?????????????????.
????? ????????????? ????????? ????????? ?????????????, ???????????? ????? ?????????? ????????????? ????????, ??? ????? ????????????? ?????????? ??? ???????????? ????????? ??????. ???????? ?????????? - ?????????? ????????? ??????? ?????? ? ?????????? ????????????? (? ??????????? ??????? ??? ?? ????????? 0.1 ????? ?????????????).

??????????? ???????? ???????? ????????? ?????????????? ????????????? ??????????? ?? ????????? ????? ???????????????? ?????????. ? ?????? ???????????????? ???????? ??????????? ?? ????? ????????????? ??????? ????????????? ?????????????? ???????? ????????? ????????????. ??? ????????????? ???????? ????????????? ?? ?????????? ???? ?????????????? ???????? ????????? ?????????? ???????????? ??????? ??????????? ? ????????? ???? (??????????????????? ??????????) ? ??????? ??. ? ????????????????? ??????? ??????? ????????? ??????????? ????????? ????? ????.

????? ????, ??????? ? ??????????? ????? ???? ??????? ??? ????????? ????????????????? ????????????? ? ??, ????????? ?????????? ??????? ?????????????? ??????????.

? ????????? ????? ???????? ????????????????? ???????????? ?? ????????? ?????? ???, ?? ??? ???? ?????????????? ???? ???????? ??????? ???????? ?????????????.

????????? ????? ????????????? ????????????? ?? ???????????? ?????? . ???????? ???? ?????? ????????????? ??????? ? ???, ????? ???????? ????????????? ?????????? ???? ????????, ????????????? ??? ????????????? ?????????????? ?????????, ???, ????? ? ????? ????????? ??? ??? ?????????? ???????????? ??? ? ???????????????? ????. ??? ????? ??????? ????????? ???????????? ???????????, ? ????? ????????? ??? ???????? ?????????? ????????. ???????? ????? ???? ????????? ? ??????????? ??????????? ?? ???? ?????????? (360?) ? ??????????? ????????? ??? ????????? ????????, ? ????? ???? ???????????? ??????? (?? ???? ??????????) ??????. ????? ???????? ??????????? ? ????? ????????? ??? ?????? ??????????, ? ?????????????? ???????? ????????? ??? ?????? ???????????????. ?????????? ??????????????????, ????? ???? ??????? ?????? ????????? ??????????? ????????? ? ??????? ?????. ??? ?????????????? ?? ???????????? ?????? ???????? ????? ??? ??????????: ??????????????? ????????????????? (???) (? 19% ???????), ???????? ???????? (? 12-23%), ???????????? ??????????? ????????? (9%), ? ????? ??????????, ????????????? ??? ?????????? ??????????? ?? ?????? ??????????. ??? ???? ????? ????????? ?????? ?? ?????? ????????????, ?? ? ??????????????? ??????. ? ????????? ????? ???????? ?????????? ??? ???????? ?? ?????.

1,5; 3 ? 6 ??? ? ??????? ?????????????, ? ????? ? ?? ???? 1 ???? ? 6 ???.

??? ????????? ?????? ???? ??????????? ?????? ????????????? ???????? ????????? ????????? ???????????? ??? ?????? ??????? ??????? ? ?????????? ? ???????????? ??? ????????? ????? ????? ?????????, ??? ??? ???? ??? ???? ?????????????? ??????? ?????? ???????? ??????.

??? ??????? ??? ??????? ?????? ?????? ????????? ??????????????? ?????? ????????? ????????, ??? ??? ???? ??? ??????? ?? ????????? ???????? ??????????????? ????????. ??????? ?????? ????????, ??? ???? ??????? ???????????? ????????? ?????? ??????, ? ??? ????? ? ??????? ??????, ? ?? ????????? ??????. ???????? ????? ?????????: ????????? ?????, ? ???? ?????????? ?????????????? ??????.

??????? ???????????, ??? ?????? ???????? ? ?????????? ??????? ???????????? ?????? ?? ????? ?????? ????? ?????????????? ??????????? ?? ?????? ? ????? ???????????? ????????????, ???????? ??? ????????????? ??????????????? ???????, ? ? ??? ?? ??? ??? ??????????? ??????? ???????? ?????.

??????? ? ?????? ???????? ?????? ????? ????????????? ??? ?????????? ???????? ?????? ????????????. ??? ??????????, ?????????? ????????? ????????????? ??????????? ? ??????????? ???????????? ????????. ????? ????? ????????? ????? ???? ??????? ??????????? ????????????? ????, ???? ? ?????????? ?????? ?????????, ????????????? ??????? ? ????????? ????????, ????????? ???????? ?????? ? ????????? ??????????? ?? ?????. ???????? ?????? ???????????? ???????? ????? ??? ??????? ? ?????? ???????? ?????? ????? ????.

23 - 46% (? ??????????? ?? ??????????? ????????), ???????????????? ??????? ? ????????????? ? ? ??????? ?? 40%, ????????????? ???????? ? ?? 19% (?????????? ??????, ??? ??????? ??????????? ????????? ? ?????????? ???????????????? ??????????????? ????????, ??????? ????????? ????? ???????).

?????? ?? ?????: ?????????????. ???????????? ??????????? | ???????? ?.?.

In the center of the retina is the macula, the light-sensitive element. Macular degeneration- This is a disease of the retina of the eye that occurs due to the pathology of blood vessels, malnutrition. 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 disease code - H35 / 3 - degeneration of the macula and posterior pole.

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. A spot appears in the center of the field of vision of the eye, which 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.

The consequences of micro-hemorrhages: due to the resulting fluid, detachment of the retina occurs and the appearance of scar tissue in this place, which leads to loss of vision.

Characteristic symptoms depend on the stage of the disease.

Main features:
- there is a feeling of lack of lighting;
- practically complete absence 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 in the retina 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, drinking 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 – infection, which is caused by the herpes virus. A healthy person does not notice his presence, but he is dangerous for people with immunodeficiency.

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, Makudzhen. 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. The drug Verteporfin is administered intravenously. Its action is activated by laser surgery. Photodynamic therapy improves visual function, but after some time the effect of the drug weakens and a second procedure is required.
3. Laser coagulation of the retina - the effect of the laser 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.
At the current level of development of medicine, macular degeneration of the retina incurable. All measures are aimed at slowing down the process, improving the quality of life.

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, giving up bad habits will help to postpone vision loss for many years.

Video:

According to the ICD, there are several categories of retinal diseases.

Chorioretinal inflammation (H30)

Chorioretinal inflammation includes the following specific nosologies:
Focal chorioretinal inflammation (H30.0);
Disseminated chorioretinal inflammation (H30.1);
Posterior cyclitis (H30.2);
Chorioretinal inflammations of other etiology (H30.8);
Unspecified type of chorioretinal inflammation (H30.9).

Diseases of the choroid of the eyeball, not elsewhere classified (H31)

This section of the ICD includes:

Chorioretinal scars (H31.0);
Degenerative changes in the choroid (H31.1);
Dystrophic processes in the choroid of a hereditary nature (H31.2);
Choroid ruptures, hemorrhages in this area of the eye (H31.3);
Choroid detachment (H31.4);
Other pathologies of the choroid (H31.8);
Unspecified choroid disorders (H31.9).

Secondary chorioretinal changes (H32)

These pathologies include:

This pathology combines:

Retinal detachment accompanied by rupture (H33.0);
Retinal cysts, retinoschisis (H33.1);
Serous retinal detachment (H33.2);
Retinal tear without detachment (H33.3);
Common retinal detachment (H33.4);
Other forms of retinal detachment (H33.5).

Retinal vascular occlusion (H34)

Occlusion of retinal vessels can be of the following types:

Transient occlusion of retinal arteries (H34.0);
Occlusion of the central retinal artery (H34.1);
Occlusion of other retinal arteries (H34.2);
Other types of retinal vascular occlusions (H34.8);
Type of retinal vascular occlusion, unspecified (H34.9).

Other retinal pathologies (H35)

Other diseases of the retina include:

Background retinopathy or retinal vascular pathologies(H35.0);
Preretinopathy (H35.1);
Other pretinopathy proliferative type (H35.2);
Degenerative changes in the macula or posterior pole (H35.3);
Degeneration of the peripheral retina (H35.4);
Hereditary retinal dystrophy (H35.5);
Hemorrhage into the substance of the retina (H35.6);
Splitting of cell layers in the retina (H35.7);
Other specified retinal disorders (H35.8);
Unspecified disorders of retina (H35.9).

Secondary retinal lesions (H36)

Hypertensive angiopathy of the retina ICb-10 code

ICD 10. CLASS IX. Diseases of the circulatory system (I00-I99)

Excludes: certain conditions arising in the perinatal period ( P00 —P96)

complications of pregnancy, childbirth and the postpartum period ( O00 —O99)

congenital anomalies, deformities and chromosomal abnormalities ( Q00 —Q99)

disease endocrine system, eating disorders and metabolic disorders ( E00 —E90)

symptoms, signs and abnormalities identified during

This class contains the following blocks:

I00 —I02 Acute rheumatic fever

I05 —I09 Chronic rheumatic heart disease

I10 —I15 Diseases characterized by high blood pressure

I20 —I25 Ischemic disease hearts

I26 —I28 Cor pulmonale and pulmonary circulation disorders

I60 —I69 Cerebrovascular diseases

I70 —I79 Diseases of the arteries, arterioles and capillaries

I80 —I89 Diseases of the veins lymphatic vessels and lymph nodes not classified elsewhere

I52 Other disorders of the heart in diseases classified elsewhere

I68 Cerebrovascular disorders in diseases classified elsewhere

I79 Disorders of arteries, arterioles and capillaries in diseases classified elsewhere

ACUTE RHEUMATIC FEVER (I00-I02)

I00 Rheumatic fever without mention of cardiac involvement

Arthritis, rheumatic, acute or subacute

I01 Rheumatic fever with cardiac involvement

Excluded: chronic diseases hearts of rheumatic origin ( I05 —I09) without the simultaneous development of an acute rheumatic process or without signs of activation or recurrence of this process. If there are doubts about the activity of the rheumatic process at the time of death, one should refer to the recommendations and rules for coding mortality set out in t 2.

I01.0 Acute rheumatic pericarditis

I00. associated with pericarditis

Excludes: pericarditis not designated as rheumatic ( I30. -)

I01.1 Acute rheumatic endocarditis

Any condition related to the rubric I00. in combination with endocarditis or valvulitis

Acute rheumatic valvulitis

I01.2 Acute rheumatic myocarditis

Any condition related to the rubric I00. associated with myocarditis

I01.8 Other acute rheumatic heart diseases

Any condition related to the rubric I00. combined with other or multiple forms of conditions

involving the heart. Acute rheumatic pancarditis

I01.9 Acute rheumatic heart disease, unspecified

Any condition related to the rubric I00. in combination with an unspecified form of heart disease

Rheumatic carditis, acute

Heart disease, active or acute

I02 Rheumatic chorea

I02.0 Rheumatic chorea involving the heart

CHRONIC RHEUMATIC HEART DISEASE (I05-I09)

I05 Rheumatic diseases of the mitral valve

Included: conditions classified under headings I05.0

and I05.2 —I05.9. whether or not specified as rheumatic

I34. -)

I05.0 mitral stenosis. constriction mitral valve(rheumatic)

I05.1 Rheumatic mitral valve insufficiency

Rheumatic mitral:

Functional insufficiency

Regurgitation

I05.2 Mitral stenosis with insufficiency. Mitral stenosis with functional failure or regurgitation

I06 Rheumatic diseases of the aortic valve

I07 Rheumatic diseases of the tricuspid valve

Inclusions: cases specified or not specified as

Excluded: cases specified as non-rheumatic ( I36. -)

I07.0 Tricuspid stenosis. Tricuspid (valvular) stenosis (rheumatic)

I07.1 Tricuspid insufficiency. Tricuspid (valvular) insufficiency (rheumatic)

I07.9 Tricuspid valve disease, unspecified. Tricuspid valve dysfunction NOS

I08 Multiple valve disease

Includes: cases specified or not specified as rheumatic

Excludes: endocarditis, valve not specified ( I38)

rheumatic diseases of the endocardium, valve

not specified ( I09.1)

I08.0 Combined damage to the mitral and aortic valves

Both mitral and aortic valve disorders, whether or not specified as rheumatic

I08.8 Other multiple valvular diseases

I09 Other rheumatic heart diseases

I09.0 Rheumatic myocarditis

Excludes: myocarditis not specified as rheumatic ( I51.4)

Endocarditis (chronic)

Valvulitis (chronic)

DISEASES CHARACTERIZED BY INCREASED BLOOD PRESSURE (I10-I15)

I10 Essential [primary] hypertension

High blood pressure

Hypertension (arterial) (benign) (essential)

(malignant) (primary) (systemic)

I11 Hypertensive heart disease

I50. -. I51.4 —I51.9. due to hypertension

I11.0 Hypertensive heart-predominant disease with (congestive) heart disease

insufficiency. Hypertensive [hypertensive] heart failure

I11.9 Hypertensive [hypertensive] heart disease without (congestive) heart disease

insufficiency. Hypertensive heart disease NOS

I12 Hypertensive [hypertension] disease with a primary lesion of the kidneys

Included: any condition listed in rubrics N18. -. N19. or N26. - in combination with any condition,

renal arteriosclerosis

arteriosclerotic nephritis (chronic)

(interstitial)

hypertensive nephropathy

nephrosclerosis

Excludes: secondary hypertension ( I15. -)

I12.0

Hypertensive renal failure

I12.9 Hypertensive [hypertensive] kidney-predominant disease without renal insufficiency

Renal form of hypertension NOS

I13 Hypertensive [hypertension] disease with a primary lesion of the heart and kidneys

Included: any condition listed in the rubric I11. -. in combination with any condition listed under the rubric I12. disease:

Cardiorenal

Cardiovascular renal

I13.0

insufficiency

I13.1 Hypertensive [hypertonic] kidney-predominant disease with renal insufficiency

I13.2 Hypertensive [hypertension] disease with a primary lesion of the heart and kidneys with (congestive) cardiac

insufficiency and renal insufficiency

I13.9 Hypertensive [hypertensive] disease predominantly affecting the heart and kidneys, unspecified

I15 Secondary hypertension

Excludes: with vascular involvement:

I 15.0 Renovascular hypertension

I15.1 Hypertension secondary to other renal lesions

I15.2 Hypertension secondary to endocrine disorders

CORONARY HEART DISEASE (I20-I25)

I20 Angina pectoris [angina pectoris]

Diabetic angiopathy of the lower extremities (ICD-10 code: E10.5, E11.5)

Diabetogenic damage to small vessels (microangiopathy) or arterial walls (macroangiopathy). The appointment of insulin in diabetes mellitus, which increases the life expectancy of patients, nevertheless does not prevent the development of micro- and angiopathy, being the cause of disability and death in 70-80% of cases.

AT clinical practice angiopathy of the vessels of the kidneys (nephroangiopathy) and eyes (angiopathy of the retinal vessels) are more often recorded, however, it should be recognized that angiopathy is systemic.

Treatment of microangiopathies with laser therapy methods is primarily aimed at restoring endothelial trophism, eliminating rheological disorders, improving the state and ratio of blood coagulation and anticoagulation systems, restoring microcirculation, restoring metabolism and oxygenation of biological tissues.

The plan of therapeutic measures includes supravenous or intravenous blood irradiation in the projection of the cubital fossa, as well as in the projection of the vessels supplying the affected regions, the impact on the neurovascular bundles projected in the femoral triangle and popliteal fossa (“vascular windows”). Monitoring the effectiveness of treatment is carried out by the method of skin thermometry of the distal parts lower extremities- by instrumental or palpation technique. As hemodynamics improves, total irradiation of the affected limb(s) is performed using a scanning technique. The speed of movement of the emitter during the implementation of the scanning impact: 0.5-1.0 cm/sec.

Modes of irradiation of medical zones in the treatment of diabetic angiopathy

The pathogenesis of diabetic retinopathy is complex. The leading link is microcirculation disorders associated with hereditary structural features of the retinal vessels and metabolic changes that accompany diabetes mellitus.

In 1992, Kohner E. and Porta M. proposed the WHO classification of diabetic retinopathy, which is currently generally accepted:

Non-proliferative retinopathy(diabetic retinopathy I) - is characterized by the presence in the retina of the eye of pathological changes in the form of microaneurysms, hemorrhages (in the form of small dots or spots of a rounded shape (there are also dashed), dark in color, localized in the central zone of the fundus or along the large veins in the deep layers of the retina), exudative foci (localized in the central part of the fundus, yellow or white with clear or blurry boundaries) and retinal edema. Retinal edema, localized in the central (macular) region or along the large vessels, is an important element of non-proliferative diabetic retinopathy.

The initial stages of the lesion are characterized by the absence eye symptoms(decreased visual acuity, pain and others). Loss or decrease in visual acuity is a late symptom, signaling a far-reaching, irreversible process (modern planned ophthalmological examination should not be neglected).

arterioles - lipogyaline arteriosclerosis ("plasma vasculosis"), precapillary arterioles and capillaries in the posterior region of the fundus are most affected;

At least once a year, people with diabetes undergo an ophthalmological examination, including questioning, measurement of visual acuity and ophthalmoscopy (after pupil dilation) to detect exudates, petechial hemorrhages, microaneurysms and proliferation of new vessels. Ideally, the examination is performed by an ophthalmologist with experience in a diabetology clinic.

In diabetic retinopathy stage I (non-proliferative retinopathy), frequent repeated ophthalmological examinations are indicated. The doctor must check how well the patient controls the level of glucose in the blood.
In diabetic retinopathy stage II or III (preproliferative and proliferative retinopathy, respectively), laser photocoagulation is indicated.

The recent DIRECT study evaluated the use of the renin-angiotensin receptor (RAS) blocker candesartan in type 1 and type 2 diabetes mellitus. The use of candesartan did not reduce the progression of retinopathy. During the study, there was a trend towards a decrease in the severity of retinopathy. In a less extensive RASS study, the development of retinopathy in type 1 diabetes mellitus was shown to be slowed down by RAS blockade with losartan and the angiotensin-converting enzyme inhibitor enalapril. Thus, the use of RAS blockers may be appropriate in patients with type 1 diabetes and retinopathy, but not in type 2 diabetes.

The only reliable factor in the prevention of diabetic retinopathy, the basis for the treatment of all its stages is the optimal compensation of diabetes mellitus (the level of glycosylated hemoglobin HbA1C< 7,0%).

^ 1 2 3 4 Efimov A. S. Skrobonskaya N. A. Clinical diabetology. - 1st ed. - K. Health, 1998. - S. 115-117. - 320 s. - 3000 copies. - ISBN 5-311-00917-9.
^ Kohner E. M. Diabetic retinopathy // Brit. Med. Bull. - 1989. - Vol. 5, No. 1. - P. 148-173.
^ Outpatient care for the endocrine patient / Ed. Efimova A. S. - 1st ed. - K. Health, 1988. - S. 37-38. - 256 p. - (Reference edition). - 81,000 copies. - ISBN 5-311-00029-5.
^ 1 2 Endocrinology / Ed. N. Lavina. - 2nd ed. Per. from English. - M. Practice, 1999. - S. 841. - 1128 p. - 10,000 copies. - ISBN 5-89816-018-3.

Diabetology Clinical stages of diabetes mellitus Classification of diabetes mellitus Clinical classes Non-immune forms

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

Angiopathy is a violation of the working capacity of blood vessels eyeball, which manifest themselves in the form of a deterioration in the tone of the vessels of the retina and the capillary bed of the fundus.

Due to 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 state manifests itself in pathological change 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:

Long-term hyperglycemia. There is an opinion about the importance of the immune factor in the origin of retinopathy.

In diabetes mellitus, the blood-retinal barrier, which prevents the penetration of large molecules from blood vessels into the retinal tissue, becomes more permeable, which leads to unwanted substances entering the retina.

There is a definite sequence in the development of symptoms: vasodilation > increased blood flow > endothelial damage > blockage of capillaries > increased permeability > formation of arteriovenous shunts and microaneurysms > neovascularization > hemorrhages > degeneration and disorganization.

preproliferative retinopathy(diabetic retinopathy II) - characterized by the presence of venous anomalies (clearness, tortuosity, the presence of loops, doubling and / or pronounced fluctuations in the caliber of vessels), a large amount of solid and "cotton" exudates, intraretinal microvascular anomalies (IRMA), many large retinal hemorrhages.
Proliferative retinopathy(diabetic retinopathy III) - characterized by disc neovascularization optic nerve and / or other parts of the retina, hemorrhages in the vitreous body, the formation of fibrous tissue in the area of preretinal hemorrhages. Newly formed vessels are very thin and fragile - repeated hemorrhages often occur, contributing to retinal detachment. Newly formed vessels of the iris (rubeosis) often lead to the development of secondary (rubeous) glaucoma.

The main cause of vision loss is diabetic retinopathy, various manifestations of which are detected in 80-90% of patients. According to Academician Efimov A.S., during an ophthalmological examination of 5,334 persons with diabetes mellitus, retinopathy of varying severity was detected in 55.2% of patients (stage I - 17.6%, stage II - 28.1%, stage III - in 9 ,5%). total loss vision among all examined was about 2%.

Retinopathy is damage to the vessels of the retina. The main "targets" for structural changes in the retina:

veins - expansion and deformation;
capillaries - dilatation, increased permeability, local blockage of capillaries, causing pericapillary edema; degeneration of intramural pericytes with endothelial proliferation, thickening of basement membranes, formation of microaneurysms, hemorrhages, arteriovenous shunts, neovascularization;
swelling of the fibers of the striatum opticum, visible as gray areas and cloud-like spots, pronounced exudates, edema of the optic nerve head, atrophy and retinal detachment.

Treatment of diabetic retinopathy is complex, carried out by an endocrinologist and an ophthalmologist. Equally important is proper nutrition and insulin therapy. It is important to limit fats in the diet, replace animal fat with vegetable fat, exclude easily digestible carbohydrates (sugar, sweets, jam), and widely use foods containing lipotropic substances (cottage cheese, fish, oatmeal), fruits, vegetables (except potatoes). Of no small importance is vitamin therapy, especially group B (B1, B2, B6, B12, B15) orally and parenterally. protective effect on vascular wall provide vitamins C, P, E (3-4 times a year, a course of 1 month). Angioprotectors include anginin (prodectin), dicynone, doxium. The drugs are taken according to the doctor's prescription.

In advanced cases and when diabetes mellitus is combined with hypertension, atherosclerosis is very serious.

In the development and progression of retinopathy in all types of diabetes mellitus, a significant role is given to the quality of compensation for the underlying disease. Aggravate the course of retinopathy in diabetes mellitus arterial hypertension and diabetic nephropathy, often associated with retinopathy. Atherosclerosis progresses most intensively among young people with diabetes mellitus and is more severe - due to the presence of microangiopathy, the possibilities of creating collateral circulation are reduced. In order to timely diagnosis every patient with diabetes mellitus should be examined by an ophthalmologist at least once a year and if there are corresponding complaints.

To prevent severe vascular lesions of the eyes, their early detection is necessary - young people with diabetes should be examined by an ophthalmologist at least once every 6 months. Special attention should be given to the condition of the eyes of patients with long-term diabetes mellitus - with an increase in the duration of diabetes mellitus, the frequency of detection of diabetic retinopathy increases.

^ 1 2 E. P. Kasatkina Diabetes in children. - 1st ed. - M. Medicine, 1990. - S. 206-207. - 272 p. - 60,000 copies. - ISBN 5-225-01165-9.
^ 1 2 3 4 Directory of pediatric endocrinologist / Pod. ed. M. A. Zhukovsky. - 1st ed. - M. Medicine, 1992. - S. 213-214. - 304 p. - 20,000 copies. - ISBN 5-225-02616-8.
^ (2000) "Alterations of the Blood-retinal Barrier and Retinal Thickness in Preclinical Retinopathy in Subjects With Type 2 Diabetes". Archives in Ophthalmology 118 (10): 1364–1369. DOI:10.1001/archopht.118.10.1364. PMID 11030818.
^ 1 2 3 4 5 Efimov A. S. Small encyclopedia of an endocrinologist. - 1st ed. - K. Medkniga, DSG Ltd, Kyiv, 2007. - S. 164-169. - 360 p. - (“Practitioner's Library”). - 5000 copies. - ISBN 966-7013-23-5.
^ A. K. Sjolie; P. Dodson; F. R. R. Hobbs (2011). "Does Renin-angiotensin System Blockade have a Role in Preventing Diabetic Retinopathy? A Clinical Review. International Journal of Clinical Practice(© Blackwell Publishing) 65 (2).

diabetes mellitus in childrenComplications of treatment: Complications

diabetes Excess insulin See also

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

The level of 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.

Indicators	Complicated myopia	Peripheral pigmentary degeneration
Visual acuity	Vision improves with correction	Vision does not change with correction
line of sight	Slight narrowing around the periphery	concentric narrowing of the visual field
Ocular fundus	Chorioretinal changes in the form of lattice dystrophy, cystic dystrophy, retinoschisis. In the form of mixed forms	Redistribution of pigment in the form of "bone bodies", may be absent

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 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

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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Will vision survive? What is retinitis pigmentosa and its treatment. Characteristic signs, methods of diagnosis and treatment of retinal abiotrophy Pigmented retinal abiotrophy mkb 10

ICD-10 code

Kinds

Angiopathy of the retina in a child

Symptoms

Treatment

Etiology of the disease and common types of course

What is this disease?

Treatment

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Chorioretinal inflammation (H30)

Diseases of the choroid of the eyeball, not elsewhere classified (H31)

Secondary chorioretinal changes (H32)

Retinal vascular occlusion (H34)

Other retinal pathologies (H35)

Secondary retinal lesions (H36)

Hypertensive angiopathy of the retina ICb-10 code

ICD 10. CLASS IX. Diseases of the circulatory system (I00-I99)

ACUTE RHEUMATIC FEVER (I00-I02)

I00 Rheumatic fever without mention of cardiac involvement

I01 Rheumatic fever with cardiac involvement

I02 Rheumatic chorea

CHRONIC RHEUMATIC HEART DISEASE (I05-I09)

I05 Rheumatic diseases of the mitral valve

I06 Rheumatic diseases of the aortic valve

I07 Rheumatic diseases of the tricuspid valve

I08 Multiple valve disease

I09 Other rheumatic heart diseases

DISEASES CHARACTERIZED BY INCREASED BLOOD PRESSURE (I10-I15)

I10 Essential [primary] hypertension

I11 Hypertensive heart disease

I12 Hypertensive [hypertension] disease with a primary lesion of the kidneys

I13 Hypertensive [hypertension] disease with a primary lesion of the heart and kidneys

I15 Secondary hypertension

CORONARY HEART DISEASE (I20-I25)

I20 Angina pectoris [angina pectoris]

Diabetic angiopathy of the lower extremities (ICD-10 code: E10.5, E11.5)

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

What's this?

general information

Short description

Classification

Diagnostics

Differential Diagnosis

Get treatment in Korea, Israel, Germany, USA

Treatment

Hospitalization

Information

Sources and literature