What is Proliferative Retinal Disease?
Retinal blood vessels supply the necessary oxygen and nutrients for the retina to properly function. However, when these retinal blood vessels become damaged due to an underlying disease, the retina is essentially “starved” of the oxygen and nutrients it needs to carry out its job. In order to get around this problem, the retina releases a chemical to enable the growth of new blood vessels. This sounds like a good idea, but these new blood vessels (also called neovascular vessels) that grow on the surface of the retina are very fragile and weak. Consequently, this process of new blood vessel growth, called neovascularization, can lead to serious vision problems because the new vessels can break and bleed into the vitreous (the clear, jelly-like substance that fills the middle of the eye between the lens and the retina).
Once the vitreous becomes clouded with blood, light cannot pass through the eye to the retina. This can blur or distort vision and often causes sudden and severe vision loss. The new blood vessels can also cause scar tissue to form which can pull the retina away from the back of the eye. This is called retinal detachment and can lead to blindness if not treated. In addition, abnormal blood vessels can also develop on the iris (the colored part in the front of the eye), which can cause a type of severe and painful glaucoma.
Causes of Proliferative Retinal Disease
Retinal conditions that can lead to neovascularization are called proliferative retinal diseases. The most common proliferative retinal disease is diabetic retinopathy. However, there are many other causes, including sickle cell disease, retinal vein occlusion, retinopathy of prematurity, ocular ischemic syndrome, Eales disease, and radiation retinopathy.
Diagnosis and Treatment of Proliferative Retinal Disease
Your ophthalmologist can usually see retinal neovascularization when examining your eye. Patients with retinal neovascularization need to have special photographs of the retina taken frequently. This series of photos is called fluorescein angiography, and it allows the your retina doctor to see which specific areas of the retina have poor or no blood flow as well as the location of the leaking neovascular vessels.
Proliferative retinal disease can be treated by either laser, intravitreal injections, or in severe cases, surgery.
These are the three most common treatment methods:
- Laser Photocoagulation: This is one of the most common treatments for neovascularization. There is little recuperation needed after laser surgery for proliferative disease. It may require more than one treatment to be effective.
- Vitrectomy Surgery: This surgical procedure is performed on patients experiencing very advanced proliferative disease or retinal detachment. During a vitrectomy, the retina surgeon removes the blood-filled vitreous and replaces it with a clear solution. This allows light to pass through the clear fluid to the retina, where the images are carried to the brain.
- Pharmacotherapy: Increasingly, a variety of medications are being used to treat proliferative retinopathy. These involve intravitreal injections of small amounts of medication into the eye.
Our physicians at Retina Consultants of Houston specialize in handling the diagnosis and treatment of proliferative retinal disease and will also work closely with your primary care physician to address any underlying conditions that could be contributing to it.