Retinal degeneration

Retinal degeneration

In this article, we will tell you:

The human eye is a very complex organ. We only see the tip of this iceberg: the pupil, iris, and cornea. To understand what this violation is, you need to understand the structure of the eye. Behind the outer shell is the lens, the vitreous body, which conducts light rays, and the retina.

The retina is a nerve tissue with special photoreceptors, often referred to as rods and cones. How well a person sees and distinguishes colors directly depends on the state of the retina and the work of its light-sensitive cells. If some kind of malfunction occurs in this important element, vision will deteriorate. We tell you what could be the cause of negative changes and how they are treated.

What can cause retinal dystrophy?

Common causes of retinal pathologies include:

  • Age changes. Due to vascular changes in the eyes, retinal dystrophy occurs and vision gradually begins to decline. As the disease progresses, visual acuity and color perception deteriorate due to problems with photoreceptors. This is called age -related macular degeneration (AMD);
  • genetic predisposition. The presence of a similar problem in blood relatives increases the likelihood of encountering it;
  • Excessive exposure to ultraviolet rays.
  • Consequence of cardiovascular diseases (hypertension, atherosclerosis);
  • untreated diabetes mellitus;
  • Doctors also attribute bad habits, an unbalanced diet, poor ecology, eye injuries and previous surgical interventions to risk factors.

Retinal dystrophy most often develops in people over 50 years old, but like many other diseases, it gets younger. That is why early diagnosis is the best preventive measure. It is important to know at what first symptoms it is time to consult an ophthalmologist in order to start treatment on time and prevent vision loss.

Signs and symptoms of retinal degeneration:

  • Visual acuity has decreased (violation of visual functions);
  • The field of view has narrowed (peripheral vision has worsened or disappeared);
  • Blind spots (scotomas) appeared;
  • You have become less able to navigate at dusk, it is difficult to adapt to changes in lighting (night blindness);
  • Opaque spots, glare, sparks, flies, and other uncharacteristic effects appeared in the field of view;
  • Straight lines seem crooked, letters are not always visible when reading, even if you are wearing glasses;
  • Violated color perception , the image seems unclear and faded.
  • You experience difficulty in recognizing letters when reading – their contours may be blurred, distorted.

Degenerative changes (dystrophy) of the retina is a very broad concept. Depending on the root cause of the violations, there are:

  • Primary (hereditary, or genetically determined) disorders. As a rule, they make themselves felt even in childhood – the quality of vision decreases, blindness develops. These diseases include amaurosis Leber , pigmented or non- pigmented punctate white degeneration, Best’s dystrophy, Wagner’s disease, abiotrophy ;
  • Secondary (acquired), which can be caused by disorders in various body systems (diabetes mellitus, hypertension).

Let us dwell in more detail on what is age -related macular degeneration of the retina. With the “dry form” of involutional dystrophy of the retina, the main cause is the natural aging process of the body, which does not bypass the organ of vision. It can also be the result of trauma, myopia, inflammatory or infectious processes in the past.

Central retinal dystrophies

The macula (yellow spot) is the central part of the retina responsible for central vision. It is on it that rays of light fall through the pupil. It contains the largest number of photoreceptors, thanks to which we see well and clearly. When the macula is affected, it results in:

  • Difficulty in reading;
  • Curvature of the contours of objects;
  • Blurred vision and even the appearance of spots on the image.

At the first symptoms and difficulties, you need to see an ophthalmologist and start treatment. If measures are not taken in time, retinal dystrophy turns into a chronic “wet form”. How does this happen? Photoreceptors are separated from blood vessels by a special membrane – Bruch ‘s membrane . In the process of aging, deposits of metabolic products of cells form between this thin layer and pigment cells, which can cause inflammation and provoke vascular proliferation. As a result, scar tissue from the growth of new blood vessels can lead to retinal detachment from the back of the organ. In addition, new blood vessels interfere with the normal outflow of fluid from the eye, resulting in increased eye pressure. And a liquid leaks out of them – exudate, which is why the form is called wet, or exudative. With this type of pathology is characteristic:

  • Visual impairment is progressive and not corrected with glasses or contact lenses;
  • Macular damage becomes irreversible;
  • In this case, there may not be pain even if the disease has been seriously started;
  • Also, the patient may not suspect a decrease in vision for a long time, because it occurs unevenly, that is, one eye compensates for the work of the second.

Peripheral retinal dystrophy is another type of this group of pathologies. It is characterized by thinning of the peripheral sections of the inner shell of the eye and is also asymptomatic, only in an advanced form it can manifest itself in the form of flies in the field of vision and problems with peripheral vision.

Diagnosis and treatment of retinal degeneration

In order not to miss the moment when treatment can save the retina and visual function, it is important to undergo regular ophthalmological examinations – at least once every 1-2 years. In order to make a diagnosis and draw up the most optimal treatment plan, the doctor needs to conduct the following examinations:

  • Visiometry to determine visual acuity;
  • Determination of refraction of the eye (refraction);
  • Tonometry – measurement of intraocular pressure (IOP), with retinal detachment, it can be lowered;
  • Perimetry – study of visual fields (lateral vision);
  • Ophthalmoscopy of the fundus for a detailed examination of the retina and its vessels;
  • Optical coherence tomography of the retina to examine the layers of the retina at a structural level;
  • Angiography to assess the state of the fundus, their integrity and the quality of the blood supply to the retina.

How is macular degeneration treated?

Unfortunately, there is no specific treatment for the “dry form” of macular retinal degeneration. Research data suggests that the course of the disease can be slowed down at an early stage by taking vitamins and dietary supplements: E, C, lutein, zeaxanthin , zinc and copper. Of course, you should definitely consult a doctor about this, because uncontrolled intake of vitamins is not recommended for anyone and can only harm the body.

With timely treatment, age-related dystrophy of the macula of the retina is successfully treated. It is only important not to miss the moment when the disease passes into the terminal stage. Treatment for “wet” AMD aims to stop the degenerative changes. For this, anti-VEGF drugs are used that can stop the formation of new blood vessels, prevent the progression of the disease, relieve retinal edema and improve vision. They are administered through injections, the number and frequency of which depends on the severity of the disease. This type of therapy proved to be effective, but it is also powerless at the stage when the retina is damaged and has scars, and central vision is greatly reduced.

In some cases, when conservative treatment (with the use of drugs) does not have the desired effect, treatment of retinal dystrophy with laser coagulation is indicated – cauterization of blood vessels to improve blood flow. Surgical treatment is not performed to improve vision, but to stop its deterioration. The procedure helps to relieve edema, improves oxygen access and allows you to solder weak vessels from which blood leaked.

How is laser photocoagulation of the retina done? It hurts?

One retinal treatment session lasts from 10 minutes to an hour and passes without any discomfort, the patient will only see flashes of light and hear clicks. The laser point glues the exfoliated parts of the retina or the affected vessels, the operation takes place under drip anesthesia. Usually cauterization is performed in 4-6 approaches with a break for a month. The procedure does not imply any special rehabilitation and long-term recovery – a person after it is able to go home himself.

People rarely completely lose their sight due to age-related changes. Yes, central vision is deteriorating, but they are still able to perform many normal daily activities and their quality of life remains the same. The dry form of age-related macular degeneration usually progresses very slowly, and the chances of maintaining good vision are high.

  • Episcleral (filling or ballooning )
  • Endovitreal , when manipulations are performed inside the eyeball, for example, vitrectomy – partial or complete removal of the vitreous body;

The problem with the retinal blood vessels is recurrent and most often recurs, and coagulation can at least slow down this process. Wet macular degeneration is a major cause of vision loss that may require repeat treatment. Check regularly and follow your doctor’s advice.

People rarely completely lose their sight due to age-related changes. Yes, central vision is deteriorating, but they are still able to perform many normal daily activities and their quality of life remains the same. The dry form of age-related macular degeneration usually progresses very slowly, and the chances of maintaining good vision are high.

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