Destruction of the vitreous body
The content of the article:
- Risk factors and causes of destruction of the vitreous body
- Forms of the disease
- Symptoms of the destruction of the vitreous body
- Diagnostics
- Treatment of destruction of the vitreous body
- Possible complications and consequences
- Forecast
- Prevention
The destruction of the vitreous humor is the partial or complete destruction of the vitreous humor of the eyeball.
The disease mainly affects the elderly. It is diagnosed with the same frequency in men and women. At a young age, it usually develops as a complication of high myopia (myopia) or eye injuries.
According to statistics, destruction of the vitreous body is more often observed in economically developed countries of the world. This is due to significant visual stress, longer life expectancy, and some other factors.
Destruction is the destruction of the vitreous humor
Risk factors and causes of destruction of the vitreous body
The vitreous humor is a gel-like substance that fills the inner cavity of the eyeball between the lens and the retina. It consists of water (99%), hyaluronic acid and collagen. Long filaments of collagen, intertwining with each other, turn into a kind of frame, the cells of which are filled with a gel formed by water and hyaluronic acid.
Normally, the vitreous body is completely transparent. However, under the influence of negative factors, the molecules of the substances that make up its composition break up into separate fragments. This leads to a change in the qualitative and quantitative composition of the gel.
Gradually, particles devoid of optical transparency accumulate in the thickness of the vitreous body. It is their patients with the destruction of the vitreous body that are considered "flying flies." In some cases, the particles mechanically irritate the retinal receptors, which is perceived as bursts of bright sparks, flashing lightning before the eyes.
During the destruction of the vitreous body, particles devoid of optical transparency accumulate in its thickness.
The reasons for the destruction of the vitreous body can be:
- Inflammation of the structures of the eyeball, including dacryocystitis, blepharitis, keratitis, endophthalmitis.
- Diseases of the endocrine glands, kidneys or liver. Dysfunction of these organs leads to a violation of the physiological ratio of the components of the stroma, glucosamines, proteoglycans and fluid.
- Violation of the blood supply to the brain and retina. Against its background, a reflex spasm of the eye muscles occurs, the blood supply to the eyeball as a whole worsens, which becomes the cause of the destruction of the vitreous body.
- Elderly age. With age, the properties of the colloidal gel gradually change. At the periphery, it becomes denser, and in the central part (where opaque particles accumulate), its rheological properties deteriorate.
- High myopia. Against its background, the spherical shape of the eyeball gradually changes to an ellipsoidal one. This process is accompanied by deformation of the structures of the eye, violation of metabolism in them, which is a trigger of the destructive process in the colloidal gel of the vitreous body.
- Traumatic eye injuries, which lead to the development of hemophthalmos, violations of the primary structure of collagen molecules.
- Iatrogenic factors. Damage to the vitreous body can be a complication of cataract surgery.
- Diabetes. Decompensation of diabetes mellitus causes damage to the blood vessels of the microvasculature. As a result, there are violations of blood supply and metabolic processes in the eyeball.
Forms of the disease
Depending on the prevalence of the pathological process, the following forms of destruction of the vitreous body are distinguished:
- partial - a cavity is formed in the central part of the vitreous body, containing destroyed collagen particles and a liquefied colloidal gel;
- complete - over time, the pathological cavity in the central part of the vitreous body increases in size and occupies the entire space between the retina and the lens. In it, cords are formed that can tightly grow together with the fundus, leading to deformation of the eyeball, the formation of adhesions, and retinal detachment.
By the type of films and strands formed, the destruction of the vitreous body is:
- filiform - mainly observed against the background of progressive myopia or atherosclerosis;
- granular - caused by inflammatory processes in the inner retinal layer;
- crystalline - damage to the vitreous body is caused by the deposition of crystals of tyrosine or cholesterol in it.
Symptoms of the destruction of the vitreous body
The main symptoms of destruction of the vitreous body:
- photopsia - a visual phenomenon consisting in the appearance of flashing "flies", lightning, sparks, "shroud" before the eyes;
- hemophthalmus - hemorrhage into the thickness of the vitreous body;
- decreased visual acuity.
The destruction of the vitreous body is manifested by photopsia, hemophthalmos and decreased visual acuity
"Flies" and "veils" in patients with destruction of the vitreous body usually occur when looking at the sky or a white monitor. When you try to focus your gaze, "flies" disappear from the field of view.
Diagnostics
To confirm the diagnosis of destruction of the vitreous body, the following diagnostic methods are used:
- Ophthalmoscopy. Empty cavities in the form of vertical slits are determined; white-gray fibrous structures are clearly visible behind the boundary membrane. With complete destruction of the vitreous body, one cavity is visualized, containing fragments of fibrils.
- Ultrasound of the eyeball in B-scan mode. Allows you to detect crystal structures in the vitreous, a focus of hemorrhage. The mobility of the observed crystals and other inclusions indicates the liquefaction of the colloidal structure.
- Slit lamp biomicroscopy. Changes in the consistency of the gel, as well as the presence of turbidity in the form of flakes, are revealed. With a filamentous form of destruction, collagen fibers are found in the vitreous in the form of loop-like structures. Granular destruction is characterized by the presence of small particles of brown or gray color, which at later stages stick together to form conglomerates.
- Optical coherence tomography. It is used in case of low information content of other methods. Allows you to identify symptoms of destruction of the vitreous body, such as heterogeneity of its structure, opacity, change in shape and decrease in size. Contraindicated in massive hemophthalmos.
- Visometry. Determination of visual acuity using special tables.
- Tonometry. Measurement of intraocular pressure, which usually rises when the vitreous is destroyed.
The diagnosis of "destruction of the vitreous body" is confirmed after a thorough examination. One of the diagnostic methods is ophthalmoscopy
Treatment of destruction of the vitreous body
There are no specific methods of therapy for the destruction of the vitreous body, therefore, the tactics in each specific case is determined by the degree of decrease in visual acuity and changes in the colloidal structure of the vitreous body.
Treatment of the destruction of the vitreous body in the initial stages consists in lifestyle correction and drug therapy. Patients are advised to avoid prolonged visual stress; when working at a computer, it is necessary to take breaks every hour, during which special exercises for the eyes are performed. To prevent the progression of pathology, it is necessary to observe the daily regimen, regularly be in the fresh air, adhere to the principles of proper nutrition, and engage in moderate physical activity.
Drug therapy is carried out with preparations of resorption action, antioxidants, angioprotectors, as well as agents that improve cerebral circulation and blood flow in the microvasculature.
Conservative treatment of the destruction of the vitreous body consists in the use of absorbable drugs, angioprotectors, antioxidants
With significant damage to the vitreous body, conservative therapy is not able to provide a lasting positive effect. In this case, surgical treatment is indicated.
Large fragments of collagen fibers are usually removed with a YAG laser, an operation called vitreolysis. The intervention is performed under local anesthesia with obligatory dilation of the pupils using short-acting mydriatics. Certain difficulties can be observed with a significant degree of mobility of pathological particles in the thickness of the colloidal gel of the vitreous body. Vitreolysis does not lead to a decrease in visual function.
In case of significant damage, surgical treatment using a YAG laser is used.
In the advanced stages of the disease, when almost complete destruction of the vitreous has occurred, it becomes necessary to remove it - vitrectomy. The operation is performed using microsurgical techniques, both under local and general anesthesia (depending on individual indications). The surgeon separates the colloidal gel into small areas and then aspirates them. After that, gas, silicone oil or balanced salt solution is injected into the cavity of the eyeball in order to normalize intraocular pressure.
Possible complications and consequences
The most common complications:
- wrinkling of the vitreous body, which leads to a significant decrease in visual acuity up to complete blindness;
- detachment of the retina.
Forecast
The outlook is generally favorable. Timely treatment can prevent or significantly slow down the progression of pathology and deterioration of visual function. Even with significant destruction of the vitreous body, surgical correction can significantly improve visual acuity, and hence the quality of life of patients.
Prevention
Prevention of the development of destruction of the vitreous body consists of the following measures:
- regular examinations by an ophthalmologist (visometry, ophthalmoscopy and tonometry);
- decrease in visual stress;
- optimization of the mode of work and rest;
- regular exercise for the eyes;
- proper nutrition with a sufficient amount of plant foods in the diet and limitation of fatty foods;
- correction of refractive errors;
- prevention of eye injuries;
- timely treatment of inflammatory eye diseases;
- correction of blood glucose levels in patients with diabetes.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
