aortic arch syndrome retinopathy
Introduction
Introduction to retinopathy of aortic arch syndrome Aortic arch syndrome (aorticarchsyndrome) is due to the aortic arch from the aorta, such as the indefinite obstruction of the innominate artery, the common carotid artery or the left subclavian artery, resulting in lowering of arterial blood pressure, weakening or disappearing of the pulsation of the neck and arms, and decreased blood flow in the upper part of the body. A series of symptoms and signs resulting from insufficient blood supply to the brain and eyes and limbs. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious Complications: optic atrophy, vitreous hemorrhage, cataract
Cause
Causes of retinopathy of aortic arch syndrome
Causes:
The exact cause of the disease is still unclear. Any cause of vascular occlusion can produce this disease. In the past, syphilitic aortitis combined with aneurysm was considered to be the main cause, but it is now believed that this disease has multiple causes, possibly with many inflammations and Related to degenerative diseases such as tuberculosis, streptococcal infection, non-specific inflammation, nodular arteritis, temporal arteritis, Buerge disease, collagen disease, rheumatism and other allergic diseases, elderly patients may be associated with elevated cholesterol, whole body Arteriosclerosis and/or atherosclerosis and thrombosis are associated with stenosis or obstruction of blood vessels.
Pathogenesis:
The specific mechanism is unclear and may be related to the autoimmune reaction. The immune response causes lymphocytes and plasma cells to infiltrate the blood vessel wall, and the wall is thickened, resulting in an ischemic reaction.
Prevention
Aortic arch syndrome retinopathy prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Pay attention to your diet and eat properly under the guidance of a doctor.
Pay attention to hygiene and actively prevent and treat all kinds of infectious eye diseases that are caused by improper care and birth canal.
Complication
Aortic arch syndrome retinopathy complications Complications, optic atrophy, vitreous cataract
Retinal neovascular hemorrhage and late optic atrophy, vitreous hemorrhage, proliferative retinopathy, and complicated cataract.
Symptom
Aortic arch syndrome retinopathy symptoms Common symptoms Fundus changes vertigo Single eye suddenly appears one... Vision centripetal reduction syncope
According to the location and extent of vascular involvement, there are different clinical manifestations, mainly caused by insufficient blood supply. Patients may have headache, dizziness, even syncope, speech and/or hearing impairment, difficulty swallowing, memory loss, emotional instability, vision loss, Necrotic perforation in the nasal septum, vascular murmur in the supraclavicular region, weakness in the upper limbs, abnormal sensation such as numbness or chill in the arm, weakening or disappearing of the pulsation of the carotid artery and the radial artery on one or both sides, blood pressure cannot be measured, temporary Hemiplegia, occasionally fever, less menstruation or menstruation, weak skin, slender hair, etc., laboratory tests may have increased white blood cells, increased erythrocyte sedimentation rate.
Due to insufficient retinal ischemia caused by insufficient blood supply to the eye, patients may have transient black eyes, monocular or binocular vision loss until darkness, visual field constriction or blindness, electroretinogram b wave reduction or extinction, blurred vision with patient position From the lying position to the sitting position and aggravation, especially on the head, it is easy to induce symptoms when wearing hard collar or high collar clothes.
The retinal artery is thinned, and the central arterial pressure drop cannot be measured. The retinal artery of the eyeball is lightly compressed, and there is no blood flow. When the position changes or the central retinal artery pressure drops to the intraocular pressure level, the central retinal artery pulsates, and the blood flow is segmental. The veins are distorted and expanded, and the swells are bean-shaped or fusiform. The blood flow in the veins is beaded or segmental. The blood flow slowly flows from the peripheral part of the retina to the optic disc, and the capillaries are distorted and expanded, especially on the surface of the optic disc and around the retina. There are microangioma formation in the early stage, and there are also the posterior pole. The central retinal artery and vein anastomosis is the most common sign of this disease, accounting for 81%. The anastomosis can occur in any part of the fundus, but it is common in the optic disc and its surroundings. It is ring-shaped and wreath-shaped, and it increases with the development of the disease. The surface of the optic disc can also have neovascularization. It can be mulberry-like or coiled, and new blood vessels can also occur in other parts. For example, the middle part of the optic can be spotted or Combustible hemorrhage, as well as retinal exudation, can produce optic atrophy in the late stage, retinal choroidal atrophy, hyperpigmentation, arterial changes White sheath, neovascularization resulting in vitreous hemorrhage, proliferative retinopathy, retinal detachment and drawing.
In addition to changes in the fundus, the conjunctival vasodilatation is distorted, and there are arteriovenous anastomosis. There are brown deposits on the posterior wall of the cornea. There are new blood vessels in the iris, often along the pupil of the iris and the root of the iris. The iris is atrophied, the pupil is enlarged, and occasionally Regulating paralysis, may be due to chronic ischemic ciliary body and iris, the secretion of ciliary body water is reduced to form low intraocular pressure, and late stage has cataract.
There are 3 main signs of Gao'an disease:
1. Arterial pulsations at the unilateral or bilateral iliac crest, iliac crest, iliac crest, carotid artery or radial artery disappear or become extremely weak.
2. Carotid sinus hyperreflexia (ie, dizziness, fainting or convulsions when the neck is compressed or pulled).
3. Unique eye lesions.
Examine
Examination of retinopathy of aortic arch syndrome
There are many positive indications for the laboratory examination of Gao'an disease, in which the blood sedimentation rate is accelerated, the C-reactive protein is increased, the serum albumin is decreased, the and globulin are increased, and the anti-aortic antibody is increased.
1. Vision: Concentric narrowing or blindness.
2. ERG check: Indicates that the b wave is lowered or extinguished.
3. Fundus fluorescein angiography: prolonged arm-retinal circulation, fine retinal artery, dilated veins, fluorescein leakage in the late vascular wall, telangiectasia filling, microangioma formation, point-like strong fluorescence, neovascularization on the optic disc surface The vase is strongly fluorescent and leaky. The anastomosis of the arteriovenous anastomosis is annular anastomosis. The retinal neovascularization shows strong fluorescence and obvious leakage. A large non-perfusion area is visible in the peripheral part of the retina.
4. Measurement of central retinal arterial pressure: suggesting a decrease in arterial pressure.
5. Doppler ultrasonography: It can show the arterial pulsation intensity and blood flow reduction at the distal end of the stenosis. The cerebral blood flow chart examination can show the decrease of cerebral blood flow.
Diagnosis
Diagnosis and diagnosis of retinopathy of aortic arch syndrome
According to typical clinical manifestations, diagnosis is not difficult.
Generally not confused with other diseases.
