Thrombosis of the central vein of a retina
Contents:
Description:
Occlusions of the central artery and vein of a retina are quite often called vascular accidents. On precipitancy of development and weight of effects for sight of fibrinferments of the central vein of a retina sometimes does not concede, and even surpasses occlusion of the central artery of a retina in occurrence frequency. Disturbance of passability of the central vein of a retina arises at 214 people from 100 000. In 67,2% of cases one of branches of the central vein is surprised.
Symptoms of Thrombosis of the central vein of a retina:
Patients with a vein thrombosis of a retina complain of sudden sharp deterioration in sight. Except extensive hemorrhages, on an eyeground hypostasis of the central department of a retina which is also the reason of decrease in sight can develop.
Thrombosis of the central vein of a retina - a long disease. Rassasyvaniye of hemorrhages takes from several months to one year.
Thrombosis develops sometimes so suddenly, as well as acute impassability of the central artery of a retina, and too is followed by the sharp falling of sight which is not reaching however to a total blindness. Oftalmoskopicheski of fibrinferments of the central vein looks is very characteristic, reminding a picture of the crushed tomato. The optic disk is edematous, dark red, contours of its stushevana. Sometimes it is not visible because of the numerous hemorrhages reminding tongues of flame at all and about an arrangement of a disk it is possible to judge only by the place of an exit of large vessels. Veins are the dark, expanded, twisting, in places lost in edematous fabric retinas; arteries are narrowed. Existence of numerous shtrikhoobrazny and round hemorrhages on an eyeground perefiriya is typical. It is observed also plasmorrhagias. Vitreous hemorrhages are possible. Process more often unilateral, but can develop also in both eyes, but usually not at the same time. At fibrinferment of one of branches of the central vein the similar picture of expansion of a vein, hemorrhages and plasmorrhagias is limited to this or that quadrant of a retina. Visual acuity suffers less and is expressed in loss of the respective site of a field of vision. The forecast for sight heavy, but more favorable in comparison with acute impassability of the central artery of a retina. Over time hemorrhages resolve, in a retina the atrophic centers and proliferating tyazh in a vitreous develop. Further the atrophy of an optic nerve is observed. A part of patients has a secondary glaucoma.
Reasons of Thrombosis of the central vein of a retina:
Thrombosis of the central vein of a retina develops against the background of
* Atherosclerosis and the arterial hypertension leading to consolidation of arteries and a prelum them veins;
* Glaucomas;
* The states which are followed by the increased viscosity of blood (a polycythemia, leukemia, reception of diuretics, contraceptive drugs).
Blood clot is formed in the place of an exit of the central vein of a retina. Venous outflow stops, veins are overflowed with blood. It leads to increase in vascular permeability, edematization of a retina and emergence of hemorrhages. There comes the compensatory spasm of arteries limiting inflow of blood to a retina and causing emergence of the so-called velvet-like centers – zones of a heart attack of a retina which become blind people.
Treatment of Thrombosis of the central vein of a retina:
Treatment of such patients has to be carried out at first in an ophthalmologic hospital, and then is out-patient, under systematic control of the oculist. It is possible to expect good result of treatment in case of early use of effective medicines.
The first 1 1/2-2 months from the beginning of a disease appoint various medicines of a local and systemic effect. If sight at drug treatment improves slightly, the patient is directed to consultation to the "laser" surgeon who determines optimum terms for use of a laser method. If thrombosis of the central vein of a retina was complicated by a vitreous hemorrhage and the carried-out medicamentous therapy did not lead to a blood rassasyvaniye, perhaps surgical treatment of a vitreous for recovery of its transparency and increase in sight. Development of amotio of a retina at which urgent operation is shown can be a complication of a vitreous hemorrhage.
At fibrinferment of the central vein of a retina at 10-40% of patients intraocular pressure can increase. Therefore to such patients is shown to measure systematically intraocular pressure, and at its increase it is necessary to appoint the drugs reducing pressure. At their insufficient action apply laser or surgical treatment.
Observations of such patients in dynamics showed that the earlier the patient saw a doctor, the outcome of the disease is better. If after sharp decrease in sight there passed several days without treatment, improvement of sight can not occur.
