Vitreous Separation Vitreous Separation Diabetic Retinopathy Diabetic Retinopathy Macular Degeneration Macular Degeneration Macular Hole Macular Hole Macular Pucker Macular Pucker Retinal Vein Occlusion Retinal Vein Occlusion Cytomegalovirus Cytomegalovirus Uveitis Uveitis Cystoid Macular Edema Cystoid Macular Edema Vitrectomy Vitrectomy Fluorescein and Indocyanine Green Angiography Fluorescein and Indocyanine Green Angiography Ultrasonography Ultrasonography Laser Photocoagulation Laser Photocoagulation Cryotherapy Cryotherapy Pneumatic Retinopexy Pneumatic Retinopexy Ganciclovir Implant Ganciclovir Implant Intraocular Injection Intraocular Injection David L. Yarian, M.D. David L. Yarian, M.D. Stuart N. Green, M.D. Stuart N. Green, M.D. Steven R. Leff, M.D. Steven R. Leff, M.D. Eric S. Friedman, M.D. Eric S. Friedman, M.D. Bruce J. Keyser, M.D. Bruce J. Keyser, M.D. H. Matthew Wheatley, M.D. H. Matthew Wheatley, M.D. Daniel B. Roth, M.D. Daniel B. Roth, M.D. Jonathan L. Prenner, M.D. Jonathan L. Prenner, M.D. Howard F. Fine, M.D. Howard F. Fine, M.D. Vitrectomy Vitrectomy Fluorescein and Indocyanine Green Angiography Fluorescein and Indocyanine Green Angiography Ultrasonography Ultrasonography Laser Photocoagulation Laser Photocoagulation Cryotherapy Cryotherapy Pneumatic Retinopexy Pneumatic Retinopexy Ganciclovir Implant Ganciclovir Implant Intraocular Injection Intraocular Injection
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Vitreous Separation
Retinal Tear
Retinal Detachment
Diabetic Retinopathy
Age-Related
Macular Degeneration
Macular Hole
Macular Pucker
Retinal Vein Occlusion
Cytomegalovirus (CMV) retinal infection
Uveitis
Cystoid Macular Edema
Retinal Vein Occlusion
Just like any other portion of our body, the retina in our eyes has both arteries and veins which are responsible for the blood circulation, delivery of oxygen and nutrients, and the removal of wastes.
Sometimes, one of these blood vessels develops a blockage. This more commonly happens in the veins than the arteries. Depending upon location of the vein blockage, visual loss could be central or peripheral, mild or severe. Fluorescein angiography may be required to help characterize the type of blood vessel occlusion and to guide treatment recommendations.
Laser photocoagulation is often employed if there is any leakage and swelling of the central retina (macular edema) or abnormal blood vessel growth (neovascularization) that has developed as a consequence of a retinal vein occlusion.
Central Retinal Vein Occlusion (CRVO)
click to enlargeThe injection of steroids and anti-VEGF agents in the eye has also been demonstrated to be very useful in the treatment of macular edema associated with branch and central retinal vein occlusions. The Retina-Vitreous Center is currently enrolling patients in new multicenter clinical trials to study these therapies further. We currently utilize these therapeutic strategies actively in our daily care of patients.
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Cytomegalovirus (CMV) Retinal Infection
Because of their impaired immune system, individuals with AIDS are susceptible to a variety of infections, many of which are rare in healthy people. CMV retinal infection is such a condition.
The CMV virus produces retinal inflammation, hemorrhage, and in its late stages, often retinal detachment. Severe vision loss or blindness can result. For this reason, prompt retinal diagnosis and treatment is warranted.
Therapy with systemic antiviral drugs or the placement of an intraocular ganciclovir implant are the current mainstays of CMV retinitis management.
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Uveitis (Iritis)
Uveitis specifically refers to inflammation of the middle layer of the eye, termed the "uvea" but in common usage may refer to any inflammatory process involving the interior of the eye.
Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States. Uveitis requires a thorough examination by an ophthalmologist.
Types
Uveitis is usually categorized anatomically into anterior, intermediate, posterior and panuveitic forms.
Anywhere from two-thirds to 90% of uveitis cases are anterior in location (anterior uveitis), frequently termed iritis - or inflammation of the iris and anterior chamber. This condition can occur as a single episode and subside with proper treatment or may take on a recurrent or chronic nature. Symptoms include red eye, injected conjunctiva, pain and decreased vision. Signs include dilated ciliary vessels, presence of cells and flare in the anterior chamber, and keratic precipitates ("KP") on the posterior surface of the cornea.
Intermediate uveitis consists of vitritis - inflammatory cells in the vitreous cavity, sometimes with snowbanking, or deposition of inflammatory material on the pars plana.
Posterior uveitis is the inflammation of the retina and choroid.
Pan-uveitis is the inflammation of all the layers of the uvea.
Symptoms
Depending on which part of the eye is inflammed in uveitis different combinations of these symptoms may be present.
Redness
Light sensitivity
Floaters
Blurry vision
Pain
These symptoms may come on suddenly, and you may not experience any pain. The symptoms described above may not necessarily mean that you have uveitis. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.
Treatment
Treatment may include steroid eyedrops, injections, or pills, as well as eyedrops to dilate the pupil and reduce pain. More severe cases of uveitis may even require treatment with chemotherapeutic agents to suppress the immune system.
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Cystoid Macular Edema
Cystoid Macular Edema
click to enlarge
This condition refers to swelling of the central retina (macula), usually secondary to abnormally leaky retinal blood vessels. CME produces blurring of the central vision and/or metamorphopsia (distortion). Fluorescein angiography is frequently used in the evaluation of macular edema.
Many eye disorders can cause macular edema, but diabetes and recent cataract surgery are most common. Treatment of CME may include medicines (eye drops, pills, or steroid injections near the eye), laser, or vitrectomy surgery, depending on the cause.
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