Retinal angiopathy: what it is and how dangerous it is

Sometimes the line "retinal angiopathy" appears in an ophthalmologist's report, and the person goes home wondering: is this a diagnosis or just a description of what the doctor saw. Let's sort out what this term means and when it is truly dangerous.

What retinal angiopathy and angioretinopathy are

Angiopathy is damage to blood vessels caused by a disorder of nervous regulation. It manifests as dystonia, that is, impaired vascular tone, temporary reversible spasms when a vessel narrows, and pareses when the vessel wall loses its ability to contract.

The retina is the light-sensitive tissue at the back of the eye: it perceives light and sends signals to the brain. The term "angiopathy" is often used to describe changes in the vessels of the fundus, hence the note about retinal vascular angiopathy. The word "angioretinopathy" is structured the same way, only it names the retina directly, so both names refer to changes in the vessels of this tissue.

Types of retinal angiopathy: hypertensive, hypotensive, diabetic, traumatic, also called traumatic retinopathy, and juvenile, or Eales disease.

Why retinal vessels change: main causes

The first cause has already been named: a disorder of nervous regulation that disrupts stable vascular tone. In diabetes mellitus, elevated blood glucose levels damage retinal vessels, and then it is called diabetic angiopathy, in which both large and microscopic vessels are affected. Changes are more likely with long-standing diabetes, elevated blood pressure, and elevated cholesterol levels, as well as with smoking, obesity, and eye trauma.

What signs may be present and why they are often absent

At an early stage of vascular changes, a person usually notices nothing: signs do not appear immediately, and such changes are found during a preventive examination. Later, vision may deteriorate gradually, blurriness appears, dots and lines appear in the visual field, that is, floaters, and it becomes harder to see in the dark. Changes may be in one eye or both, hence the note about angiopathy of the retina of both eyes.

The absence of complaints says nothing about the state of the vessels: a person with good vision may have noticeable fundus changes. That is why regular examinations are prescribed for diabetes rather than waiting for discomfort to appear.

How angiopathy is detected: fundus examination

The main method is examination of the fundus with a dilated pupil: drops are instilled, the pupil dilates, and the doctor examines the retina to see signs of damage. Instrumental tests are used additionally:

• fundus photography, that is, images of the back of the eye;
• optical coherence tomography — detailed images of the inner layers of the eye;
• fluorescein angiography — assessment of the condition of retinal vessels;
• visual field testing, that is, how wide a person can see to the sides.

For diabetes, the doctor prescribes regular fundus examinations.

Why angiopathy is dangerous and when a doctor is needed

Diabetic retinal vascular changes go through three stages and increase gradually over several years. At the first stage, there are signs of vascular damage, but vision is not affected. At the second stage, there is more damage, and there is a risk to vision in the future, so examinations are done more often. At the third stage, the changes are serious: they can deprive a person of vision. Lost vision cannot be fully restored, so care is aimed at preventing it from deteriorating further.

You should see a doctor if, with diabetes, vision deteriorates over time, floaters have appeared, or it is hard to see in the dark. If vision has changed abruptly, a conversation with a doctor is needed without delay.

Retinal angiopathy by itself is not a reason to call an ambulance; 103/112 — if vision has sharply worsened or disappeared, flashes of light have appeared, or floaters have suddenly increased: these may be signs of a serious retinal problem, such as detachment.

This material is for reference and does not replace a doctor's consultation: only a doctor during an examination can see your vessels and discuss what they mean specifically for you.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer