Retinopathy

General characteristic of a disease

The retinopathy is a serious vascular disorder of a retina of an eye. Most often the disease occurs at newborns and is called as a retinopathy of premature. In most cases disorders of blood supply of a retina arise under the influence of high concentration of oxygen in the couveuse. They are vital for ensuring breath of the newborn with undeveloped lungs, but quite often lead to development of a retinopathy of premature.

The highest percent of a retinopathy of premature meets, strangely enough, in the countries the high level of development of medicine. Neonatal technologies of these states are capable to support life of the children with a 500-gram weight who were born before term for 3 months and earlier. However imperfection of these technologies leads to sight pathologies as couveuse conditions considerably differ from natural medium for development of the child – a female uterus.

In less developed countries the problem of a retinopathy of premature has no such relevance for only that reason that there the general percent of survival of prematurely born children with a small weight is much worse.

Retinopathy symptoms

Symptoms of a retinopathy of premature can be direct and indirect. Carry the small weight of the child (less than 1,5 kg), an unstable state after the birth to the second group of symptoms of a retinopathy and use of the couveuse in the first weeks of life.

Indirect symptoms of a retinopathy premature in the first two years of life are visual acuity disturbances, squint, preferential use of one of eyes.

The main symptom of a retinopathy – underdevelopment of vessels of a retina of an eye, abnormal educations from connecting fabric in a retina, and then and a crystalline lens. It is possible to diagnose these pathologies only by means of the special ophthalmologic equipment.

Stages of a retinopathy of premature

Depending on disease severity allocate several stages of a retinopathy of premature.

The full amotio of a retina caused by an excessive tension of tissues of eye is characteristic of the V stage of a retinopathy. Premature, respectively, are characteristic of the I stage of a retinopathy minimum vascular disturbance of a retina. The III stage of a retinopathy is considered threshold. During it the child goes for treatment of a retinopathy by means of a technique of laser coagulation.

Diabetic retinopathy

More rare form of disturbance of blood supply of a retina at adult patients is a retinopathy of a diabetic etiology. In this case the disease is a consequence of a diabetes mellitus, both insulin-dependent, and non-insulin-dependent type. The diabetic retinopathy is quite often accompanied by two other vascular disorders of a retina of the atherosclerotic and hypertensive nature.

Symptoms of a retinopathy of a diabetic form are a little expressed. At the patient gradually develops swelled makula (the central part of a retina). Swelled leads to multiple hemorrhages of a vitreous of an eye. Further symptoms of a retinopathy of diabetic type depend on a disease form.

Defeat of small vessels and long-term disease is characteristic of a background or not proliferative diabetic retinopathy. It is quite often called the I stage of a retinopathy of diabetic type.

Preproliferativny form – the II intermediate stage of a diabetic retinopathy before approach of a proliferative form of a disease. Symptoms of a retinopathy of this stage are multiple extensive zones of disturbance of blood supply and considerable decline in quality of sight.

Diagnosis of a retinopathy

Planned inspection on a retinopathy of premature is carried out each 2 weeks a month later after the child's birth. Surveys continue before full formation of vessels of a retina.

In the presence of retinopathy symptoms examination is conducted every week or 1 time in 3 days. Diagnosis of a disease is carried out by means of the device of an indirect binocular oftalmoskopiya. In eyes to the child atropine for a mydriasis is dug in previously. In addition in diagnosis of a retinopathy of premature ultrasound examination of eyes can be also applied.

Planned ophthalmologic inspections at patients with a diabetes mellitus are performed each 5 years.

Treatment of a retinopathy

In treatment of a retinopathy premature the timely beginning of therapy is extremely important. At the I stage of a disease dynamic observation of a condition of a retina is recommended. One of auxiliary measures at this stage – treatment of a retinopathy by means of a krioretinopeksiya (freezing of peripheral areas of a retina).

At achievement of the III threshold stage of a disease laser treatment of a retinopathy – cauterization of the periphery of a retina is carried out by the laser. On site burns hems are formed. Sight on this site of a retina is lost, however by means of laser treatment of a retinopathy it is possible to keep the central sight and to prevent peeling of a retina.

At a diabetic form of vascular disorders of a retina treatment of a retinopathy also preferential laser. However as pathologies of blood supply of a retina in this case are a complication of a basic disease, more in treatment of a diabetic retinopathy control over glucose level in blood is important. Timely correction of composition of blood – the best prevention of further progressing of a diabetic retinopathy.

At heavy stages of a disease perhaps surgical treatment of a retinopathy by means of a vitrectomy technique. Thanks to its use clots from a cavity of an eye and a vitreous are removed. Thus, access to a retina is facilitated. After recovery and an attachment of a retina the laser the vitreous of an eye is replaced with special oil or gas.

This method of surgical treatment of a retinopathy is highly effective, however has high risk of a complication in the form of the increased intraocular pressure.