Spotted or flaming hemorrhage of the fundus

Introduction 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.

Cause

Causes of point-like or flaming bleeding in the fundus:

(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.

an examination

Related inspection

Ophthalmologic examination fundus examination slit lamp serum interleukin-6

Examination and diagnosis of point-like or flaming hemorrhage in the fundus:

Based on these symptoms, you can diagnose:

(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.

Differential diagnosis

Differential diagnosis:

According to the time of retinal hemorrhage, the color of blood and the law of change, it is divided into hemorrhage period, blood stasis period, absorption and mechanization period. Each period has pathological characteristics. Therefore, on the basis of syndrome differentiation and treatment, it is necessary to treat in stages. In order to be fully effective.

First, the bleeding period: the use of hemostasis and phlegm method:

Features: bleeding begins or there is a tendency to repeated bleeding, the onset time is more than 15 days, the spotted hemorrhage on the retina or the center of the optic papilla, radial bleeding, bright red color.

Second, the blood stasis period, the use of blood circulation, qi and collateral:

Characteristics: The onset of the disease is between 15-45 days after the bleeding, no fresh bleeding, dark red bleeding and exudation can be seen in the fundus. Treatment to promote blood circulation, qi and collateral.

Third, absorption and mechanization period, blood circulation, Ligan Sanjie:

Characteristics: After 45 days of onset, the disease accumulates for a long time, the fundus is dark and black, there is yellow-white exudation lesion, macular edema, retinal color is dark yellow turbid, or choroidal occlusion is white-lined, proliferating organic compound .

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