Proliferative Retinal Disease including Sickle Cell Disease

What is Proliferative Retinal Disease?

Retinal blood vessels supply the necessary oxygen and nutrients for the retina to function properly. 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.

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.

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.

How is Proliferative Retinal Disease diagnosed and treated?

Your doctor can usually see retinal neovascularization when he or she examines your eye. Patients also need to have special photographs of the retina taken frequently. This series of photos is called fluorescein angiography and they allow the doctor to see which specific areas of the retina have poor or no blood flow and the location of the leaking neovascular vessels.

Proliferative retinal disease can be treated by either laser, intravitreal injections, or in severe cases, surgery.

  • Laser photocoagulation is one of the most common treatments for neovascularization. There is little recuperation needed after laser surgery for proliferative disease. Laser surgery may require more than one treatment to be effective.

  • Vitrectomy surgery is performed for patients experiencing very advanced proliferative disease or retinal detachment. During a vitrectomy, the 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.

Retina Consultants of Houston is specialized in handling the diagnosis and treatment of proliferative retinal disease and will work closely with your primary physician to address any underlying conditions that could be contributing to it.