fundus hemorrhage
Introduction
Introduction to fundus bleeding Fundus hemorrhage is not an independent eye disease, but a feature shared by many eye diseases and certain systemic diseases. Common in retinopathy caused by hypertensive retinopathy, diabetes and kidney disease. Retinal vein inflammation, retinal vein occlusion, optic disc vasculitis, and blood diseases cause retinopathy, ocular traumatic fundus hemorrhage. The same pathological damage, such as retinal hemorrhage, exudation, microangioma, neovascularization, etc., due to various causes. Due to the complicated etiology, the disease has a long course of disease and is prone to repeated attacks, which seriously affects vision and causes many serious complications. Such as macular degeneration (macular cystic edema, macular degeneration), neovascular glaucoma, vitreous hemorrhage, optic atrophy, proliferative retinopathy, traction retinal detachment, if not timely and effective treatment, often can lead to blindness. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people. Mode of infection: non-infectious Complications: cystoid macular edema, macular degeneration, vitreous hemorrhage, optic atrophy
Cause
Cause of fundus hemorrhage
(1) mechanical obstruction, such as thrombosis;
(2) inflammatory diseases or immune complexes invade the blood vessel wall, such as perivascular retinal inflammation, optic disc vasculitis, etc.;
(3) systemic vascular disease and blood diseases such as hypertension, diabetes and other retinopathy;
(4) Retinal vascular abnormalities, the same pathological damage caused by various causes, such as retinal hemorrhage, exudation, microangioma, neovascularization and the like.
Capillary lesions are the most common, especially from the venous hemorrhage. Most of the patients have local or systemic lesions. The bleeding from the arteries is rare, mainly due to capillary endometrial damage, increased permeability, and blood infiltration. Out, hemodynamic changes, high blood viscosity, venous blood flow or retention, venous thrombosis, inflammation of the vein wall, etc. Arteries are mainly found in local atherosclerosis or vascular embolism in the arterial wall.
Prevention
Fundus bleeding prevention
It is advisable to use eyesight to prevent bleeding. Don't read newspapers and TV for a long time. It is recommended to take a rest for 2 to 3 minutes after 40 minutes. Don't be overly excited, tired, excited or angry, and maintain good and adequate sleep.
Usually pay attention to:
1. Sufficient sleep helps to moisturize the eyes and reduce the blood of the eyes.
2. Clean the eyelids to avoid eye irritation caused by debris, oil, bacteria, cosmetics and other dust, and bloodshot.
3. Use good eyesight to reduce dry eyes. It is bloodshot.
4. Go to bed early, don't wait until 12 o'clock to sleep, it is already very late, preferably before 10 o'clock. Sleep time is 8 hours. Relax and do more outdoor activities.
Complication
Fundus hemorrhage complications Complications cystic edema macular degeneration vitreous hemodynamic atrophy
Due to the complicated etiology, the disease has a long course of disease and is prone to repeated attacks, which seriously affects vision and causes many serious complications. Such as macular degeneration (macular cystic edema, macular degeneration), neovascular glaucoma, vitreous hemorrhage, optic atrophy, proliferative retinopathy, traction retinal detachment, if not timely and effective treatment, often can lead to blindness.
Symptom
Fundus hemorrhage symptoms Common symptoms See things have small black spots visually impaired eyes before the eyes
(1) Suddenly, the front of the eyes is dark, only manual or only light.
(2) If there is a round black shadow in front of the eyes, it will not float with the eyes. The object in the middle direction will be completely missing, and the objects on both sides will be blurred.
(3) Suddenly, there is a line of black shadows in a certain direction, and the progress is rapid, and gradually increase, and finally, to cover the eyes, the object is blurred and cannot be distinguished.
(4) Suddenly there was a red glow in front of him, and gradually increased, so that the red light was full and the object was unknown.
(5) Aura of onset, most of them have eye swelling, eyeball beating and other feelings.
(6) Most recurrent episodes, each episode, there are some of the above symptoms, even if the blood does not retreat, when continuing to bleed, there may be some of the above feelings.
Because of the causes and locations of fundus hemorrhage, the prognosis and the impact on the patient's vision are also different. According to the amount of bleeding, the bleeding site is different and different symptoms are produced. If the amount of bleeding is small, located in the optic papilla and the periphery of the retina, there may be no obvious symptoms, such as a large amount of bleeding, the patient feels that there is a black shadow floating in front of the eyes, the line of sight is partially or completely blocked, and only the visual acuity of the light is left. If the bleeding is located in the center of the retina (the macular area), the patient's vision is lost, that is, the central area is unclear and has dark shadows, and there is still some vision around.
Examine
Examination of fundus bleeding
For general examination, the "eye CT scanning method" can be used as follows:
1. Transverse scan: The patient should lie on the examination bed and make a continuous scan from the top side of the 1cm skull below the ear line. The level of the 5mm thick layer inspection requires 6-8 layers. For thin layer scanning (1 mm layer thickness), nearly 40 layers are required for all eyelids.
2, coronal scan: the patient lay down or prone on the examination table, the head is too stretched, so that the head sagittal line is consistent with the bed surface, the ear line on both sides is perpendicular to the scanning baseline, and the front ear canal is continuously scanned 4 cm in front of the ear canal. Thick 4 to 5mm). For CT scan of intraocular lesions, the eyeball begins to scan backwards.
3. Contrast enhancement method: It is necessary to inject the contrast agent within a few minutes, and then start scanning after all the injections are completed.
4, neck examination: the conventional CT scan of the internal iliac varices is generally not developed, or only a small part of the lesion, to observe the full range of lesions can be neck pressure examination. Wrap the sphygmomanometer bag around the patient's neck, position it, pressurize it to 5.33 kPa (higher than the venous pressure), and then scan it. The balloon will be relaxed immediately after the scan.
Diagnosis
Diagnosis and diagnosis of fundus hemorrhage
Diagnosis can be made based on medical history, clinical manifestations, and examination. No need to distinguish from other diseases.
