Angiopathy of the retina with signs of moderate hypertension. What is hypertensive retinal angiopathy: treatment and prevention. Hypertensive angiopathy of both eyes

Angiopathy of the retina hypertonic type- a pathology that is characterized by damage to the vessels of the visual analyzer. This is a chronic disease that often accompanies hypertension (persistent increase blood pressure).

There are several stages in the development of the disease. On the first of them, the patient experiences practically no discomfort, and on the last one, he may completely lose his sight. That is why timely treatment is the main guarantee of recovery or stabilization of the condition to prevent dangerous complications.

Causes of angiopathy

Hypertensive retinal angiopathy is a consequence of prolonged hypertension. An increase in pressure affects about half of the people, and this disease develops in both elderly and young patients. Often, hormonal imbalances or changes, as well as constant stress, lead to hypertension. nervous tension. Almost always it accompanies atherosclerosis of vessels. Men get sick less often, but more severely than women.

Risk factors for the development of hypertension:

excess weight;
passive lifestyle;
frequent stressful situations;
emotional lability;
vascular problems;
not proper nutrition(in particular, excess cholesterol).

Departments of the central nervous system, responsible for the parameters of blood pressure in the vessels, are overexcited, and their functions are impaired. As a result, the value of systolic pressure increases, and its rate is over 140 mm Hg. Art. as if becoming a "norm" for the regulatory departments of the brain. Experienced hypertensive patients experience discomfort at a pressure of 120/80, and values of 180/100 are relatively acceptable for them, although healthy person it's the other way around.

The reasons for this phenomenon are the hormones adrenaline and norepinephrine, which begin to be released into the blood more than usual. The effect is obvious: the vessels narrow, the pressure rises. In addition, cardiac output increases, and because of this, renin and angiotensin spasm the vessels even more, and the endocrine regulation of pressure in the vessels starts. As a result, pressor hormones affect the tone of the vascular walls (their muscle layer), increasing it.

Such a mechanism is a kind of vicious circle, and hypertension is constantly maintained. Reversible and irreversible changes occur in organs, including the retina.

Arterioles, small arteries, are the first to be affected. The muscle layer of their walls and the number of elastic fibers increase. Because of this, the lumen in the vessel narrows. Subsequently (especially after frequent jumps in blood pressure), lipids are deposited in the walls, muscle fibers are replaced by hyaline, and wall extensibility (elasticity) decreases. The result of these processes can be thrombosis and microinfarctions. This process occurs in the vessels of many organs, in particular, in the retina.

Vascular sclerosis is an overgrowth connective tissue in lipid plaques on the walls of blood vessels (often formed from cholesterol). In addition, the process is accompanied by calcification of the walls. The artery is blocked. In the presence of the described changes in the vessels of the fundus against the background of hypertension, the doctor diagnoses “hypertensive angiosclerosis of the retina”.

Diagnosis and symptoms

An ophthalmologist, when examining the fundus, will determine changes in the walls of blood vessels and in the tissues of the retina. Naturally, their severity depends on the stage of the disease. The onset of the pathological process can occur in one eye, and later go to both.

The doctor will see that the veins are dilated, dark, in the form of a corkscrew, sometimes even look like a cyst. The arteries will be pale, double-circuit, tortuous. Blood runs intermittently in the veins. There is a symptom of Salus - the intersection of narrow dense arteries and dilated veins.

Another diagnostic sign is a copper wire symptom (arteries are tense, narrowed). In a later stage, it is replaced by a silver wire symptom (pale arteries). Point hemorrhages appear around the capillaries. These signs in this type of angiopathy are more often observed asymmetrically in the right and left eyes. A severe course is characterized by foci of “cotton wool” in the form of a star (these are exudates with a large amount of fibrin) and at the same time swelling around the disc optic nerve.

Stages of angiopathy of the hypertensive type:

Violation of microcirculation. There are no complaints, changes are noticeable when examining the fundus.
Sealing of the walls of blood vessels. There is swelling of the retina and hemorrhages.
Angioretinopathy. Presence of exudates. Aggravation of all changes. Critical blood flow disorder. Complete loss of vision is possible.

The patient during the course of the illness complains of clouding in the eyes, nosebleeds, pain in the legs, myopia, sometimes bleeding occurs. gastrointestinal tract. Peripheral vision deteriorates.

In addition, other symptoms of hypertension are observed: headaches and heart pain, fatigue even with light exertion, and so on.

Children can also develop this disease. The first symptoms of hypertension in them will be dizziness, headaches, fainting, heart palpitations. Memory is decreasing. Complications are very serious, up to pulmonary edema and convulsions in some cases.

Treatment of retinal angiopathy

To cure angiopathy of the hypertensive type, it is necessary to begin therapy for the underlying disease that caused vision problems.

If hypertension has developed due to renal pathology, then you should contact a nephrologist, if due to excess weight and similar disorders - to an endocrinologist.

To relieve symptoms and improve the condition of the eyes, the ophthalmologist will prescribe drugs for vasodilation (vasodilators), angioprotectors, antioxidants (for example, vitamin C), and enzymes for resolving hemorrhages. Oxygen inhalation also helps (relieve hypoxia), antiplatelet agents (prevent thrombosis, in particular, acetylsalicylic acid).

Comprehensive treatment of pathology is the only way to recovery. You can not take a wait-and-see attitude, as the state of vision will worsen more and more. It is important to take timely measures to prevent serious consequences.

Such a disease is manifested by the expansion of the venous vessels of the fundus, branching of the vascular bed, its tortuosity and pinpoint hemorrhages.

Hypertensive angiopathy of the retinal region occurs against the background of stable high level pressure. So, for the formation of such a complication, it is necessary that the indicators of cardiac blood pressure be more than 140 mm Hg. Art., and renal - from 90 mm Hg. Art.

The reasons for this condition are manifold:

genetic predisposition;
deficiency of potassium, magnesium and sodium;
overweight;
excessive salt intake;
bad habits;
inactive lifestyle.

In some cases, the pressure increases against the background of other diseases. These can be pathologies of the central nervous system, failures in the endocrine system, and so on.

Prolonged elevation of blood pressure leads to structural changes in the vascular wall, which leads to a slowdown in blood supply and disruption of the functioning of certain systems and organs. This condition often provokes the occurrence of a number of more significant complications.

Increase the likelihood of hypertensive retinal angiopathy can:

chronic intoxication;
all kinds of injuries;
age-related changes in the vessels;
osteochondrosis;
blood diseases;
failures in metabolic processes and so on.

Symptoms

At the initial stage of the development of the disease, there are no bright manifestations. Unpleasant sensations appear a little later, they consist in the deterioration of vision and the flickering of stars or "flies" in the eyes.

When examined by an ophthalmologist, narrowing and elusiveness of the retinal arteries, a change in the vascular lumen and a symptom of a corkscrew (Guista) are found. In severe cases, manifestations such as accumulation of extravasates, hemorrhage and obstruction of blood through the vessels appear.

Hypertonic retinal angiopathy begins with changes in the small vessels of the distal retina. Then sclerosis occurs, while their lumen narrows, they become tortuous and empty in places in the arterioles.

These changes are accompanied by symptoms indicating damage to the retina: hemorrhage and blurred and poor vision.

What should be remembered about the development of the disease?

Angiope tia retina is always the result of stable high blood pressure that didn't fall long time. This condition leads to neuroregulatory dysfunction, vasodilatation of the fundus and small hemorrhages that are visible in eyeball.

If the disease is not treated, irreversible changes occur in the retina. Its areas become more cloudy, but timely and competent therapy can eliminate this symptom.

At the initial stage of angiopathy development, when there is no characteristic symptoms, it is still possible to diagnose the presence of changes in the retina. This is done using fluorescein angiography, which shows the presence of a change in even the smallest vessels.

Hypertensive angiopathy is sometimes accompanied by damage to the vessels of the central nervous system, heart and urinary system. Often the vessels cannot get used to excessive pressure, so they become brittle, which causes hemorrhage in the heart and brain.

Due to a violation of cerebral circulation, neurological disorders appear:

decreased mental activity;
irritability;
lack of concentration;
emotional instability;
bad memory.

Hypertensive angiopathy of both eyes

Due to the fact that hypertension affects vascular system of the whole organism, a disease such as angiopathy develops immediately in both eyes. In this case, the disease progresses slowly, as a result of which blood circulation is disturbed.

In the process of the development of the disease, the arterial wall thickens and elements of connective tissues are formed in it. As the disease progresses, some areas of the retina swell and bleed.

In addition, against the background of changes occurring in the vascular walls and circulatory disorders, complications such as impaired patency of the leading artery and its branches often develop. In this case, the venous vessels suffer, so blockage of the central retinal vein may occur.

The nutrition of the optic nerve is also disturbed. Such complications are quite serious, as they can cause a sharp and irreversible deterioration in vision.

Treatment and prevention

A disease such as a hypertensive form of angiopathy of the retinal region can be cured only if arterial hypertension is eliminated by normalizing the level of blood pressure. For this purpose, the doctor prescribes drugs that reduce pressure.

Exist various groups drugs that affect blood pressure:

Calcium channel blockers - they expand the lumen of blood vessels. These drugs include Felodipine and Corinfar.
Beta-blockers - make the heart rate normal by lowering the distal vascular resistance. To achieve this effect, Lokren, Atenolol and others are used.
Diuretics - remove excess water. These agents include Clopamid and Hydrochlorothiazide.
Drugs that suppress angiotensin-converting enzyme - inhibit the synthesis of renin, which contributes to an increase in blood pressure. This group includes drugs such as Spirapril, Kapoten, Prestarium.

In addition to antihypertensive drugs, drugs that dilate blood vessels can be used. They activate blood circulation in the capillaries and large vessels (Vazonite, Trental, etc.).

Still often prescribed drugs that thin the blood (Dipyridamole, Cardiomagnyl, Aspirin) and drugs that reduce the permeability of the vascular walls (Ginkgo, Parmidin).

Also, the doctor can prescribe drugs that improve blood circulation - Actovegin, Pentoxifylline and Solcoseryl and drugs that activate metabolism in tissues (Cocarboxylase, ATP). Will not be redundant vitamin complexes, including ascorbic and nicotinic acid and B vitamins.

In addition, the patient needs to reconsider his lifestyle and nutrition:

avoid stress;
forget about bad habits;
refuse salty and fatty foods;
do not drink alcohol.

In order not to develop retinal angiopathy of the hypertonic type, it is necessary to stabilize the level of blood pressure. To this end, you need to periodically be examined by a cardiologist and do not forget about moderate physical activity, including warm-up exercises and morning exercises. No less useful will be light jogging, cycling and walking. In this regard, information about how to treat pressure takes on a new meaning!

Hypertensive retinal angiopathy is a consequence of prolonged hypertension. An increase in pressure affects about half of the people, and this disease develops in both elderly and young patients. Often, hormonal imbalances or changes, as well as constant stress, nervous tension, lead to hypertension. Almost always it accompanies atherosclerosis of vessels. Men get sick less often, but more severely than women.

Risk factors for the development of hypertension:

excess weight;
passive lifestyle;
frequent stressful situations;
emotional lability;
vascular problems;
malnutrition (in particular, excess cholesterol).

The departments of the central nervous system responsible for the parameters of blood pressure in the vessels are overexcited, and their functions are impaired. As a result, the value of systolic pressure increases, and its rate is over 140 mm Hg. Art. as if becoming a "norm" for the regulatory departments of the brain. Experienced hypertensive patients experience discomfort at a pressure of 120/80, and values of 180/100 are relatively acceptable for them, although the opposite is true for a healthy person.

Such a mechanism is a kind of vicious circle, and hypertension is constantly maintained. Reversible and irreversible changes occur in organs, including the retina.

Vascular sclerosis is the proliferation of connective tissue in lipid plaques on the walls of blood vessels (often formed from cholesterol). In addition, the process is accompanied by calcification of the walls. The artery is blocked. In the presence of the described changes in the vessels of the fundus against the background of hypertension, the doctor makes a diagnosis of "hypertensive angiosclerosis of the retina".

Stages of angiopathy of the hypertensive type:

Violation of microcirculation. There are no complaints, changes are noticeable when examining the fundus.
Sealing of the walls of blood vessels. There is swelling of the retina and hemorrhages.
Angioretinopathy. Presence of exudates. Aggravation of all changes. Critical blood flow disorder. Complete loss of vision is possible.

The patient during the course of the disease complains of clouding in the eyes, nosebleeds, pain in the legs, myopia, sometimes bleeding of the gastrointestinal tract occurs. Peripheral vision deteriorates.

In addition, other symptoms of hypertension are observed: headaches and heart pain, fatigue even with light exertion, and so on.

At the initial stage of the development of the disease, there are no bright manifestations. Unpleasant sensations arise a little later, they consist in the deterioration of vision and the flickering of stars or "flies" in the eyes.

Hypertonic retinal angiopathy begins with changes in the small vessels of the distal retina. Then sclerosis occurs, while their lumen narrows, they become tortuous and empty in places in the arterioles.

Angiopathy of the retina is always the result of a stably elevated pressure that has not subsided for a long time. This condition leads to neuroregulatory dysfunction, vasodilatation of the fundus and small hemorrhages that are visible in the eyeball.

If the disease is not treated, irreversible changes occur in the retina. Its areas become more cloudy, but timely and competent therapy can eliminate this symptom.

At the initial stage of the development of angiopathy, when there are no characteristic symptoms, it is still possible to diagnose the presence of changes in the retina. This is done using fluorescein angiography, which shows the presence of a change in even the smallest vessels.

Due to a violation of cerebral circulation, neurological disorders appear:

decreased mental activity;
irritability;
lack of concentration;
emotional instability;
bad memory.

You will need to read: 5 min

It is known that vision is the main of the human senses. With the help of vision, we learn the world, preferring to "see once." This is the reason for the fear of the dark: after all, we cannot see what it hides, which means we do not feel protected. Therefore, it is so important to take care of the health of the eyes: diseases noticed at an early stage are much easier to cure than trying to heal the “neglected” ones at least a little.

Hypertensive retinal angiopathy is a change in the vessels of the retina of the eye, observed in people who have been suffering from hypertension for a long time. The most common is hypertensive angiopathy of the retina in both eyes. Angiopathy manifests itself in both children and adults, but more often middle-aged people, that is, older than 35 years, suffer from this disease. It also occurs in pregnant women - as a rule, after 6 months.

The reason for the development of the disease

In fact, hypertensive retinal angiopathy is one of the complications of hypertension, along with myocardial infarction and stroke. Due to constantly elevated pressure, vascular damage occurs: it is known that in patients with hypertension, the pressure in the ophthalmic artery normalizes 3 times slower than in a healthy person, and vasodilation takes 2-5 times longer.

Stages of hypertensive angiopathy

The first stage is characterized by a violation of blood circulation due to narrowing of the veins and dilation of the arteries. Changes at this stage can be seen only when examining the fundus.

In the second stage, the walls of the vessels become denser, which leads to a violation of the blood supply to the retina. Changes become more noticeable: the veins expand and branch, there is a shine of the vessels due to wall compaction, swelling of the retina; frequent hemorrhage.

The third stage, called angioretinopathy, is characterized by a critical violation of blood circulation, the formation of exudate (fluid containing proteins, minerals, microbes, red blood cells, causing inflammatory processes) at the bottom of the eyeball, as well as aggravation of changes in past stages and the risk of complete loss of vision. Therefore, it is better to treat a disease such as angiopathy of the hypertensive type in a timely manner, without bringing it to this stage of development.

Diagnostic measures

Hypertensive angiopathy of the retinal vessels is diagnosed by an ophthalmologist when examining the fundus. In the place where the optic nerve enters the retina, a small spot forms, normally round or oval.

With angiopathy, due to swelling of the nerve, this spot loses its shape, its edges become uneven. The circulatory system is changing. As mentioned above, the arteries narrow, which is why many patients complain of flickering "flies" before their eyes and a narrowing of the field of vision.

Clinical picture of the disease

With retinal angiopathy, the following symptoms are observed:

slight visual impairment. Despite the fact that the changes in the second stage are already significant, vision persists for a long time;
periodic blurred vision - due to changes in blood pressure as under the influence of special drugs;
the appearance of fatty spots on the eyes - deposits yellow color(Guist symptom), branched vessels, hemorrhages;
in the third stage, there is a significant deterioration in vision, up to blindness;
nosebleeds;
possible gastrointestinal bleeding;
progressive myopia;
pain in the legs.

How is the treatment done?

At present, thanks to timely diagnosis and new methods of treatment, it has become possible to eliminate eye diseases that were previously considered incurable. Despite major changes taking place even in initial stages, hypertensive angiopathy of the retina is eliminated quite simply: it is enough to eliminate the manifestations of hypertension, and the condition of the fundus will soon normalize.

Causes and signs of vascular changes
Therapy for angiopathy of the hypertensive type

Types and classifications

Hypertensive retinopathy contributes to the defeat of medium and small vessels that are involved in the nutrition of the organ of vision. Taking into account the severity of the pathological process and the degree of vascular disorders, 3 stages of the disease can be distinguished:

Hypertensive angiopathy. It is characterized by pathological changes, the severity of which is insignificant. At the same time, a pronounced angiospastic process is traced.
Hypertensive angiosclerosis.
Hypertensive angioretinopathy, neuroretinopathy.

Features of pathogenesis

Treatment is always complex, includes measures of a general and symptomatic nature. The patient is advised to change the diet, in particular to limit the intake of fluids, salt and foods rich in cholesterol.

It is necessary to give preference to food enriched with vitamins, antioxidants, amino acids and mineral components. The menu includes lean meats, dairy products, fish, seasonal vegetables and fresh fruits.

The second point of therapy is lifestyle correction. You should give up cigarettes, alcohol, excessive power loads, bring your emotional background back to normal. Ignoring this point leads to further progression of the disease.

Other components of treatment:

Adequate therapy of hypertension, constant control of blood pressure. For this, drugs are recommended with diuretic effect to remove excess fluid from the body, angiotensin-converting enzyme inhibitors.
Calcium antagonists contribute to the expansion of blood vessels - Felodipine; beta-blockers normalize the heart rate, lower the distal vascular resistance (Lokren).
Anticoagulants are prescribed to thin the blood. For example, drugs such as Aspecard or Clopidogrel.
The use of medications to enhance metabolic processes in the retina - Trental, Mildronate.
The therapy includes vitamin preparations such as Vitrum, Aevit; topical agents are used in the form of eye drops. For auxiliary purposes, you can use bioadditives. The most effective dietary supplement is Normalife.

With a high probability of retinal rupture or against the background of persistent bleeding, laser coagulation or other methods of instrumental therapy may be prescribed.

The success of the prognosis for the cure of angiopathy of the hypertensive type is due to the timeliness of therapy and the speed of stabilization of pressure indicators at the required level. Lack of adequate medical care fraught with complications and a high risk of blindness.

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Diagnosis and symptoms

In order for the treatment to be successful and adequate, the doctor must first conduct a thorough diagnosis.

The most popular diagnostic method is ophthalmochromoscopy. Its essence boils down to the fact that the number of vessels in red and redless light is determined. Thus, the vessels in the fundus in the red spectrum are not seen as clearly as in ordinary or redless light. Arterial vessels, which are narrowed in hypertensive angiopathy, are not seen as well as normal ones.

For examination, ultrasound of the organs may be required so that the doctor can assess the complete picture of blood circulation. Due to Doppler scanning, it is possible to assess changes in the vascular walls. Sometimes the doctor prescribes x-ray examination using a contrast agent to observe the patency of the vascular lumen.

Usually, hypertensive angiopathy of the retina is diagnosed by ophthalmoscopy, during which the ophthalmologist detects the following pathological changes on the retina:

Uneven narrowing of arterioles and expansion of venules;
Angiosclerosis, that is, thickening of the vascular wall, as a result of which it takes the form of a silver wire;
Retinopathy, when, due to hemorrhages, the retina is saturated with blood components;
Neuroretinopathy is damage to the optic nerve head.

Can be used additional methods research:

Ophthalmodynamometry - measurement of pressure in the vessels of the retina;
Doppler ultrasonography;
Rheoophthalmography - registration of blood circulation in the eye in the form of a graphic image;
Fluorescent angiography of retinal vessels.

These methods allow you to study the state in more detail. blood vessels retina.

What can a patient complain about?

At the initial stages of angiopathy, patients, as a rule, do not complain, an ophthalmologist can notice changes, and even then, not always.

A little later, when hypertension is stable, complaints may appear on:

Poor eyesight at dusk;
Deterioration of lateral vision;
Incomplete vision of the subject, dark spots, interfering to consider the subject;
Decreased visual acuity.

The degree of retinal changes in hypertension depends on the stage of development of the disease, its severity, and the form of the disease. The longer there is hypertension, the more pronounced are the symptoms of hypertensive retinal angiopathy.

Discovered on early stages hypertension can be cured and fundus changes regress.

Possible Complications

If the disease is not treated, the following complications may occur: retinal detachment, glaucoma, cataracts. All of them lead to visual impairment or blindness.

Features of therapy

Drugs that lower blood pressure:

beta blockers - "Atenolol", "Metoprolol";
ACE inhibitors - "Berlipril", "Vazolong";
calcium channel blockers - "Verapamil", "Amlodipine";
angiotensin II receptor blockers - "Losartan", "Valsartan";
diuretic drugs - "Torasemide", "Hydrochlorothiazide".

Drugs that improve the functioning of the retina:

Means that thin the blood and prevent the formation of blood clots: Magnikor, Clopidogrel.
Drugs that expand the wall of blood vessels: Vinpocetine, Cavinton.
Medicines that protect the wall of blood vessels: Trental, Actovegin.
For resorption of exudate on the retina: "Papain".
Vitamins: "Slezevit", "Blueberry forte".
Eye drops: "Taufon", "Quinax".

Treatment and prevention

A disease such as a hypertensive form of angiopathy of the retinal region can be cured only if arterial hypertension is eliminated by normalizing the level of blood pressure. For this purpose, the doctor prescribes drugs that reduce pressure.

There are various groups of drugs that affect blood pressure:

Calcium channel blockers - they expand the lumen of blood vessels. These drugs include Felodipine and Corinfar.
Beta-blockers - make the heart rate normal by lowering the distal vascular resistance. To achieve this effect, Lokren, Atenolol and others are used.
Diuretics - remove excess water. These agents include Clopamid and Hydrochlorothiazide.
Drugs that suppress angiotensin-converting enzyme - inhibit the synthesis of renin, which contributes to an increase in blood pressure. This group includes drugs such as Spirapril, Kapoten, Prestarium.

In addition to antihypertensive drugs, drugs that dilate blood vessels can be used. They activate blood circulation in the capillaries and large vessels (Vazonite, Trental, etc.).

Still often prescribed drugs that thin the blood (Dipyridamole, Cardiomagnyl, Aspirin) and drugs that reduce the permeability of the vascular walls (Ginkgo, Parmidin).

Also, the doctor can prescribe drugs that improve blood circulation - Actovegin, Pentoxifylline and Solcoseryl and drugs that activate metabolism in tissues (Cocarboxylase, ATP). Vitamin complexes, including ascorbic and nicotinic acid and B vitamins, will not be superfluous.

In addition, the patient needs to reconsider his lifestyle and nutrition:

avoid stress;
forget about bad habits;
refuse salty and fatty foods;
do not drink alcohol.

In order not to develop retinal angiopathy of the hypertonic type, it is necessary to stabilize the level of blood pressure. To this end, you need to periodically be examined by a cardiologist and do not forget about moderate physical activity, including warm-up exercises and morning exercises. No less useful will be light jogging, cycling and walking. In this regard, information about how to treat pressure takes on a new meaning!

In this case, the diet should be enriched with fruits, vegetables, herbs, seafood, cereals and lean meats. If there is excess weight, then it must be normalized. It is also important to get enough sleep and fully relax after hard physical and mental work.

The well-being of the prognosis of hypertensive angiopathy is interrelated with the timeliness of treatment and the speed of normalization of blood pressure levels. But in the absence of adequate therapy, severe complications can develop, which lead not only to a deterioration in visual function, but also to complete blindness.

Therefore, a disease such as hypertensive retinal angiopathy requires mandatory therapy. In addition, stable high blood pressure is a significant reason for contacting not only a cardiologist, but also an ophthalmologist who can assess the condition of the eye vessels. Interesting video in this article will tell about the angiopathy of retinal vessels.

Preventive measures such a disease is based on a change in lifestyle. Each patient needs to lead an active, healthy lifestyle - do exercises every morning, move a lot throughout the day, switch to proper nutrition, monitor their weight and get rid of bad habits.

After treatment, you must follow diet food avoid various stressful situations. A very important point in prevention is the maintenance of visual hygiene: make sure that it is sufficiently illuminated workplace, take breaks while working at the computer and exercise for the eyes.

If you experience discomfort in the eyes, pain or other symptoms, you should immediately contact your doctor. It is also necessary to frequently conduct an examination of the fundus in case of hypertension.

For prevention, you need to monitor the general condition of the body, lead a healthy lifestyle. Specific actions for the eyes are not required, since retinal angiopathy is an echo of either a genetic anomaly, or injury, or congenital anomalies and vascular diseases.

Sources: etodavlenie.ru, rblinevo.ru, setchatka-glaza.ru, lechenie-sosudov.ru, ozrenii.com

For people who are genetically prone to the disease or are overweight, they should think about the prevention of hypertension. To do this, you need to follow the following simple recommendations:

Perform physical training. Thanks to them, you can normalize the psycho-emotional state and heart function.
Improve nutrition. The diet should include vegetables, berries, fruits, seafood, greens. It is necessary to exclude from the diet those foods that lead to a disorder of the heart or blood circulation. This should include salt, garlic, alcohol, carbonated drinks.
Bring back the weight.
Normalize the work so as not to overwork the body. You need to find time for rest and emotional unloading, and also normalize sleep.

The main direction in the prevention of hypertensive angiopathy is the strict observance of all medical recommendations regarding the treatment of arterial hypertension.

findings

Hypertensive retinal angiopathy is a common disease in ophthalmology. It can be treated, since in most cases a positive trend is visible. But only if you seek help in a timely manner. Otherwise, a variety of complications may occur that lead to partial or complete loss of vision.

Heart attacks and strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blockage of the arteries of the heart or brain.

Especially terrible is the fact that the mass of people do not suspect at all that they have hypertension. And they miss the opportunity to fix something, simply dooming themselves to death.

Symptoms of hypertension:

Headache
Increased heart rate
Black dots before the eyes (flies)
Apathy, irritability, drowsiness
blurred vision
sweating
Chronic fatigue
swelling of the face
Numb and chill fingers
Pressure surges

How to treat hypertension when there are a large number of drugs that cost a lot of money?

Most medicines won't do any good, and some can even hurt! At the moment, the only medicine that is officially recommended by the Ministry of Health for the treatment of hypertension is NORMIO.

Hypertensive angiopathy is a consequence of long-term hypertension, usually stage I-II B.

The disease is characterized by dilation of the venous vessels of the fundus, changes in their tortuosity, the appearance of branching of the vascular bed, disproportionate lumen of the arteries, and the possibility of pinpoint hemorrhages. When such a disease is detected, an appointment is required emergency treatment Otherwise, the patient may partially or completely lose sight.

ICD-10 code

I79.2* Peripheral angiopathy in diseases classified elsewhere

I10 Essential [primary] hypertension

Causes of hypertensive angiopathy

Hypertensive angiopathy appears due to prolonged hypertension - chronically high blood pressure. Blood pressure is considered high if its systolic values are equal to or greater than 140 mmHg and diastolic values are equal to or greater than 90 mmHg.

There can be many reasons for this condition, and, first of all, it is a hereditary predisposition, excessive body weight, bad habits, lack of physical activity, eating excessively salty foods, lack of magnesium and potassium salts in the body.

Sometimes blood pressure rises as a result of other diseases and pathological conditions: these are disorders of the endocrine function, pathologies of the central nervous system, etc.

A prolonged state of high pressure causes a structural disorder in the vascular wall, which entails a deterioration in blood supply in the body, disruption of the functioning of some organs and systems, which can provoke a number of even more serious complications.

The situation could be aggravated various injuries, osteochondrosis, metabolic disorders, blood diseases, age-related changes in blood vessels, chronic intoxication, etc.

Symptoms of hypertensive angiopathy

The initial stage of development of hypertensive angiopathy may not be accompanied by any complaints. Discomfort appears a little later, when the patient notes a drop in vision, the appearance of "flies", spots and stars in front of the eyes. An ophthalmologist during examination detects narrowing of the retinal arteries, their resourcefulness, the presence of a corkscrew symptom (Guist), a change in the vascular lumen. In more severe stages, there is a lack of passage of blood through the vessels, hemorrhages, accumulations of blood in the form of extravasates.

The disease begins with the appearance of changes in the smallest arterial vessels in the distal retina and around the circumference of the macula. Gradually, the pathology progresses, there are signs of sclerosis of the vessels, their lumen becomes uneven, tortuous with periodic desolation in the arterioles. The above violations are accompanied by signs of retinal damage: deterioration and blurred vision, hemorrhages in various places of the eyeball.

It is still possible to eliminate the initial changes in hypertensive angiopathy, more advanced cases are much more difficult to treat.

Angiopathy of hypertensive type

What you need to remember about the development of angiopathy of the hypertensive type:

this type of angiopathy is exclusively a consequence of prolonged high blood pressure. Hence - dilated venous vessels of the fundus, small hemorrhages on the eyeball, neuro-regulatory dysfunction;
if no action is taken, the disease will provoke a series of changes in the retina. In particular, areas of the retina become cloudy, which can be corrected by timely and the right treatment hypertension;
even in the initial stages of angiopathy, the disease can be detected with a thorough examination of the fundus area. When the patient does not yet feel signs of visual impairment, the method of fluorescein angiography allows you to determine a fairly clear picture of the smallest vascular changes.

Hypertensive angiopathy of the retinal vessels may be accompanied by damage to the vessels of the urinary system, heart, and central nervous system. Sometimes the vessels do not have time to adapt to excessive pressure, they become brittle, which causes hemorrhages in the tissues of the brain and heart. Due to changes in blood circulation in the brain, neurological disorders are observed: irritability, suspiciousness, emotional imbalance are noted. Memory, concentration of attention worsens, weakening of mental activity is observed. If left untreated, the disorders become irreversible.

Hypertensive angiopathy of both eyes

Since hypertension, as a rule, affects the vessels throughout the body, hypertensive angiopathy develops simultaneously in both eyes.

The disease progresses gradually, passing through certain stages in its development. Disorders of vascular function are manifested in the narrowing of the arterial lumen and the expansion of the venous lumen: this contributes to impaired blood circulation. As a rule, such changes are noticeable only with a careful examination of the fundus.

The dysfunction of the vessels gradually develops into a change in the arterial wall, which becomes thicker. It contains elements of connective tissue. Due to the thickening of the walls, the blood circulation in the retina is disturbed mainly due to the deterioration of the blood outflow.

Over time, microcirculation undergoes more and more disturbances: the appearance of edematous areas of the retina, or small hemorrhages, is observed. When examining the fundus, compacted narrowed arterial vessels are found, as well as dilated and tortuous venous vessels.

Hypertensive angiopathy of the retina is a disorder of the retina due to extreme disorders of blood circulation in it. The fundus of the eye is covered with areas of hemorrhages (microinfarcts) and lipid accumulations in the tissue layer of the retina. Retinal edema worsens.

In addition, the development of complications that are provoked by circulatory disorders and changes in the walls of blood vessels is not excluded. These complications include, first of all, impaired patency of the central retinal artery and its branches. Venous vessels also suffer: blockage of the main retinal vein and its branches is possible. The trophism (nutrition) of the optic nerve is disturbed. All complications are quite serious and can lead to a sudden and often irreversible deterioration in visual function.

Diagnosis of hypertensive angiopathy

For successful and adequate treatment of hypertensive angiopathy, it is necessary to conduct qualified diagnostics. Diagnostic methods selected and appointed by an ophthalmologist.

A common diagnostic method is ophthalmochromoscopy, which includes determining the number of vessels in red and redless light. The essence of this method is that the vessels (especially arterial) in the fundus in the red spectrum are not visible as well as in ordinary or redless light. Arterial vessels, narrowed in hypertensive angiopathy, are seen worse than normal vessels, and completely disappear from sight when viewed in red light. The use of this method can make it possible to objectively assess the condition of the blood vessels in the fundus.

An ultrasound of the vessels may be required, providing a complete picture of the blood circulation. Doppler scanning allows you to evaluate changes in the vascular walls. Sometimes an X-ray examination using a contrast agent is prescribed to observe the patency of the vascular lumen, or an MRI.

AT last years increased incidence of angiopathy and childhood. It is worth noting that in children the disease must be detected as quickly as possible, since circulatory disorders in the retina in a child proceed much more rapidly. Signs of angiopathy can be detected by a careful examination of the capillary network of the fundus.

Treatment of hypertensive angiopathy

Main medical measures in hypertensive angiopathy should be aimed at eliminating hypertension and stabilizing blood pressure. To do this, the doctor prescribes drugs that lower blood pressure.

Several groups are known medicines that can affect high blood pressure:

β-blockers - slow down the heart rate, reduce distal vascular resistance. These drugs include atenolol, lokren, etc.;
drugs that inhibit angiotensin-converting enzyme - inhibit the production of renin in the body, which provokes an increase in pressure. These are prestarium, capoten, spirapril, etc .;
agents that block calcium channels in the vascular walls and increase the vascular lumen (corinfar, felodipine, etc.);
diuretic drugs that remove excess fluid from the body (hydrochlorothiazide, clopamide, etc.).

Apart from antihypertensive drugs may use the following medicines:

drugs that dilate blood vessels. They are used to improve blood circulation, both in capillaries and in larger vessels. These agents include trental, vazonite, etc.;
drugs that improve blood circulation (solcoseryl, pentoxifylline, actovegin);
means that reduce the permeability of the vascular wall (parmidine, ginkgo, etc.);
blood thinners (aspirin, cardiomagnyl, dipyridamole);
vitamin complexes, including ascorbic and nicotinic acid, B vitamins;
means for improving metabolic processes in tissues (ATP, cocarboxylase).

Prevention of hypertensive angiopathy

Prevention of hypertensive angiopathy is directly related to the stabilization of blood pressure. This is especially true for people with a hereditary predisposition to hypertension. A healthy lifestyle and periodic examinations by a specialist cardiologist will help prevent the development of hypertension.

Thinking about the prevention of hypertensive angiopathy should be for everyone who periodically and even more so constantly experiences an increase in blood pressure.

First, it is necessary to pay attention to the habitual way of life and, perhaps, change it a little. Should be included in your daily routine physical exercise, consisting of morning exercises and periodic warm-up exercises. Biking, walking and light jogging are encouraged.

Secondly, it is necessary to establish a balanced dietconsisting of vegetables, herbs, berries and fruits, as well as cereals, lean meats and seafood. Be sure to reduce the amount of salt, exclude alcoholic and low-alcohol drinks. If there is excess weight, then it is important to take steps to normalize it.

Thirdly, you need to take care of your emotional state, avoid and resist stress, do not overwork, get enough sleep, find time, both for work and for good rest.

It has been scientifically proven that happy people rarely get sick hypertension and angiopathy, even in the presence of a hereditary predisposition. So the best prevention maybe besides healthy lifestyle life, moral well-being in the family and the presence of a favorite job.

Prognosis of hypertensive angiopathy

The prognosis of hypertensive angiopathy largely depends on timely treatment and stabilization of blood pressure.

Against the background of long-term high blood pressure without appropriate therapy, very serious complications can subsequently occur, leading not only to visual impairment, but sometimes to complete blindness.

If therapeutic measures are started on time, vascular changes can be reversible and completely disappear after stabilization of blood pressure.

Hypertensive angiopathy requires mandatory treatment. Moreover, constant signs of high blood pressure are a sufficient reason to contact not only a cardiologist, but also an ophthalmologist who will conduct a preventive examination and assess the condition of your vessels.

Hypertensive angiopathy of the retina is called the consequences of long-term hypertension, most often its stages I and II. With angiopathy, the veins of the fundus expand, their tortuosity changes, the lumen of the vessels becomes disproportionate, petechial hemorrhages are possible. The patient needs emergency treatment, since hypertensive angiopathy can lead to partial or even complete loss of vision.

What happens in pathology?

The hypertensive variant of angiopathy is caused by a persistent increase in blood pressure (arterial hypertension). In addition, there are a number of pathologies that can aggravate the situation and accelerate the development of the disease. These include injuries, metabolic problems, blood pathologies, osteochondrosis, age-related changes in blood vessels, intoxication, etc.

With a persistent increase in pressure in a patient, the veins of the fundus expand, small hemorrhages occur in the eyeball, and neuroregulatory dysfunction is also observed. If treatment is not started on time, the retinas of both eyes begin to “succumb” to the influence of hypertension and become cloudy. This pathology is successfully treated with timely therapy. At first, the disease usually does not manifest itself in any way, the patient does not feel discomfort and does not go to the doctor. That is why it is so important to pass preventive examinations from specialists at least once every six months or a year.

In some cases, hypertensive retinal angiopathy occurs along with damage to the veins and arteries of the urinary system, central nervous system and heart. In these cases, the disease can have really serious consequences not only for vision, but also for the health of the patient as a whole: hemorrhages in the brain and heart, neurological disorders up to the weakening of mental activity can be diagnosed. If you do not start treatment on time, the consequences will be irreversible!

Angiodystonia by hypertensive type

This pathology is not independent, but acts as one of the manifestations of other diseases. Angiodystonia is a decrease in vascular tone. This pathology can have different causes and different localization Problems. Angiodystonia manifests itself according to the hypertensive type in different ways, but the main symptoms are as follows:

headaches, different in strength, localization and character;
jumps in blood pressure;
dizziness;
sleep disturbance;
numbness of the limbs;
feeling of heaviness in the head;
constant feeling of tinnitus;
deterioration of memory, vision, hearing, smell, etc.

Hypertensive angioretinopathy

This disease is also associated with an increase in blood pressure. The patient has oxygen starvation of the retina due to problems with the vessels. If we talk about angiosclerosis of the retina, then in this case we are talking about organic changes in the vessels of the eye. We can say that both retinopathy and angiosclerosis are one of the last stages in the development of eye pathologies due to arterial hypertension.

What all of these pathologies have in common is what causes them. arterial hypertension. In addition, the differences between diseases are insignificant. For example, with angiopathy, functional changes in the arteries and veins are observed, with angiosclerosis - their organic changes, and with retinopathy - problems occur in the retina and fundus.

Rheoencephalography (REG) as a diagnostic method

Rheoencephalography allows you to assess the blood supply to the brain and blood circulation in it. Electrodes are placed on the patient's head, which record the necessary readings. The specialist examines the results of the examination and compares them with the norm. The patient may experience several types of vascular behavior.

Dystonic - characterized by constant jumps in vascular tone. With it, the so-called hypotension and reduced pulse filling are most often observed. This condition is often accompanied by problems with venous outflow.
The angiodystonic type of reg differs slightly from the dystonic type. In this case, also due to the pathology of the structure of the vessel wall, their tone is disturbed. Because of this, the elasticity of the veins and arteries decreases, and blood circulation becomes difficult.
The hypertonic type is characterized by a constant increase in the tone of the adducting vessels. At the same time, the outflow in the veins is also difficult.

All the described types of rheoencephalography are not separate diseases, but diagnostic "beacons" for finding a problem and assessing the blood circulation of the brain. They only accompany individual pathologies, but are not independent diseases.

Remember that only timely treatment of all these pathologies is the key to recovery and avoiding blindness. To protect yourself from serious consequences, you must follow the instructions of your doctor!