The macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Age-related macular degeneration (AMD) occurs when the arteries that nourish the retina harden. Deprived of nutrients, the retinal tissues begin to weaken and die, causing vision loss. Patients may experience anything from a blurry, gray or distorted area to a blind spot in the center of vision.
There are two kinds of AMD: wet (neovascular/exudative) and dry (non-neovascular). About 10-15% of people with AMD have the wet form. “Neovascular” means “new vessels.” Accordingly, wet AMD occurs when new blood vessels grow into the retina as the eye attempts to compensate for the blocked arteries. These new vessels are very fragile, and often leak blood and fluid between the layers of the retina. Not only does this leakage distort vision, but when the blood dries, scar tissue forms on the retina as well. This creates a dark spot in the patient’s vision.
Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). These weak vessels can leak, swell or develop thin branches, causing a loss of vision. Changes to your vision may not be noticeable at first. But in its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots – and, eventually, blindness. This damage is irreversible. Diabetic retinopathy is the most common diabetic eye complication and a leading cause of blindness in American adults. Macular edema, which is leaking fluid that causes blurred vision, often occurs with diabetic retinopathy.
Fortunately, diabetic retinopathy is preventable. People with diabetes are most susceptible to developing it, but your risk is reduced if you follow your prescribed diet and medications, exercise regularly, control your blood pressure, and avoid alcohol and cigarettes. Regular eye exams are an integral part of making sure your eyes are healthy.
Although damage caused by diabetic retinopathy cannot be corrected, patients diagnosed with the condition can be treated to slow its progression and prevent further vision loss. Treatment methods include laser and surgical procedures.
Intravitreal injections are an exceptionally effective medical treatment for several different ocular diseases. The injected medication holds many advantages over both oral and topical processes, as well as invasive surgery, including:
- Immediate localization; no need to wait for absorption through secondary media
- Lower effective dosage and frequency required
- Minimally invasive; fewer complications than surgery
Several retinal diseases are treatable with intravitreal injections, including macular degeneration, retinal vein occlusion, and diabetic retinopathy. All of these can cause blindness in their most progressed stages and thus timely treatment by intravitreal injection is crucial. In fact, macular degeneration (wet-subtype) is responsible for approximately 90% of all blindness caused by disease.
Laser retina surgery can be used to treat a wide range of retinal conditions through minimally invasive techniques that produce precise, long-lasting results. Although your eyes may look and feel normal with these diseases, they can often lead to serious complications such as hemorrhaging and blindness. Lasers have been used to treat eye diseases for over 30 years and produce effective results with no damage to surrounding tissue and no need for needles. It has quickly become the standard for eye disease treatment.
Laser surgery can be used to treat diabetic retinopathy, retinal vein occlusions, age-related macular degeneration, retinal detachments and more. Depending on the patient’s condition, the laser may be used to seal leaking blood vessels, repair tears, remove newly formed blood vessels or destroy tumors. These procedures are performed in the doctor’s office and require only anesthetic eye drops to numb the area prior to treatment. Laser treatment usually takes less than 30 minutes to perform, and patients can go home immediately following surgery. Most patients return to work and other normal activities the next day.
Fluorescein angiography is the practice of taking photographs of blood vessels inside the eye (an angiogram) with the help of a contrast dye (fluorescein dye). These pictures help doctors evaluate the retina and diagnose and track problems such as diabetic retinopathy, macular degeneration, abnormal vessel growth, swelling, leaking, retinal detachment, cancer or tumors.
First, the patient’s pupils are dilated with eye drops. Then a few photographs are taken with a special ophthalmic camera. Next, the contrast dye is injected, usually in the patient’s arm. The dye travels up to the eye within a few seconds and “lights up” the blood vessels for the camera. Once the dye is in place, the doctor will take more photographs. Then the needle is removed. After about 20 minutes, a final set of photographs is taken for comparison.