Thrombosis of blood vessels and the central vein of the retina. Thrombosis of the blood vessels of the eye: symptoms and treatment of pathology How to restore vision after eye thrombosis

One of the most important components of the circulatory system, contributing to the enrichment of the eyes with vital components, is the central retinal vein.

The formation of blood clots disrupts normal blood flow in the vessels of the eyes.

Retinal vein thrombosis interferes with the normal functioning of the system, which causes deterioration, provoking the development of ophthalmological diseases. With this disorder, vision most often decreases and blindness occurs.

Causes

Most often, thrombosis of the blood vessels of the eye occurs due to the formation of blood clots. At the same time, blood is thrown into the capillary of the eye in which the blockage has occurred. As a result, blood pressure increases, which can cause retinal hemorrhages and significant swelling.

Common causes of blood clots in the blood vessels of the eyes are:

the development of atherosclerosis of the arteries most often causes blockage of the central vein of the retina;
presence of arterial hypertension;
progression of diabetes mellitus, regardless of type (pathology occurs with sudden surges in sugar that occur with poor compensation of diabetes);
flu;
presence of blood poisoning;
infections in the mouth and sinuses;
regular high pressure inside the eyes;
presence of papilledema;
presence of a tumor.

Most of the reasons mentioned above provoke thickening of blood vessels, due to which nearby arteries can compress the retinal veins. The result of this effect is a slowdown in normal blood circulation, which causes blockages to form. When venous blood stagnates, the inner surface of the eye suffers, since the vascular walls become permeable, causing extensive hemorrhage and swelling.

Risk group

The following factors contribute to the development of retinal vein blockage:

Non-surgical eye treatment in 1 month.

passive lifestyle;
excess body weight;
presence of cardiovascular diseases;
problems with the functioning of the endocrine glands;
incorrect choice of therapy for the treatment of hypertension, diabetes and other diseases.

The risk group includes people with problems with the normal functioning of the endocrine system, in particular if the pathology is not treated correctly and in a timely manner. Thrombosis occurs no less often in older patients. In this case, there is an age-related deterioration in the quality of vision, but the blockage of the veins develops suddenly. Also, the development of pathology can be provoked by the presence of primary glaucoma, trauma to the eyeballs and changes in blood viscosity.

Stages of thrombosis

Thrombosis of the central vein of the retina is divided into stages of development:

State of prethrombosis - at this stage, the veins of the patient’s eyes are uneven, dilated and tortuous with hemorrhages having a thread structure. Swelling of the central region of the retina appears. This stage is characterized by an inconspicuous course of the disease. The patient may experience a slight deterioration in general condition, against the background of which malaise and isolated cases of blurred vision may occur.
Thrombosis - the surface of the retina is covered with numerous hemorrhages. At the same time, vision decreases significantly, a veil appears before the eyes and spots appear.
Retinopathy is a post-thrombolytic condition that is chronic. The first manifestation is noted after a couple of months. The fundus of the eye is covered with old hemorrhages and solid fluids. The presence of new formed vessels, which should not be present in healthy eyes, is also noted. Swelling of the central zone still persists. At this stage, it is important to continue treatment, since the pathology can recur.

Symptoms

Thrombosis of the central retinal vein can be diagnosed based on the symptoms accompanying the development of the disorder.

Symptoms of the pathology are:

Sudden loss of visual acuity. As a rule, the disorder develops over a period of several hours to several weeks. During this time, the patient does not feel pain or discomfort.
Floaters may appear before the eyes. The vision becomes clouded. Such manifestations are not necessarily long-term; they may appear periodically and disappear again. Most often, patients encounter this manifestation in the morning after waking up after sleep. It is not uncommon to experience blind spots when looking at objects. The extent of such manifestations depends on the severity of the blockage.
Swelling gradually begins to appear. It is clearly visible during the examination through ophthalmoscopy, since the specialist has difficulty determining the edge of the optic nerve head.
The vitreous body becomes covered with hemorrhages, which can resolve within several months. In this case, the quality of vision is not restored.
Damage to the back of the retina may occur. In this case, the pathology does not provoke vision loss. Maculopathy is characterized by the development of secondary posthemorrhagic glaucoma and degeneration of the retina.

Diagnostics

A specialist can make an accurate diagnosis after using several diagnostic methods. In one case, fundus ophthalmoscopy is sufficient for this. Angiography is used to determine the extent of the lesion. The anterior areas of the eyes are also examined. Additionally, the following indicators may be needed:

blood pressure level;
blood clotting index;
urine and blood test indicators, biochemistry.

Treatment

To avoid the negative consequences of blockage, the pathology should be identified and treated in a timely manner. When treating central vein thrombosis, it is necessary to:

ensure resorption of the resulting hemorrhages;
improve the quality of blood supply to the retina and reduce its swelling;
improve the quality of nutrition of retinal cells;
reduce pressure inside the eyes.

The following medications are used to treat the disease:

Nifedipine, Phenigidine - normalize blood pressure;
Lasix – lowers blood pressure and relieves swelling;
Timolol – reduces external pressure on the retina;
Plasminogen – accelerates the destruction of thrombotic formations;
Clexane, Novoparin - prevent the formation of new blockages and stop the development of existing ones;
Plavix and Trental - used to prevent the formation of new blood clots;
Lucentis and Ozurdex help reduce macular edema and prevent hemorrhages.

If conservative methods do not produce results, a specialist may prescribe surgery. This procedure is called laser coagulation.

Complications

If diagnosed early, a blood clot in the eye can be treated. In this case, vision restoration begins within several months after the end of therapy. Swelling gradually decreases, hemorrhages resolve.

If you ignore the specialist’s prescriptions, complications may develop in the form of:

secondary glaucoma;
retinal dystrophy;
optical neuropathy;
blood entering the vitreous body.

Forecast

Improper treatment of central retinal vein thrombosis can worsen the quality of vision without return. In this case, the patient will not only become blind, but also lose his ability to work and acquire the status of a disabled person. In order not to encounter the negative consequences of pathology, you should pay attention to preventive measures and regular examination by a specialist. When a diagnosis of “central vein thrombosis” is made, you should strictly adhere to the ophthalmologist’s prescriptions; improvement in the condition can be expected in a short period.

The course of the pathology may be accompanied by a significant decrease in the quality of vision. Complete loss of visual function is possible. The severity of possible complications directly depends on which vein is affected by the disease. Damage to the lateral veins causes the least harm, since in this case the quality of vision will gradually be restored. Damage to the central veins takes much longer to repair. In severe forms of the pathology, the likelihood of restoring visual functions is minimal.

Prevention

Blockage of the central retinal vein is easier to prevent than to treat. To do this, you need to follow the recommendations of specialists:

you should lead a healthy lifestyle and give up bad habits;
Eliminate foods that increase blood pressure from your diet as much as possible;
move more, increase activity through sports;
develop the ciliary muscle by performing special exercises;
visit an ophthalmologist as often as possible to check the condition of the retina and eyes in general;
treat problems of the cardiovascular system in a timely and correct manner, do not forget to monitor blood pressure.

Eyes are important human organs. The condition of the eyes largely depends on the patient’s lifestyle. We must not forget about the need to take care of them.

Source: proglazki.ru

Thrombosis of the central retinal vein

Retinal vein thrombosis is a circulatory disorder in the most important vessels of the eye - the central retinal vein (CRV) and its branches. This is the most common cause of visual impairment or even blindness. Out of one hundred thousand people, two hundred have this pathology. Only in 30% does thrombosis of a branch of the central vein occur, and more often the vein itself is affected.

Causes

As a rule, retinal thrombosis most often occurs in elderly people due to the following diseases:

atherosclerosis;
hypertension;
diabetes mellitus;
inflammatory and destructive processes of the walls of blood vessels (vasculitis);
various disorders affecting blood clotting.

Possible causes of thrombosis of the central nervous system of the eye:

complication after viral and infectious diseases;
increased pressure inside the eye;
swelling of the optic nerve;
tumor inside the eye;
autoimmune ophthalmopathy.

Patients at risk are:

obese;
with thyroid diseases;
leading a sedentary lifestyle;
alcohol abusers.

Symptoms

This disease passes without any special symptoms. The development of thrombosis can occur in just a few hours, manifest as deterioration or even cause complete loss of vision in one eye, and in some cases both.

With thrombosis of the branches, symptoms may manifest as:

dark spots;
fog in the eyes;
distorted vision;
sensation of pain when blinking, as if sand had gotten into the eyes.

However, more often, for example, if the center of the retina is not affected, vision is preserved and the disease can only be detected during examination. Therefore, it is so important to periodically visit an ophthalmologist, especially for patients at risk.

Varieties

according to the degree of retinal changes;
by stages of development.

Degrees

In the first case, the pathology is divided into:

non-ischemic - mild retinal damage that has virtually no effect on vision;
ischemic thrombosis - a serious disturbance of blood flow, severe damage to the vessels of the retina, extensive hemorrhages, while visual acuity is significantly reduced, and there is a high risk of complete loss.

The degree of ischemia directly affects the level of vision.

Stages of development

This pathology is characterized by several stages in its development:

Prethrombosis state - characterized by the presence of uneven, dilated, tortuous veins, thread-like hemorrhages, the central region of the retina swells. As a rule, the patient at this stage does not feel the presence of the disease, and not numerous blurred vision is considered a consequence of malaise.
Thrombosis itself - characterized by the appearance of hemorrhages on almost the entire surface of the retina, visual acuity noticeably decreases, and sensations of a veil and floaters appear more often.
Post-thrombotic condition (retinopathy) is a chronic thrombosis that appears over several months. The fundus has old hemorrhages, hard exudates, and the presence of newly formed vessels, which are not present in normal conditions. The central zone has an edematous state.

The disease may recur.

Diagnostics

Symptoms of thrombosis, especially in the initial stages, are practically impossible to determine without diagnosis. Recognizing the disease is not difficult for highly qualified specialists using diagnostic techniques:

Perimetry;
Visometry;
Biomicroscopy;
Ophthalmoscopy;
Laboratory tests;
ECG, blood pressure measurements, retinal OCT;
Angiography of retinal vessels.

The prognosis of the disease with correct, timely treatment prescribed by the attending physician is usually favorable. Various complications (optic atrophy, glaucoma, retinal dystrophy, and so on) are possible only if treated incorrectly.

Treatment

The main task in case of thrombosis is to detect the disease in time and begin to treat it as quickly as possible.

Medications

The use of medications is aimed at the following actions:

dissolution of hemorrhages;
restoration of blood circulation;
normalization of retinal nutrition;
reduction of swelling.

The following means are used:

Antihypertensive (hypotensive) - reduce blood pressure, reduce swelling of the retina (intravenous injections of Dibazol, Papaverine, oral tablets - Lizoril, eye drops - Arutimol, Timolol);
Fibrinolytic agents - promote the resorption of blood clots, restore blood circulation (daily eye injections of Plasminogen, Fibrinolysin, 0.5 milliliters for two weeks);
Antithrombotic (anticoagulant) agents are used after a course of fibrionalytics to prevent blockages of the vessel. The direct-acting anticoagulant “Heparin” is used as a complex injection intramuscularly and into the lower eyelid area, the course is a week;
Antiplatelet drugs - to prevent recurrence of the disease: Aspirin, Plavix tablets;
Hormonal agents - serve to relieve inflammation and swelling. Drugs containing the active substance dexamethasone are administered by injection into the lower eyelid for a week;
Vitamins - groups C and B.

Treatment at home

It is important to understand that it is impossible to fully cure eye thrombosis with folk remedies. They serve rather to prevent this disease. At the first suspicion, be sure to contact a qualified specialist.

This includes the following options:

Drops

Take twenty grams of herbs, for example: cumin, cornflower flowers or plantain leaves, insist on two hundred grams of boiling water, strain. Instill five times a day during the entire course of treatment.
Take clover, woodlice, squeeze out the juice and bury it.

Contraindications are possible in case of individual intolerance to the components.

Compresses

Compresses are made from tea leaves, cucumber juice, and herbal infusions. Twenty grams of any ingredient are poured with boiling water and left for an hour. The mixture in gauze is placed on the eyelids and kept for half an hour to fifty minutes. The procedure is carried out for two weeks, then after a break of fourteen days, the course is repeated.

Infusions, decoctions

It is good to use infusions from the following plants:

hawthorn flowers;
sage;
mint leaves;
lemon balm;
elecampane root and others.

They can be brewed as tea, or the decoction can be infused in a thermos, or a vodka tincture can be prepared for ten days.

Gymnastics and massage

There are many options for eye exercises, here are some of them;

Open and close your eyes with tension (five times); look right, left, up, down (five times).
Blink intensely for two minutes.
Massage with light pressure on the eyeball for two seconds. Repeat up to ten times.

Laser surgery

Laser treatment (laser coagulation) has a great effect; it is used after therapeutic treatment with medications, if the disease is ischemic in nature and the use of pharmaceutical drugs does not produce noticeable results.

The intervention is based on the effect of a laser on a blood clot, with the aim of resolving it and, as a result, normalizing blood flow in the retina.

Prevention

In order to fully treat such a disease, it is necessary not only to use medications and laser surgery, but also to adhere to therapeutic rules:

reduction of loads;
following a diet that normalizes blood pressure.

The diet for the prevention of thrombosis consists of:

at least two liters of fluid per day;
a large number of vegetables and fruits;
seafood, fish;
low-fat dairy products.

And also be sure to include in the diet:

dates;
soy products;
beef liver;
nuts;
legumes;
cereal;
asparagus;
nettle and mint leaves;
watermelon;
salad;
spinach;
blueberries.

It is necessary to exclude from the diet everything fatty, fried, baked goods, chocolate, coffee, and alcohol.

The products indicated for consumption do not need to be consumed all at once, but they should be present in the daily diet to prevent thrombosis. If you follow all the doctor’s recommendations, the prognosis for treatment and prevention of recurrence is always positive.

Source: glazexpert.ru

Thrombosis of blood vessels and the central vein of the retina

Article publication date: 09/16/2018

Article updated date: 05/30/2019

Thrombosis of blood vessels and the central retinal vein (CRV) is a dangerous pathological condition characterized by blockage of the central retinal vessel and its branches with blood clots. The result of the disease is a circulatory disorder.

This pathology is diagnosed in many people and is a common cause of loss of visual function and disability.

The mechanism of pathology development

Most often, thrombosis of the central retinal vein and its individual branches is determined in humans. The condition is characterized by a sharp disruption of normal blood flow through the orbital veins and vessels.

If there is a blockage of the central vein, then there is a violation of the outflow of blood. It begins to accumulate in the vessels, which contributes to their deformation. The vascular walls become denser, which leads to slower blood flow. Gradually, a blood clot forms, disrupting normal blood circulation.

Prolonged stagnation of blood leads to the release of its liquid part into the tissues around the vessel. There is an increase in pressure inside the eye, and hemorrhage and swelling may develop. One possible consequence is macular edema, a swelling of the central region of the retina.

In such a case, the condition is dangerous; complete restoration of vision remains in question.

If the blood supply to the eye is disrupted, optic nerve ischemia is often diagnosed, characterized by a sharp decrease in visual function and monocular blindness. The disease occurs more often in men and can lead to complete loss of vision.

Occlusion of the central retinal artery (CRA) and its branches poses a serious danger due to the rapid development of unpleasant symptoms and irreversible consequences.

Types of thrombosis

Depending on the degree of damage to the retinal veins, two types of thrombosis are distinguished:

Ischemic. With this type, most of the vessels in the eyeball are damaged. A serious hemorrhage in the retina is diagnosed, and visual function is seriously reduced. Irreversible consequences may develop if treatment is not started on time.
Not ischemic. A small area of blood vessels is affected, there is no hemorrhage, visual impairment is minimal and unnoticed by the patient.

In medicine, there is also the concept of complete and incomplete thrombosis of the central vein. The first group includes the ischemic form, the second – non-ischemic. The degree of ischemia directly affects the quality of a person’s vision.

Reasons for development

This pathological condition develops as a consequence of various health problems of the patient.

There is a division of the most common causes according to the patient’s age:

Factors that provoke the development of the disease are also identified:

Increased body weight.
Passive lifestyle.
Alcohol abuse.
Lack of vitamins in the body.

These factors are not capable of independently triggering the development of thrombosis, but their combination increases the likelihood of its occurrence several times. This disease affects women and men equally.

Clinical picture

Thrombosis develops gradually. With partial occlusion, a person does not notice any bright signs, the change in vision is minimal. The disease is often diagnosed accidentally during an examination by a doctor.

A sick person may experience:

Slight decrease in visual function.
Peripheral hemorrhages.
Pallor of the arteries.
Areas of excess blood are difficult to discern.

The ischemic form of thrombosis is characterized by the presence of more pronounced symptoms:

Massive hemorrhages.
Severe swelling.
Excess blood accumulation is very noticeable.
Noticeable loss of vision.
Poor reaction of the pupils to light.
Marked narrowing of the ophthalmic artery.

There are several stages of thrombosis. Each of them is characterized by the development of different symptoms.

The first stage is called prethrombosis. At this stage, venous blood stagnates. The veins become wider, darken, and tortuosity of the vessels appears. The center of the retina becomes swollen. At the first stage, a person may experience blurred vision; this phenomenon is not perceived as a symptom of the disease.
The second stage is thrombosis. It is characterized by serious circulatory disorders, the occurrence of hemorrhages in the retina and other parts of the eyeball. The boundaries of the optic nerve are poorly visible or not visible at all. Macular edema is present and visual function is severely impaired. The patient notes the presence of a veil before the eyes, loss of visual boundaries. In the absence of adequate treatment, complete or incomplete thrombosis develops, and pathological changes in the retina are noted.
Postthrombotic retinopathy is the third stage of the disease. The return of a person's vision occurs at a slow pace. Unnatural capillary formations are diagnosed. There are residual hemorrhages in the fundus. During the recovery period, new blood vessels may form in places where they should not be.

Unfortunately, relapse of the disease is possible in the absence of proper treatment.

Diagnostics

An experienced ophthalmologist can easily determine the degree of thrombosis. Diagnosis of the disease consists of interviewing the patient and conducting specific examinations. The doctor finds out when changes in visual functions began, what medications the patient is taking, and whether the person has certain diseases.

After conducting a survey and collecting information, studies are prescribed using special techniques:

Visometry. The method involves studying visual acuity. In the ischemic form of thrombosis, the severity exceeds 0.1, in the non-ischemic form - below this indicator.
Tonometry. During the study, the pressure in the eyeball is measured. Indicators are taken throughout the day. In a diseased organ, the numbers will be 2-3 mmHg. Art. lower than in a healthy person.
Perimetry. A method that helps determine the narrowing of the field of vision (scotoma). With thrombosis, a similar phenomenon is observed in the area of the affected retina. The density of the scotoma varies with different amounts of hemorrhage and the presence of ischemic foci.
Microperimetry. The method is used to determine the reaction of certain parts of the retina to light, which allows you to accurately identify the affected area.
Biomicroscopy. Allows you to see signs of thrombosis: crushing of the anterior chamber of the eye, a suspension of blood in the vitreous body, lack of a friendly reaction of the pupils when illuminating the diseased eye.
Optical coherence tomography. Examination using a scanning beam helps determine the structure, size of swelling and features of the course of the disease. The method is used to evaluate the effectiveness of treatment.
Fluorescein angiography (FA). An effective technique that helps determine the type of thromboembolism, the degree of the pathological process, the affected area, and the period of onset of the disease. The method is often used during the first examination; it helps determine the presence of thrombosis if other methods have not helped.

After confirming the diagnosis, appropriate treatment is prescribed aimed at eliminating the causes and symptoms of thrombosis and restoring visual function.

Self-determination of the disease at an early stage is impossible.

Symptoms are minimal; people often do not pay attention to minor visual impairment. Intense signs are observed during a serious course of the disease, when the person no longer sees well.

A preventive ophthalmological examination is required at least once every 6 months. Regularly visiting a medical specialist will help you not to miss the onset of the disease and select therapy on time.

Principles of treatment

Treatment of thrombosis depends on the severity of the disease. For uncomplicated types, the use of medications is sufficient.

Complicated forms of thrombosis will require surgical intervention. The choice of treatment method remains with the doctor.

Conservative treatment

The use of medications helps restore normal blood circulation in the eyeball and visual functions.

The doctor will select medications based on the degree of thrombosis and the patient’s condition. Before treatment, the patient must inform the doctor about the medications he is taking.

Medicines used in therapy:

Medicines that lower blood pressure. These can be tablets - Nefedipine, Phenigidine. A solution of the drug Dibazol is administered through a vein; Lasix is used for intramuscular administration. Timolol will help reduce pressure in the eyes.
It is possible to normalize blood flow with the use of fibrinolytic drugs. The drug Plasminogen is injected into the under-eye space for two weeks.
To avoid relapse of the disease, the patient may be prescribed Acetylsalicylic acid. The intake is carried out under the supervision of a doctor to monitor blood clotting.
Special hormonal drugs are used to reduce swelling and inflammatory processes. Dexamethasone is often used for a similar purpose - administered under the eyeball, or in the form of droppers.
If there is pain, analgesics are used.
Vitamin complexes are required, with the main focus on ascorbic acid and B vitamins.

All medications are prescribed by a doctor. Independent choice of medications can lead to an exacerbation of the process and serious negative consequences.

Surgical methods

Even after successful drug treatment, the patient is recommended to undergo laser coagulation of the retina. The operation is performed under local anesthesia on an outpatient basis. Its duration is no more than half an hour.

It is performed by a qualified ophthalmologist. During surgery, a laser is applied to the blood clot, causing it to dissolve. The result is the restoration of normal blood flow in the vessels of the eyeball.

The operation has some contraindications:

Retinal disinsertion.
Presence of cataracts.
Hemorrhages are diagnosed in the fundus.
Reduced transparency of the eye media.

Possible consequences

In 10% of all cases of vascular thrombosis, complete loss of vision is possible. This complication often occurs as a result of ischemia of the entire central vein and optic nerve atrophy.

Insufficient blood supply leads to other complications after thrombosis:

Atrophic changes in the nerve.
Repeated macular edema.
Secondary glaucoma.

The appearance of a scotoma is possible - an area of the retina of the eyeball with altered or lost visual acuity.

Forecast

With proper and timely treatment, vision can be restored completely. Incomplete recovery or loss is diagnosed in 10% of all cases of the disease.

To quickly recover from ocular vascular thrombosis, it is recommended to limit physical activity, avoid sudden movements, cover your eyes with sunglasses, and keep your blood pressure under control.

It is necessary to stop watching TV and working at the computer for a long time.

Prevention of recurrent thrombosis

It is possible to avoid relapses of the disease by following preventive measures:

Monitor blood pressure readings.
Monitoring glucose levels in diabetes mellitus, taking prescribed medications.
Diseases of the endocrine system require careful attention and treatment.
Be sure to visit an ophthalmologist once every six months.

For prevention, it is permissible to perform some exercises that help improve vision.

Compresses made from tea leaves, herbal infusions, and cucumber juice have a good effect on the condition of the eyes. Moisten gauze into the infusion of any element and place it on the eyelids for half an hour. Repeat this procedure for 14 days, take a break for the same amount of time and repeat. It is recommended to use infusions of hawthorn flowers, mint leaves, lemon balm, and sage, brewed as tea.

Source: infoserdce.com

Retinal thrombosis - methods of diagnosis and control

Alas, now ophthalmologists often report retinal thrombosis. Moreover, this phenomenon has become significantly younger over the past 5 years - the blood vessels of the eyes are in a “deplorable” state not only in older people. First of all, this condition should be feared by those suffering from diabetes and hypertension, as well as people with glaucoma (increased intraocular pressure).

Causes

Retinal vascular thrombosis is always a consequence of long-standing chronic eye pathology and/or systemic therapeutic diseases.

Risk factors and precursor diseases of retinal thrombosis:

Atherosclerosis . The deposition of “harmful” lipids in the inner lining (intima) of blood vessels leads to damage to their walls. In response to this, inflammation occurs, which provokes the migration of coagulation factors to the site of damage and increased thrombus formation.
Diabetes. This disease not only aggravates the course of atherosclerosis, but also contributes to the fragility and pathological tortuosity of blood vessels. There is even the term “diabetic retinopathy” - pathological changes in the vessels of the retina as a result of damage by structurally altered glycosylated (saturated sugars) proteins.
Arterial hypertension . People with high blood pressure should be especially wary of retinal vascular thrombosis. Due to hypertension, the smallest vessels are damaged, blood supply is disrupted and the formation of blood clots is accelerated.
Vasculitis - from Latin the term literally translates as “inflammation of blood vessels.” It occurs as an allergic reaction or as a result of connective tissue and blood diseases (hemorrhagic vasculitis, systemic lupus erythematosus, scleroderma, etc.).
Protruding eyes due to long-term and persistent thyrotoxicosis . Excess thyroid hormones affect the periorbital tissue - it begins to grow. The eyeball literally “sticks out” outward. The vessels cannot keep up with it - they burst and thrombose.
Tumors . They can grow both from eye tissue and metastasize from other organs. Sometimes a piece of tumor that gets into the vessel blocks its lumen. Read more about neoplasms of the eyelids and eyeball →

Stages and types of retinal thrombosis

Central retinal vein thrombosis (CRVT) can be of two types:

thrombosis of the central vein, scientifically - central occlusion;
thrombosis of one or more branches of the central vein - peripheral occlusion.

This division is necessary to assess the following parameters:

Damage area . With thrombosis of the central vein, most of the retina is damaged, and if there is a thrombus in a small venule, only a small area may be affected.
Severity of possible consequences and urgency of hospitalization . Central vein thrombosis is dangerous due to significant loss of vision and requires immediate hospitalization. Thrombosis of the peripheral retinal veins, with early diagnosis and a small affected area, can be treated even on an outpatient basis.
Scope of ophthalmological care . Treatment for central occlusion will be more prompt and extensive than for peripheral occlusion.

Stages of the thrombotic process in the retina

The development of the disease occurs in several stages:

Prethrombosis . It is characterized by dilation and tortuosity of the veins, single point hemorrhages. At this stage there are no clinical manifestations yet, but periodic blurring before the eyes may appear.
Direct thrombosis . Numerous linear hemorrhages, swelling of the macula on the retina, which is responsible for color perception, and unclear boundaries of the optic nerve head are visible in the fundus. There is a sharp decrease in visual acuity and a persistent “veil” before the eyes.
Postthrombotic changes . Traces of hemorrhages and newly formed vessels with thin walls are visible in the fundus. Visual acuity recovers slowly.

Clinical symptoms and diagnosis of retinal thrombosis

Symptoms largely depend on the location of the blood clot and the degree of narrowing of the vessel (occlusion).

If there is thrombosis of the central vein of the retina, at least 3/4 of the retina is damaged: there will be large multiple hemorrhages, rapid deterioration of vision and distortion of color perception.

If thrombosis of a branch of the central retinal vein (a small branching vessel) occurs, visual acuity decreases slowly and is often not regarded as an alarming symptom. Blurry black spots or a “fog” may appear in the field of vision.

Complete occlusion (occlusion of the vein lumen by 95% or more) has pronounced clinical symptoms. Fortunately, it is rare. Partial occlusion may not be clearly visible. The manifestation of signs of thrombosis begins when the lumen of the vessel narrows by 70 percent or more.

Thrombosis of the central retinal artery is always an urgent (emergency) condition that requires prompt qualified assistance! If with venous occlusion there is a chance to preserve vision, then with occlusion of the central nervous system there is a risk of complete blindness.

Diagnostics

A 100% specific sign of thrombotic changes in the retina during fundus examination with a magnifying glass is the appearance of a “crushed tomato.”

Also, during visometry, reduced visual acuity is diagnosed - a person cannot see the lines of letters and notes that he has begun to see worse than the day before.

Angiography with fluorescent contrast agent will help make a final diagnosis and pinpoint the location of the thrombus.

Treatment

Treatment is carried out in 4 stages:

Restoring blood flow in a thrombosed vessel.
Reducing retinal edema.
Dissolution and elimination of formed hemorrhages (if they are small in area).
Improving microcirculation in the retina.

Therapy methods

To treat retinal thrombosis, an integrated approach is used:

The clot can be dissolved by Fibrinolysin or Plasminogen. They are administered using a syringe under the eye. The only caveat: no more than 2 hours should pass from the onset of clinical manifestations of thrombosis.
Heparin in the form of injections, Warfarin or Clopidogrel are used to prevent further thrombus formation and reduce blood clotting in small vessels.
Trental can improve blood circulation and protect the walls of blood vessels from hypoxia. It is administered intravenously 2 times a day.
Retinal edema is treated by injecting glucocorticosteroid solutions (Prednisolone, Hydrocortisone) into the tissue around the eye. For severe pain in the eye, anti-inflammatory drugs are prescribed intravenously.

Traditional therapy

In addition to traditional therapy, there are many traditional medicines. But they are used only for preventive purposes. To maintain the elasticity of the walls of blood vessels, nettle decoction, sage tincture, mint in all varieties (tincture, tea, juice) are suitable. Forest honey helps improve vision.

Drops made from freshly squeezed clover or cornflower juice are excellent in preventing eye diseases. Take 1 tablespoon of chopped herbs per glass of boiling water. The mixture is infused for 2 days, then filtered. You need to put 2 drops in each eye at least 4 times a day.

Natural remedies are, of course, good, but not for emergency help. They can slow down the rate of development of pathological changes. But in the presence of complications or severe neglect of the process, only traditional, scientifically proven methods can save.

Since complications of a blood clot in the retina include, at a minimum, decreased vision, and a maximum of optic nerve atrophy and complete blindness, it is important to recognize the symptoms in time and provide qualified assistance. But it’s easier to prevent negative consequences.

Prevention measures

Retinal thrombosis can actually be prevented. You just need to undergo annual examinations and follow your doctor’s prescriptions. Methods for preventing retinal vein thrombosis depend on the presence of a specific risk factor and concomitant pathology.

In case of hypertension, medications are needed to normalize blood pressure. There are many of them; an individual combination is selected for each patient. You should consult a cardiologist regarding the effects of specific medications.
For all types of diabetes, the main task is to achieve a constant normal blood glucose level. This can be achieved through diet, adequate physical activity and carefully selected medications. For type 1 diabetes, you need to set the dosage of insulin, for type 2 diabetes, the type and frequency of use of glucose-lowering drugs.
Any eye diseases require increased attention. Under no circumstances should glaucoma be advanced. Not only does it threaten thrombosis of the blood vessels of the eye, it also leads to a complete absence of lateral vision. People with various types of retinopathy (diabetic or hypertensive) need to be checked by an ophthalmologist once every six months.
Correction of hormone levels. If the thyroid gland is overactive, medications that reduce thyroxine levels are needed. Women are not recommended to get carried away with oral contraceptives - they increase the risk of blood clots.
Prevention of increased aggregation (“sticking together”) of platelets - take Aspirin (ThromboASS or Plavix) daily, 1 tablet per day. This is especially necessary for those who suffer from cardiovascular diseases.

Vision is a special sense organ, without which a person loses the ability for self-care and normal social life. Patients with eye diseases should understand that thrombosis of the blood vessels of the eyes leads to irreversible changes. No operation will return or “resurrect” the retinal neurons that died as a result of oxygen starvation. It is better to start preventing retinal thrombosis right now.

Causes

Retinal vascular thrombosis is always a consequence of long-standing chronic eye pathology and/or systemic therapeutic diseases.

Risk factors and precursor diseases of retinal thrombosis:

Atherosclerosis . The deposition of “harmful” lipids in the inner lining (intima) of blood vessels leads to damage to their walls. In response to this, inflammation occurs, which provokes the migration of coagulation factors to the site of damage and increased thrombus formation.
Diabetes. This disease not only aggravates the course of atherosclerosis, but also contributes to the fragility and pathological tortuosity of blood vessels. There is even the term “diabetic retinopathy” - pathological changes in the vessels of the retina as a result of damage by structurally altered glycosylated (saturated sugars) proteins.
Arterial hypertension . People with high blood pressure should be especially wary of retinal vascular thrombosis. Due to hypertension, the smallest vessels are damaged, blood supply is disrupted and the formation of blood clots is accelerated.
Vasculitis - from Latin the term literally translates as “inflammation of blood vessels.” It occurs as an allergic reaction or as a result of connective tissue and blood diseases (hemorrhagic vasculitis, systemic lupus erythematosus, scleroderma, etc.).
Protruding eyes due to long-term and persistent thyrotoxicosis . Excess thyroid hormones affect the periorbital tissue - it begins to grow. The eyeball literally “sticks out” outward. The vessels cannot keep up with it - they burst and thrombose.
Tumors . They can grow both from eye tissue and metastasize from other organs. Sometimes a piece of tumor that gets into the vessel blocks its lumen.

Stages and types of retinal thrombosis

Central retinal vein thrombosis (CRVT) can be of two types:

thrombosis of the central vein, scientifically - central occlusion;
thrombosis of one or more branches of the central vein - peripheral occlusion.

This division is necessary to assess the following parameters:

Damage area . With thrombosis of the central vein, most of the retina is damaged, and if there is a thrombus in a small venule, only a small area may be affected.
Severity of possible consequences and urgency of hospitalization . Central vein thrombosis is dangerous due to significant loss of vision and requires immediate hospitalization. Thrombosis of the peripheral retinal veins, with early diagnosis and a small affected area, can be treated even on an outpatient basis.
Scope of ophthalmological care . Treatment for central occlusion will be more prompt and extensive than for peripheral occlusion.

Stages of the thrombotic process in the retina

The development of the disease occurs in several stages:

Prethrombosis . It is characterized by dilation and tortuosity of the veins, single point hemorrhages. At this stage there are no clinical manifestations yet, but periodic blurring before the eyes may appear.
Direct thrombosis . Numerous linear hemorrhages, swelling of the macula on the retina, which is responsible for color perception, and unclear boundaries of the optic nerve head are visible in the fundus. There is a sharp decrease in visual acuity and a persistent “veil” before the eyes.
Postthrombotic changes . Traces of hemorrhages and newly formed vessels with thin walls are visible in the fundus. Visual acuity recovers slowly.

Clinical symptoms and diagnosis of retinal thrombosis

Symptoms largely depend on the location of the blood clot and the degree of narrowing of the vessel (occlusion).

Diagnostics

A 100% specific sign of thrombotic changes in the retina during fundus examination with a magnifying glass is the appearance of a “crushed tomato.”

Also, during visometry, reduced visual acuity is diagnosed - a person cannot see the lines of letters and notes that he has begun to see worse than the day before.

Angiography with fluorescent contrast agent will help make a final diagnosis and pinpoint the location of the thrombus.

Treatment

Treatment is carried out in 4 stages:

Restoring blood flow in a thrombosed vessel.
Reducing retinal edema.
Dissolution and elimination of formed hemorrhages (if they are small in area).
Improving microcirculation in the retina.

Therapy methods

To treat retinal thrombosis, an integrated approach is used:

The clot can be dissolved by Fibrinolysin or Plasminogen. They are administered using a syringe under the eye. The only caveat: no more than 2 hours should pass from the onset of clinical manifestations of thrombosis.
Heparin in the form of injections, Warfarin or Clopidogrel are used to prevent further thrombus formation and reduce blood clotting in small vessels.
Trental can improve blood circulation and protect the walls of blood vessels from hypoxia. It is administered intravenously 2 times a day.
Retinal edema is treated by injecting glucocorticosteroid solutions (Prednisolone, Hydrocortisone) into the tissue around the eye. For severe pain in the eye, anti-inflammatory drugs are prescribed intravenously.

Traditional therapy

Prevention measures

In case of hypertension, medications are needed to normalize blood pressure. There are many of them; an individual combination is selected for each patient. You should consult a cardiologist regarding the effects of specific medications.
For all types of diabetes, the main task is to achieve a constant normal blood glucose level. This can be achieved through diet, adequate physical activity and carefully selected medications. For type 1 diabetes, you need to set the dosage of insulin, for type 2 diabetes, the type and frequency of use of glucose-lowering drugs.
Any eye diseases require increased attention. Under no circumstances should glaucoma be advanced. Not only does it threaten thrombosis of the blood vessels of the eye, it also leads to a complete absence of lateral vision. People with various types of retinopathy (diabetic or hypertensive) need to be checked by an ophthalmologist once every six months.
Correction of hormone levels. If the thyroid gland is overactive, medications that reduce thyroxine levels are needed. Women are not recommended to get carried away with oral contraceptives - they increase the risk of blood clots.
Prevention of increased aggregation (“sticking together”) of platelets - take Aspirin (ThromboASS or Plavix) daily, 1 tablet per day. This is especially necessary for those who suffer from cardiovascular diseases.

Useful video about retinal thrombosis

Thrombosis of the central retinal vein with the development of postthrombotic retinopathy is the second most common microvascular disorder. More often, only changes in the retinal vessels occur. Postthrombotic retinopathy can occur at almost any age (although more often after age 50). The severity of vision loss varies from asymptomatic to significant visual impairment.

Postthrombotic retinopathy is the most common cause of severe unilateral visual impairment. Vision loss usually occurs secondary to the development of macular edema. Retinal vein occlusion can affect either the central retinal vein or one of the branches of the central retinal vein.

Thrombosis of the central retinal vein. Pathogenesis

Retinal vein occlusion is mainly due to the formation of a blood clot in the lumen of the vessel, but systemic vasculitis or external compression of the vein wall by an arterial vessel may also be the cause. It is believed that thickening of the arteriole wall leads to compression of the venule, ultimately resulting in occlusion.

The release of blood from the vascular bed in combination with hypoxia leads to further disruption of the permeability of the wall of the venous vessel, causing increasing stagnation of blood, leading to the formation of a “vicious circle”. Ischemic retinal injury stimulates the production of vascular endothelial growth factor (VEGF), which leads to the growth of new vessels along the retinal surface. Postthrombotic retinopathy can be expressed by hemorrhages into the eye cavity, the formation of macular edema and the development of neovascular glaucoma. Factors contributing to the development of postthrombotic retinopathy:

Old age
Somatic diseases (hypertensive heart disease, elevated blood lipid levels, diabetes)
High pressure inside the eye
Systemic inflammatory diseases (eg, sarcoidosis, Behçet's syndrome)
Violation of blood coagulogram

Branch retinal vein thrombosis is much more common than central retinal vein thrombosis. Depending on the location of the thrombus: central vein, macular branch or peripheral branch of the central retinal vein, the prognosis of the disease varies.

Postthrombotic retinopathy. Symptoms and complaints

Symptoms of retinal vein thrombosis depend on the area of the lesion and the presence of collateral blood flow (that is, additional small branches of blood vessels through which blood could flow out). The most common manifestations of retinal vein occlusion are: unilateral, painless blurred vision, decreased visual acuity, distortion of objects (metamorphopsia), and peripheral vision defects. Symptoms can appear at any time, however, they often occur at night and the person only discovers them when he wakes up. Visual acuity depends on the degree of involvement of the macula in the pathological process. The fundus of the eye takes on the appearance of a “crushed tomato”; multiple streak-like hemorrhages in combination with retinal edema give this picture.

Thrombosis of the central retinal vein. Diagnostics

The main thing in diagnosing central retinal vein thrombosis is the collection of complaints, anamnesis and slit lamp examination of the patient’s eye. An ophthalmological examination can reveal not only the presence of retinal venous occlusion, but also identify complications of this condition.

However, after a routine examination by an ophthalmologist, it is extremely important to determine the presence and severity of macular edema and the nature of the central retinal vein occlusion (ischemic or non-ischemic). Ischemic thrombosis of the central retinal vein or thrombosis of the branch of the central retinal vein is characterized by a significantly poorer prognosis for visual functions, longer and more multifaceted treatment, and the presence of secondary complications from other ocular structures.

To determine the severity and presence of macular edema, the retinal optical coherence tomography (OCT) technique is used. Optical coherence tomography of the retina is based on the principle of layer-by-layer scanning of the posterior structures of the eye, which allows you to accurately calculate the height of macular edema and monitor fluid resorption after treatment or in the intervals between procedures.

The second diagnostic and extremely important examination is fluorescein angiography of the retina. Fluorescein angiography of the retina is based on the intravenous administration of an iodine-containing contrast agent, which stains the vessels located in the retina. The area of impaired blood supply is the criterion for determining the nature of thrombosis (ischemic type or non-ischemic). All examinations are performed on an outpatient basis with a dilated pupil.

Retinal vein occlusion. Differential diagnosis

Diabetic retinopathy.
Other diseases that cause sudden unilateral vision loss, for example: retinal detachment, retinal artery occlusion
Age-related macular degeneration
Anterior ischemic neuroopticopathy

Thrombosis of the central retinal vein. Treatment

Treatment of postthrombotic retinopathy should begin as early as possible. The success of therapy depends on the area and degree of occlusion, as well as on the nature of thrombosis (ischemic or non-ischemic) and the presence of secondary complications.

Primary care for a patient with central retinal vein thrombosis is carried out in the form of conservative treatment. This therapy includes parabulbar injections of drugs that dilate blood vessels, relieve swelling and dilute blood clots. This therapy is aimed at reducing the area of retinal damage and reducing the severity of ischemic changes in the retina. With timely treatment, blood flow can be completely restored, hemorrhages resolve and vision returns to normal.

However, if the treatment is not performed on time or the area of damage to the venous bed is extensive, edema forms in the macular area. Macular edema due to thrombosis of the central retinal vein is cystic in nature. Macular edema leads to the death of cells (photoreceptors) in the retina, for this reason it is extremely important to get fluid out of the retinal layers as soon as possible.

First of all, thrombosis of the central vein of the retina is treated with intravitreal injection (into the vitreous cavity) of corticosteroid drugs (Kenalog) and angiogenesis inhibitors (Lucentis or Avastin). After intravitreal administration, the liquid is absorbed, which allows for improvement in both the anatomy of the retina and its functions. In some clinical cases, laser coagulation of the paracentral zone of the retina (panretinal laser coagulation of the retina) can achieve similar results.

Complications of central retinal vein thrombosis

The main cause of the development of secondary complications, that is, postthrombotic retinopathy, is chronic ischemia of the posterior pole of the eye. Such changes are more typical for thrombosis of the entire central retinal vein of the ischemic type. Ischemic postthrombotic retinopathy occurs in 10% of cases.

Postthrombotic retinopathy is associated with the growth of pathological new vessels along the surface of the retina. Their growth is associated with the production of vascular growth factors in response to insufficient blood supply.

The most common complications are:

Neovascular secondary glaucoma
Hemophthalmos
Optic atrophy
Recurrent macular edema
Epiretinal fibrosis
Optic atrophy

Treatment of complications. Postthrombotic retinopathy

Treatment of postthrombotic retinopathy will be aimed in two main directions: reducing the likelihood of complications and compensating for existing changes. For example, after fluorescein angiography the ischemic nature of the occlusion is established, in such cases it is necessary to perform panretinal laser coagulation of the retina prophylactically. Or in case of decreased vision due to secondary neovascular glaucoma, the goal of treatment will be to compensate for the pressure inside the eye.

Fundus examination with control optical coherence tomography of the retina must be performed every 3 months. This multiplicity is dictated by control over the absence of newly formed vessels at the posterior and anterior poles of the eye. When the first signs of neovascularization appear, it is necessary to perform panretinal laser coagulation of the retina and intravitreal injection of Lucentis.

For the recurrent nature of macular edema, the drug Ozurdex is used in modern practice; intravitreal administration of Ozurdex allows one to achieve long-term and stable remission. In the absence of Ozurdex, the required number of intravitreal injections of glucocorticosteroids is performed.

Hemophthalmos of the eye requires surgery on the vitreous body. Blood that has escaped from the vascular bed into the vitreous cavity must be removed by filling the vitreal cavity with a temporary tamponing agent, this operation is called vitrectomy.

Prognosis of postthrombotic retinopathy

In most cases, during treatment, vision is completely or almost completely restored. However, in 10 percent of cases when thrombosis is ischemic in nature, vision remains poor. Despite the anatomical restoration of the fundus.

Vessel thrombosis of the eye– a condition characterized by the formation of blockage of the central retinal vessel or its branches. As a result, blood circulation is disrupted and stagnation begins. Retinal thrombosis is currently one of the causes of progressive vision loss. In most cases, the disease affects older people, but the pathology can develop at any age.

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Thrombosis of the eye. What is this?

Thrombosis of the central retinal artery– acute disturbance of blood flow through the retinal artery or its branches, leading to the development of ischemia. It is this condition that develops rapidly and poses a danger to visual function.

When the central retinal vein and its branches are blocked, the outflow of blood is disrupted. Overcrowding of blood vessels with excess blood provokes their overstretching and deformation. The wall thickens and becomes denser. The blood flow slows down and a blood clot forms in the vessel.

As a result of blood stagnation, the permeability of the vascular wall increases, this contributes to the formation of reverse blood flow into the capillaries and its further release into the tissues surrounding the vessel. Intraocular pressure increases, which can result in hemorrhage and swelling. In more than 80% of cases, the blockage occurs in the superotemporal branch of the central retinal vein.

Retinal vein thrombosis is divided into:

ischemic - there is a significant circulatory disorder, visual function is impaired, hemorrhages are found on the retina, the tissue is swollen, immediate treatment is required;
non-ischemic - retinal damage is less pronounced, visual acuity is reduced or remains at the same level.

Reasons for development

Thrombosis of the eye rarely develops as an independent disease. More often it is a consequence of the development of concomitant pathology. Among the main reasons for the development of the disease:

atherosclerosis;
diabetes;
systemic vasculitis;
blood coagulation disorder;
hypertonic disease;
thyrotoxicosis;
infectious processes in the oral cavity and sinuses;
increased intraocular pressure;
intraocular neoplasms.

Particularly often, thrombosis of the central vein develops with sudden changes in glucose concentration, as well as with changes in blood pressure. In addition, we can identify factors whose presence creates a predisposition to pathology:

excess weight;
age;
endocrine diseases, taking hormonal drugs;
inactive lifestyle.

Stages of development

Thrombosis of the central vein and its branches goes through several stages in its development:

Stage 1 (prethrombosis): stagnant processes begin, the veins become dark, dilated, arteriovenous crossovers and tortuosity form, a slowdown in blood flow is noted, small hemorrhages occur, and vision periodically becomes blurred;
Stage 2 (thrombosis): the vascular walls are tense, extensive hemorrhages form in the retina, vitreous body, permeability is increased, swelling is noted along the vein, thrombosis forms, the patient complains of blurred vision, loss of the field of vision in the affected areas;
Stage 3 (post-thrombotic retinopathy): occurs 1-2 months after thrombosis, hemorrhages resolve, atrophy and degenerative changes in the retina begin, vision is restored, but not to the initial level, new vessels grow, even in places where they should not be This may create an increased risk of recurrent retinal vein thrombosis.

Symptoms

In the early stages of the disease, most patients do not notice any significant impairment of visual function. Rarely, blurred vision and a slight decrease in visual acuity may occur. The greatest severity of symptoms is observed in the morning, after waking up. This is due to the fact that during sleep all stagnant processes intensify. Intense symptoms begin when more than 70% of the lumen of the vessel is blocked.

Symptoms are determined by the location of the thrombus and the degree of stenosis of the vessel. When the central vein is blocked, at least 75% of the retina is damaged. Multiple hemorrhages occur, vision deteriorates, and color perception is impaired. When a branch of the central vein is blocked, functions are disrupted slowly; often such changes do not cause alarm to the patient. Blurry dark spots appear in the field of vision, vision is blurred. Severe symptoms are characterized by complete occlusion of the central vein; in this condition, the lumen of the vessel is blocked by at least 95%, but this is rare.

Diagnostics

If the slightest appears, you should contact an ophthalmologist as soon as possible. If there is a complete blockage of the central vein, assistance should be provided within an hour. If blood flow is restored during this time, visual impairment can be avoided.

To diagnose this condition, the doctor clarifies the patient’s complaints, medical history and conducts an examination. Instrumental research methods are also used:

visometry - testing visual acuity using a table or counting the number of fingers;
perimetry - determination of scotomas in the field of view;
biomicroscopy - detection of opacities in the vitreous body;
ophthalmoscopy is a study that allows you to assess the condition of the fundus of the eye, determine the presence of hemorrhages; in case of thrombosis, a characteristic picture of a “crushed tomato” is revealed;
fluorescein angiography (FA) - a study of retinal vessels, which makes it possible to identify the degree of thrombosis, the size of the affected area and the condition of the vessels;
Retinal tomography displays the presence of blood clots in the vessel, allows you to diagnose retinal detachment, detect hemorrhages in the retina, and inflammatory processes.

Laboratory tests include general and biochemical blood tests. All patients also undergo electrocardiography and their blood pressure is changed.

Treatment

Therapeutic measures are carried out in several stages:

restoration of blood circulation;
reduction of retinal swelling;
elimination of hemorrhages in a small area;
restoration of microcirculation.

Conservative therapy

If retinal thrombosis is diagnosed in the initial stages, drug therapy has a good effect:

fibrinolytics (Fibrinolysin) dissolve thrombotic masses and are administered parabulbarly (under the eyeball) using a syringe, but their use can be done no later than 2 hours after the onset of symptoms;
hormones (Dexamethasone) reduce swelling, inflammation and pain and are injected into the area around the eye;
anticoagulants (Heparin, Warfarin) are used to prevent recurrent thrombosis;
antiplatelet agents (Aspirin) reduce blood clotting;
angioprotectors (Emoxipin) restore the structure and function of blood vessels;
antihypertensive drugs (Nefidipine) reduce blood pressure;
vitamin complexes.

In the acute phase of thrombosis of the central vein of the eye, treatment is carried out in an ophthalmology hospital, then in a clinic, under the supervision of a doctor.

Treatment of blockage of the central retinal artery must begin in the first hours of the development of the pathology, otherwise restoration of vision will be impossible. Emergency help consists of massaging the eyeball, this helps restore blood flow. Eye drops and diuretics are used to lower intraocular pressure.

Surgery

After a course of conservative therapy, laser coagulation of the retina is performed - cauterization. The purpose of this procedure is to destroy the blood clot and restore normal blood circulation. This operation is performed on an outpatient basis - hospitalization in a hospital is not required. The procedure is painless, it is performed under local anesthesia and is highly effective. However, there are contraindications:

cataract;
retinal disinsertion;
hemorrhages in the fundus;
low transparency of the eye media.

After surgery, the patient must limit physical activity, avoid sudden movements, wear sunglasses, and monitor blood pressure. Watching TV and working on a computer is prohibited.

Complications and prognosis

Ischemic thrombosis of the central vein can be complicated by neovascular glaucoma, recurrent vitreous hemorrhage, tractional retinal detachment, and a persistent decrease in visual acuity. The non-ischemic form of the pathology in most cases has a favorable prognosis: the condition gradually improves and vision is restored. However, after recovery there is still a risk of relapse, so people who have had retinal vein thrombosis should be observed by an ophthalmologist for 6 months. They must undergo examination periodically.

In case of retinal thromboembolism, the prognosis depends on the timely initiation of treatment. Vision is restored 2-3 months after treatment, swelling decreases, hemorrhages resolve. If treatment is not timely or recommendations are not followed, complications may develop:

secondary glaucoma;
optic nerve atrophy;
hemophthalmos;
degenerative processes in the retina;
recurrent hemorrhages;
optic neuropathy

Prevention

Central retinal vein thrombosis can be prevented. To do this, you need to monitor your health and undergo an annual examination. Reduces the risk of developing the disease by eliminating the pathogenetic factor:

in case of hypertension, you should take medications to normalize blood pressure;
for diabetes mellitus, control glucose levels: follow a diet, normalize weight and take recommended endocrine medications;
if retinopathy is present, patients should visit an ophthalmologist every 6 months;
endocrinological diseases, especially pathology of the thyroid gland, also require correction; women should remember that oral contraceptives increase the risk of blood clots - you should not get carried away with them;
people suffering from cardiovascular pathology should take anticoagulants: for example, Aspirin daily.

Currently, a large number of special exercises have been developed that not only prevent deterioration of eye condition, but also increase visual acuity.

Eye training:

Sharply open and close your eyes 5 times, alternately look left and right, then up and down;
blink quickly for 2 minutes;
lightly press on the closed eyelid for a couple of seconds, repeat 10 times.

In addition to exercising, it is important to maintain a healthy lifestyle. Moderate physical activity and the elimination of stress are necessary for the health of the body, including the eyes. Compliance with diet is an important component of the prevention of thrombosis of any location. Eating blueberries has a good effect: these can be fresh berries, frozen or pharmaceutical preparations.

Patients with predisposing factors should understand that eye thrombosis can lead to irreversible consequences that cannot be eliminated by any drugs or surgeries. That is why it is necessary to constantly prevent blood clots, lead a healthy lifestyle, and consult a doctor at the first symptoms of the disease.

Retinal artery thrombosis. How not to lose your sight

A thrombus can form in any part of a person’s circulatory network, and predominantly in older people, thrombosis of the central vein, that is, the central retinal vein, can develop. This is an acute condition characterized by partial or complete blockage of a vessel or its branches, which disrupts the healthy circulatory process and causes complications, including complete loss of vision. Self-medication in this case is unacceptable; the patient must consult a doctor for an accurate diagnosis and prescription of adequate therapy.

Reasons for development

In rare cases, thrombosis of a branch or the central retinal vein develops as a primary disease, most often preceded by other pathologies of the cardiovascular system. They cause weakening of the walls of blood vessels, narrowing their lumen, slowing blood circulation and increasing blood clotting, which leads to the formation of blood clots. In addition, the walls of the central retinal artery may thicken, causing it to compress the vein and its branches, and this can also lead to thrombus formation.

Most often, the following pathologies lead to the formation of a blood clot in the central vein:

atherosclerosis is a disease that occurs due to cholesterol deposits in blood vessels;
hypertension – persistently elevated blood pressure;
diabetes;
systemic vasculitis - an inflammatory disease of small blood vessels;
thrombophilia – constantly increased blood clotting.

All of these diseases affect blood circulation in one way or another: pressure in the vessels may increase, their walls may be damaged, blood speed may be reduced and viscosity increased, etc. In addition, the occurrence of a blood clot in the venous network of the eye may be indirectly affected by others diseases:

infectious pathologies;
ophthalmohypertension – increased intraocular pressure;
swelling of the optic nerve;
benign or malignant tumors localized in the eye area;
endocrine ophthalmopathy - an autoimmune disease accompanied by forward displacement of the eyeball;
endocrine pathologies.

The listed diseases can cause harm in themselves, or they can also be affected by improper treatment. Thrombosis of the central vein of the retina can also form under the influence of provoking factors, which include excess weight, alcohol consumption, smoking, sedentary lifestyle, etc.

Stages and symptoms

The disease develops gradually and does not always lead to complete loss of vision if treatment is started on time. There are two types of occlusion (obstruction) of the vessels of the eye - non-ischemic, in which visual acuity usually does not fall below 0.1, and ischemic, which is characterized by extensive hemorrhages in the retina. In addition, retinal vein thrombosis can be divided into several stages of development.

The first stage of the onset of ocular vascular pathology is called prethrombosis. During this period, minor changes occur, which are usually not clearly expressed in the form of symptoms. Patients may notice a slight decrease in visual acuity or blurring, usually occurring in the morning or after physical activity.

The vision of patients who have not previously complained of a decrease in its acuity remains within the range of 0.6-1. Upon closer examination, you can see a slight expansion or change in color of the vein or its branches. During the diagnosis, the doctor may additionally see a slowdown in blood circulation and pinpoint hemorrhages.

Prethrombosis may not lead directly to thrombosis if there is no influence of provoking factors.

In the second stage, in most cases, characteristic symptoms appear, since the branches of the central retinal vein experience significant pressure. The patient clearly feels a decrease in visual acuity, feels fog or a veil before the eyes, and a scotoma, that is, a “blind spot,” is also possible. Due to increased pressure, multiple hemorrhages occur in the retina, and the tissues of the eye swell.

The second stage is direct thrombosis of the central retinal vein, that is, the formation of a blood clot that partially or completely blocks the lumen of the vessel. All symptoms observed previously increase in intensity, and atrophic or degenerative changes occur in the tissues of the eye.

In the absence of treatment or continued exposure to negative factors, thrombosis can cause a complication - post-thrombotic retinopathy. This is a disease characterized by pathological changes in the retina, for example, the proliferation of blood vessels or the occurrence of cystic edema. In this case, the same symptoms are observed as with thrombosis of the central vein.

The severity of the clinical picture directly depends on the individual characteristics of the patient’s body, the area of vascular damage, the severity of the disease and the presence of negative external influences. If any disturbing changes occur, you should definitely contact an ophthalmologist.

Diagnosis of pathology

First, the doctor must conduct a survey of the patient, which will reveal the time of occurrence of complaints, their intensity and characteristics. Usually, making a diagnosis at this stage does not present any particular difficulties. Additionally, specialized diagnostic methods may be prescribed:

Visometry. Determination of visual acuity using tables. In the future, the results will allow us to determine the type of thrombosis - ischemic or non-ischemic.
Tonometry. Determination of eye pressure using a special tonometer.
Perimetry. Examination of the boundaries of the visual field to determine the presence or absence of a scotoma.
Biomicroscopy. Determining the condition of the eyes using a slit lamp.
Ophthalmoscopy. Examination of the fundus using an ophthalmoscope or fundus lens.
Microperimetry. The combined use of computer perimetry and a fundus camera to determine the photosensitivity threshold of the retina at any specific point.
Fluorescein angiography. The examination of blood vessels with the preliminary introduction of a contrast agent into them is carried out using a fundus camera.

In addition, the patient may be prescribed other nonspecific tests - blood and urine tests, ECG, blood pressure measurements, etc. Additionally, a consultation with a therapist, endocrinologist, cardiologist or neurologist may be required if there are primary diseases associated with the occupation of these doctors. Also, a visit to these specialists may be associated with differential diagnosis, which allows identifying complications of the disease.

Thrombosis of the eye is often discovered accidentally during a routine examination.

Treatment of the disease

After making a final diagnosis, the doctor prescribes a treatment regimen suitable for the individual patient. As a rule, it requires hospital stay under constant medical supervision. If treatment is carried out promptly and correctly, the patient can be completely relieved of the symptoms of the pathology and restored to his original vision.

Surgical intervention is required only in advanced cases, when irreversible changes are observed and there is a risk of complete loss of vision. Often, thrombosis of the central retinal vein is treated with conservative methods. These include taking medications in the form of tablets, intravenous injections through a drip, etc.

Treatment is aimed at dilating the blood vessels of the eye to normal values, restoring blood circulation and returning former visual acuity. Therapy is prescribed individually based on the characteristics of the patient and the primary disease that provoked the thrombosis.

First of all, fibrinolytics are prescribed. These are medications that destroy fibrin, a protein involved in the formation of a blood clot. As a result of the effects of these drugs, blood flow is restored, and the symptoms gradually decrease in intensity. Most often from this group Fibrinolysin and Plasminogen are prescribed. These drugs are injected daily into the area under the eye for two weeks.

The doctor also prescribes antihypertensive drugs that lower blood pressure and help eliminate swelling. These drugs can be in different forms - in the form of tablets (Nifedipine, Phenigidine), intramuscular injections (Lasix), intravenous injections (Papaverine, Dibazol) or drops (Arutimol, Glautam and Okumed). These drugs are most effective in the presence of hypertension or ocular hypertension.

After completing the course of fibrinolytics, anticoagulants can be prescribed - drugs that prevent pathological blood clotting and the formation of blood clots. The treatment course with these drugs should not exceed a week. The main representative of anticoagulants used in the occurrence of thrombosis of various localizations is Heparin. It can be used in the form of injections or tablets.

If the root causes of the disease have not been eliminated, a blood clot in the vessels of the eye may form again, so in such cases the doctor prescribes a course of antiplatelet medications. These drugs, like anticoagulants, prevent the formation of blood clots, but act on the body more delicately. Most often, Aspirin or Plavix, familiar to many, is prescribed as preventive therapy.

Additional medications may be prescribed to relieve symptoms. Non-steroidal anti-inflammatory drugs include Ibuprofen or Diclofenac; antispasmodics include Papaverine, No-shpu and Riabal. If NSAIDs do not help, the doctor prescribes corticosteroid medications. To restore immunity, vitamins are prescribed.

For more serious lesions, therapy is carried out in a short time and more intensively, since doctors need to prevent complications from occurring and try to avoid surgical interventions. Preventive courses after such treatment are prescribed more often, and their duration increases.

If conservative therapy does not produce results, or there is a danger of irreparable consequences, the patient is prescribed laser coagulation. This is a non-invasive treatment method that allows you to achieve the desired effect in a short time. In this case, after completion of the intervention, the patient is prescribed a specialized course of medication.

ethnoscience

Some people prefer to treat diseases according to the advice of traditional healers, but in the case of eye thrombosis this is unacceptable. Alternative medicine recipes can be used only as a symptomatic addition to the main therapy and only in consultation with the attending physician.

A popular folk remedy is eye drops made from natural ingredients, which help relieve swelling, lower blood pressure and eliminate pain. To prepare such a remedy, you can use cumin, plantain, dandelion or cornflower. A glass of boiling water is poured into 1 tbsp. l. selected plant or their collection, the mixture is infused, cooled and filtered.

You can also make eye lotions from tea leaves, cucumber juice or decoctions of the listed herbs. The selected mixture should be hot, but not scalding; gauze is moistened in it, which is then applied to closed eyelids. The procedure should last from half an hour to an hour, after which the eyes should be rinsed with warm water.