Peripheral retinal dystrophy: causes, symptoms and treatment methods

Under retinal dystrophy, ophthalmologists combine heterogeneous pathologies accompanied by progressive death, that is, thinning of its tissues. If the foci of dystrophy are located in the peripheral part of the retina of the eye, the risk of its tearing increases many times, which is fraught with complete and irreversible loss of vision.

This disease is equally common in young and elderly patients and has no gender preferences, and symptoms become noticeable only after a significant spread of pathological foci. This is why peripheral retinal dystrophy is dangerous — more than 50% of diagnoses are made when the changes have become irreversible.

Reasons

Ophthalmologists call the most common cause of peripheral retinal degeneration a myopic type of refraction disorder, that is, banal myopia. In this disease, the eyeball is elongated along the anterior-posterior axis. With this form of the eye, its periphery is constantly in tension, which worsens the blood supply to tissues, including the retina. Traction is formed on the latter — areas with excessive tension, on which a gap forms over time. A liquid fraction of the vitreous body “seeps” into it, which leads to the peeling of the mesh shell from the vascular substrate. Thus, this part of the visual apparatus finally loses its power sources and dies.

According to statistics, peripheral retinal dystrophy in 30-40% of cases is caused by myopia. Farsightedness accounts for no more than 8% of all diagnoses. In people with normal vision and no problems with refraction, such a retinal lesion is diagnosed in 3% of cases.

In addition to congenital or acquired myopia (myopia), dystrophy can provoke:

  • acute and chronic inflammation of the eyes and intraocular structures, provoked by viral and bacterial infections or autoimmune processes;
  • cataract;
  • eye injuries, including injuries and surgical interventions;
  • chronic systemic diseases — diabetes mellitus, hypertension, atherosclerosis of blood vessels, coronary heart disease and others;
  • chronic poisoning, including alcohol metabolites and tobacco smoking products;
  • chronic deficiency of nutrients, vitamins and minerals;
  • age-related changes.

Useful to know! According to statistics, the owners of light skin and blue iris are the most susceptible to peripheral retinal dystrophy. Among them, the main cause of pathology, in addition to those listed, is the traumatic effect of ultraviolet light on the eyes.

As for the age distribution of the disease, in young patients its causes are more often refractive errors, injuries and infections, and in the elderly, dystrophy occurs against the background of vascular anomalies and age-related changes.

Symptoms

Peripheral retinal dystrophy is characterized by nonspecific symptoms that resemble most visual impairments:

  • gradual decrease in visual acuity in one or both eyes — there is a need for brighter lighting when reading, etc.;
  • gradual narrowing of the fields of vision — a person ceases to clearly see objects located on the periphery;
  • scotoma — the appearance in the field of vision of an impenetrable or transparent spot, a solid veil or the illusion of a foreign object between the eye and the object in question;
  • distortion — the perceived picture becomes undulating, as if the object is being looked at through the water column;
  • reduced twilight vision acuity;
  • color inversion is a distortion of color perception, for example, red is perceived as blue, etc.;
  • metamorphopsy is a violation of the perception of the shape and localization of objects in space;
  • inability to determine the state of an object relative to space, that is, to recognize whether it is moving or at rest.

The listed symptomatic manifestations may disturb the patient simultaneously or appear sporadically one at a time. As the size of pathological foci increases, they become more pronounced, and some of them remain forever. This is typical for all forms of retinal dystrophy.

Diagnostics

It is possible to identify peripheral retinal dystrophy before the appearance of symptoms. The anomaly is well visualized during the examination of the fundus by the following methods:

  • ophthalmoscopy is a study using a slit lamp, during which the doctor will see dystrophic changes on the retina that look like light and dark spots of various shapes and configurations (the so—called snail trail, frost—like, in the form of radial stripes, grids, etc.);
  • the perimetry method allows you to detect narrowing of the visual fields even before the patient will begin to make complaints;
  • visometry — measurement of visual acuity using special tables (it may correspond to the norm against the background of a decrease in peripheral vision);
  • refractometry is an instrumental diagnosis designed to determine the degree of refractive error.

The most informative way to make a diagnosis is an ultrasound of the eye. This procedure allows you to identify the problem before the appearance of significant dystrophic processes, for example, at the stage of traction formation. It also helps to determine the cause of the disease, if it was changes in the size of the eye along the longitudinal axis, vitreous anomalies, vascular malformations, etc.

Methods of treatment

Unfortunately, peripheral retinal degeneration cannot be completely and irrevocably eliminated. Modern medicine offers patients with such a diagnosis a comprehensive treatment aimed at stopping the spread of dystrophic foci. In the asymptomatic and early stages of the disease, conservative methods of therapy are used, consisting mainly of medicines of several groups:

  • Antiplatelet agents are drugs that reduce blood viscosity and reduce the risk of thrombosis. The preferred form is tablets, sometimes injections are prescribed. The names of the drugs are products based on acetylsalicylic acid.
  • Vasodilators are drugs that relieve vasospasm and improve microcirculation. Along with tablets, injectable forms of drugs are prescribed.
  • Angioprotectors are medications that protect and strengthen the walls of blood vessels. It is prescribed in the form of tablets or intravenous injections.
  • Microcirculation stimulators are agents that have the property of increasing vascular conductivity and reducing blood viscosity.
  • Regenerating and regenerating drugs — medicines and dietary supplements that enhance metabolic processes, restore microcirculation and regeneration. Preferably, the use of means of local action — drops and intraocular injections.
  • Vitamin complexes are preparations enriched with B vitamins, retinol, keratin, lutein and other compounds useful for the eyes. They are recommended in the form of capsules or tablets.

If peripheral retinal dystrophy continues to progress after 2 courses of conservative therapy, physiotherapy procedures are used:

  • electrophoresis;
  • exposure to magnetic fields;
  • photo, electro and laser stimulation;
  • the ILBI procedure (intravenous laser irradiation of blood).

If these measures have not led to a noticeable slowdown in the progression of the disease, a minimally invasive or full-fledged surgical intervention is performed. Laser coagulation of the retina is considered the most effective and low-traumatic, during which the doctor “solders” the retina to the vascular base and simultaneously eliminates scarring.

If the disease is at an advanced stage, when the vitreous body has emerged through a gap in the retina, vitrectomy is performed: the vitreous body is removed, the retina is fixed and the eyeball is filled with polymer.

Forecast

With timely detection of dystrophic changes in the peripheral region of the retina, the prognosis is favorable. Despite the fact that most patients fail to regain 100% vision, they maintain visual contact with the outside world, can serve themselves and work. Improves the prognosis of giving up bad habits and excessive physical exertion. Even in the absence of noticeable changes for the worse, patients with such a diagnosis need to be examined by an ophthalmologist twice a year.

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