Retinal vascular diseases can be triggered by medical conditions such as high blood pressure, cardiovascular disorders, diabetes, bleeding, clotting, autoimmune disorders, history of stroke, and artherosclerosis or the thickening of blood vessels. Depending on what type of disorder you have, retinal vascular diseases can be signaled by different symptoms. Some of the most common signs of the disease are:.
Retinal Vascular Diseases: Symptoms, Prevention & Treatment
Retinal vascular diseases are usually linked with an underlying medical condition that affects the blood vessels and circulation. So a lot of the ways of preventing them have to do with maintaining healthy habits. To avoid conditions such as diabetes and hypertension, you need to maintain a healthy diet, moderate your sugar and fat intake, exercise, and get enough hours of sleep. Going to regular check-ups would also help detect health issues ahead of time and treat them before they get serious and affect the eyes.
Other treatments for macular edema following central retinal vein occlusion include intraocular injections of Ozurdex Allergan or Lucentis Genentech.
Based on the study data, the study authors estimated that If you have sudden vision loss or any other symptoms of eye stroke, visit your doctor immediately. A branch retinal artery occlusion usually occurs suddenly. While typically painless, a BRAO can cause an abrupt loss of peripheral vision. In some cases, you may also lose central vision. If you have sudden vision loss or other symptoms of an "eye stroke," see your doctor immediately. Usually the cause is a clot or plaque embolus that breaks loose from the main artery in the neck carotid or from one of the valves or chambers in the heart.
No ocular therapy has been proven to help. However, some ophthalmologists may try ocular massage or a fluid tap from the eye anterior chamber paracentesis in the case of an acute or sudden arterial occlusion. Your ophthalmologist also may prescribe a glaucoma medication to dislodge the embolus, if the condition has been present for fewer than 12 to 24 hours. You also will be evaluated for cardiovascular risk factors and treated accordingly, often in conjunction with your regular doctor. Most people with BRAO have narrowing of the carotid or neck artery, high blood pressure, cholesterol disorders, cardiac disease or combinations of these disorders.
Your eye doctor will evaluate you every one to two months until your vision is stable. Vision recovery depends on whether the central macula is involved initially.
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Rarely, you may develop other complications from BRAO, such as neovascularization of the retina or iris. Neovascular glaucoma also is possible. People who have a branch retinal vein occlusion near the retina may have decreased vision, peripheral vision loss, distorted vision or blind spots. A BRVO involves only one eye and usually develops in a person with high blood pressure or diabetes.
The cause of BRVO is a localized clot thrombus development in a branch retinal vein due to hardening of the arteries arteriosclerosis in an adjacent, small branch retinal artery.
Your ophthalmologist will see retinal bleeding along the involved retinal vein in a clear pattern that nearly always leads to the correct diagnosis. Many ophthalmologists will do a fluorescein angiogram during the recovery period if neovascularization is suspected.
A fluorescein angiogram is a safe, in-office diagnostic procedure in which fluorescein dye is administered through the vein IV or sometimes orally for retinal photography. If neovascularization develops or if the BRVO involves a significantly large area of retina leading to neovascularization, you may undergo pan-retinal laser photocoagulation to repair damaged areas.
For many people, retinal hemorrhage and macular swelling will end in a few months, with retention of good vision. If you need laser treatment, your ophthalmologist will use strict criteria to determine whether you will benefit. These criteria result largely from the Branch Retinal Vein Occlusion Study, in which patients with BRVO who had laser treatment were compared with those who didn't have it. For macular edema caused by BRVO, your eye doctor may recommend treatment with injections of medication into the eye.
Retinal Vascular Diseases
In June , Ozurdex Allergan became the first injectable drug therapy to gain FDA approval for the treatment of macular edema following branch retinal vein occlusion or central retinal vein occlusion CRVO. Ozurdex treatment consists of injection of a biodegradable implant into the vitreous of the eye that delivers dexamethasone a potent corticosteroid to the retina.
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The implant enables an extended release and effect of dexamethasone to reduce macular swelling and improve visual acuity. In clinical studies, 20 to 30 percent of patients suffering from retinal vein occlusion experienced a three-line improvement in best-corrected visual acuity with an onset of effect within the first two months following therapy, according to Allergan. In June , the FDA approved Lucentis Genentech , another medical treatment for macular edema caused by retinal vein blockage. Lucentis treatment consists of monthly injections of a medicine called ranibizumab into the vitreous to reduce macular swelling and restore vision.
Ranibizumab binds to and inhibits something called vascular endothelial growth factor A VEGF-A in the eye, which can trigger the growth of fragile new blood vessels in the retina. These abnormal blood vessels can leak blood and fluid into the eye, contributing to macular edema. One study leading to FDA approval of Lucentis showed that 61 percent of people treated with monthly ranibizumab injections had significant vision improvement, compared with 29 percent who received sham injections. Management There is no established treatment for the eyes specifically, although isolated case reports have suggested possible benefits from systemic steroids or hyperbaric oxygen.
Management of the underlying cause is the mainstay of treatment. Outcome Fundal changes often resolve within a few weeks and spontaneous visual recovery of at least 2 Snellen lines is seen in half of the cases. Management There is no specific treatment. Digital fundal imaging has demonstrated that narrowing of arterioles is associated with the duration of treatment with HAART, or with the prolonged inflammatory state associated with AIDS. Outcome The severity of HIV retinopathy is correlated with worsening visual morbidity eg, visual field loss.
It may also serve as a marker for the severity of systemic atherogenic vascular disease which is also associated with chronic HIV infection and prolonged treatment with HAART. Anaemia Some anaemias can cause retinal changes including flame haemorrhages with pale centres Roth's spots , cotton wool spots and venous tortuosity. Optic neuropathies are also described - particularly in pernicious anaemia. However, these changes are often innocuous and rarely of diagnostic importance. Management lies in treating the underlying cause of anaemia. Leukaemia Retinopathy is relatively common in leukaemia and is characterised by similar findings to those described for anaemia.
The cotton wool spots may represent leukaemic infiltrates. There may also be orbital involvement particularly in children , spontaneous subconjunctival haemorrhage and optic neuropathy. Hyperviscosity states Retinopathy shows venous dilatation, tortuosity and retinal haemorrhages. There may be cotton wool spots and disc swelling. Management Where aneurysm rupture leads to haemorrhage management is restricted to observation until it involutes as laser treatment cannot be carried out through the haemorrhage.
Laser treatment is then performed to the lesion. The use of intravitreal injection of vascular endothelial growth factor VEGF inhibitors, such as ranibizumab or bevacizumab, have been used with good outcomes in a few isolated cases. Outcome Involution of the haemorrhage is very common but, occasionally, there is a chronic leak resulting in permanent loss of central vision. Description This group of rare, idiopathic disorders may be congenital or acquired.
There are various vascular abnormalities tortuosities, leakages, aneurysms and deposition of hard exudates which often progress over time. Management This depends on the subtype and severity. Management ranges from observation to photocoagulation laser therapy, cryotherapy, vitreoretinal surgery and intravitreal injection of anti-vascular endothelial growth factor anti-VEGF. Management This depends on the exact findings but this may include topical steroids, anti-VEGF, laser treatment or surgery. Outcome This depends on the degree of retinopathy.
Poor prognostic features include optic nerve involvement and neovascularisation. Did you find this information useful? We'd love to send you our articles and latest news by email, giving you the best opportunity to stay up to date with expert written health and lifestyle content.
What are the signs of retinal vascular disease?