What does angiopathy mean?
When examining the fundus, the doctor evaluates the caliber of the arteries and veins, their course, walls and ratio. With increased pressure, the arteries narrow, their walls become denser, and at the intersections they compress the veins. In diabetes, microaneurysms and pinpoint hemorrhages appear in small vessels. If changes affect the retina itself—edema, exudates, and hemorrhages appear—they speak of retinopathy. The term “angiopathy” is more often used in domestic practice; It is important to understand what disease causes the changes and how pronounced they are.
- Hypertensive angiopathy
- Diabetic angiopathy and retinopathy
- Atherosclerotic angiopathy
- Traumatic angiopathy
- Angiopathy during pregnancy
- Transient changes in newborns
Causes and risk factors
The most common cause is arterial hypertension: prolonged high blood pressure gradually damages the walls of small arteries. In diabetes, high glucose levels damage the inner layer of capillaries, making them leaky and fragile. Atherosclerosis and high cholesterol narrow the lumen of blood vessels. Kidney diseases, anemia, blood diseases and vasculitis also change the picture of the fundus. In pregnant women, changes in retinal vessels may be a sign of preeclampsia. In newborns after childbirth, dilation of the retinal veins is often temporary and goes away without treatment.
- Arterial hypertension
- Diabetes mellitus
- Atherosclerosis and high cholesterol
- Smoking
- Chronic kidney disease
- Blood diseases and vasculitis
- Preeclampsia during pregnancy
Symptoms
Angiopathy is asymptomatic for a long time and is usually detected during a routine examination or examination for blood pressure and diabetes. A person may notice eye fatigue and blurred vision, but these complaints are nonspecific. When changes turn into retinopathy, a veil appears, spots before the eyes, distortion of objects, and decreased visual acuity. Sudden, painless loss of vision in one eye may indicate vein thrombosis or retinal artery occlusion. Against the background of a hypertensive crisis, flashing before the eyes and headache are possible.
- More often - no symptoms
- Blurred vision
- Spots and veils before the eyes
- Distortion of objects
- Flickering during pressure surges
- Sudden loss of vision due to thrombosis
What examinations are needed
The ophthalmologist examines the fundus with dilation of the pupil, assesses the stage of changes and, if necessary, prescribes optical coherence tomography to detect retinal edema and fluorescein angiography to assess blood flow. At the same time, you need to find out the reason. Blood pressure measurements, 24-hour monitoring, ECG, glucose and glycated hemoglobin analysis, lipid profile, creatinine and urinalysis to evaluate the kidneys are carried out. A cardiologist or therapist selects treatment for hypertension, an endocrinologist for diabetes. For people with diabetes, fundus examinations are recommended at least once a year.
- Fundus examination with pupil dilation
- Optical coherence tomography
- Fluorescein angiography according to indications
- 24-hour blood pressure monitoring and ECG
- Glucose and glycated hemoglobin
- Lipid profile
- Creatinine and urinalysis
Treatment and prevention
There are no special tablets or drops that specifically treat angiopathy, and courses of vascular medications without indications have not proven effective. The main thing is to control the disease that caused the changes: regularly take prescribed blood pressure medications, maintain target glucose and cholesterol levels, stop smoking, lose weight and limit salt. For diabetic retinopathy and macular edema, the ophthalmologist prescribes laser coagulation or intravitreal injections, and for severe complications, vitrectomy. Pregnant women with changes in the vessels of the fundus need monitoring by an obstetrician-gynecologist.
- Regular blood pressure monitoring
- Maintaining target glucose levels
- Reducing cholesterol
- Quitting smoking
- Weight loss and salt restriction
- Laser photocoagulation and injections for retinopathy
- Regular fundus examinations
