General characteristics of the disease
Retinopathy - a serious vascular disorders of the retina. Most often, disease occurs in newborns and is called retinopathy of prematurity. In most cases, retinal circulatory disturbances occur under the influence of high concentrations of oxygen in the incubator. They are vital for breathing newborn with undeveloped lungs, but often lead to the development of retinopathy of prematurity.
The highest percentage of retinopathy of prematurity found, oddly enough, in countries with a high level of development of medicine. Neonatal technology of these countries are able to maintain the lives of children with a 500-gram weight, were born prematurely on 3 months earlier. However, the imperfection of these technologies leads to pathologies of view, since the conditions are very different from the incubator of the natural environment for the development of the child - the female uterus.
In less developed countries, the problem of retinopathy of prematurity has no such relevance for the sole reason that there are significantly worse overall survival rate of prematurely born children with low birth weight.
The symptoms of retinopathy
The symptoms of retinopathy of prematurity can be direct or indirect. The second group of symptoms of retinopathy include low weight baby (less than 1, 5 kg), an unstable state after birth and the use of incubator in the first weeks of life.
Indirect signs of retinopathy of prematurity in the first two years of life are a violation of visual acuity, strabismus, preferential use of one eye.
The main symptom of retinopathy - underdevelopment retinal vessels, abnormal formation of connective tissue in the retina, and then the lens. To diagnose the disease can only be with a special ophthalmologic equipment.
Stages of retinopathy of prematurity
Depending on severity of the disease have identified a number of stages of retinopathy of prematurity.
For stage V retinopathy characterized by complete retinal detachment caused by excessive tension of the eye tissue. For stage I retinopathy of prematurity, respectively, characterized by a minimum of vascular disorders of the retina. Stage III is considered the threshold retinopathy. During her child is referred for treatment of retinopathy using the technique of laser coagulation.
A more rare form of retinal circulatory disorders in adults - is diabetic retinopathy etiology. In this case, the disease is a consequence of diabetes, like insulin, and insulin-dependent type. Diabetic retinopathy is often accompanied by two other atherosclerotic vascular disorders of the retina and the nature of hypertension.
Symptoms of diabetic retinopathy form little pronounced. The patient gradually developed swelling of the macula (the central retina). Edema leads to multiple hemorrhages of the vitreous of the eye. Further symptoms of diabetic retinopathy are dependent on the type of disease form.
For background or nonproliferative diabetic retinopathy is characterized by loss of small vessels and long-term course of the disease. It is often referred to as stage I of diabetic retinopathy type.
Preproliferative form - II intermediate stage before the onset of diabetic retinopathy, proliferative forms of the disease. Symptoms of this stage of retinopathy are multiple large areas of blood disorders and a significant decline in the quality of vision.
Diagnosis of Retinopathy
Routine screening for retinopathy of prematurity is held every 2 weeks a month after birth. Inspections are continuing to complete the formation of blood vessels of the retina.
If you have symptoms of retinopathy survey is conducted weekly or 1 every 3 days. Diagnosis of the disease is carried out using the apparatus of the indirect binocular ophthalmoscopy. In the eyes of a child previously buried atropine for pupil dilation. Additionally, the diagnosis of retinopathy of prematurity can also be applied ultrasound eye.
Routine eye examinations in diabetic patients are held every 5 years.
Treatment of retinopathy
In the treatment of retinopathy of prematurity is very important to the timely initiation of therapy. On stage I disease is recommended dynamic monitoring of the retina. One of the support measures at this stage - treatment of retinopathy using krioretinopeksii (freezing of the peripheral areas of the retina).
Upon reaching the threshold stage III disease is carried out laser treatment of retinopathy - burning peripheral retinal laser. At the site of burns scars are formed. The vision in this area of the retina is lost, but with the help of laser treatment of retinopathy manages to maintain central vision and prevent retinal detachment.
In diabetic vascular disorders of the retina form of treatment for retinopathy is also preferably laser. However, since the pathology of retinal blood supply in this case is a complication of the underlying disease, more important in the treatment of diabetic retinopathy has control of blood glucose levels. Timely correction of the blood - the best prevention of further progression of diabetic retinopathy.
In severe stages of the disease possible surgical treatment of retinopathy using vitrectomy techniques. Thanks to its use of blood clots are removed from the cavity of the eye and the vitreous. Thus, to facilitate access to the retina. After restoring and attaching the retina laser vitreous of the eye is replaced by a special oil or gas.
This method of surgical treatment of retinopathy is highly effective, but it has a high risk of complications in the form of elevated intraocular pressure.