Vitreoretinal diseases are a group of eye conditions concerning the retina and the vitreous in your eye. These structures can become damaged, often with age, and lead to eye problems that can affect your vision.

Age-related macular degeneration is a common vitreoretinal condition that occurs in people over the age of 50. The macula becomes damaged, and central vision is impaired. Fortunately, symptom management and surgical treatment options are available.

Posterior vitreous detachment occurs naturally in everyone, and it usually happens over the age of 60. With age, the vitreous gradually detaches from the retina, usually without any problems. Complications, such as retinal tear or detachment, can sometimes occur during this process.

Retinal tears can be caused by injury to the eye, but they are primarily the result of posterior vitreous detachment. For some people, retinal tears are mild and don’t present with any serious symptoms. Severe retinal tears, however, can lead to retinal detachment. In such a case, surgical treatment is necessary.

patient receiving cataract surgeryA vitreoretinal surgery is any type of surgical intervention performed on the vitreous or the retina. With modern advances in eye surgery, vitreoretinal surgeries are minimally invasive, highly effective, and have relatively quick recovery times.

Not all vitreoretinal diseases require surgical intervention, but for those that do, there are many surgical treatment options available. Vitrectomy, laser therapy, cryotherapy, photodynamic therapy, and traditional eye surgery are all surgical treatment options for various vitreoretinal conditions.

If you are experiencing symptoms of a vitreoretinal disease, speak with your eye doctor about your treatment options. In mild cases, surgery may not be recommended, as many vitreoretinal symptoms clear up on their own over time. In more severe cases, vitreoretinal surgery may be a good treatment option.

What Are Vitreoretinal Diseases?

Vitreoretinal diseases are a type of eye condition that affect the retina and the vitreous, a gel-like substance in the eye that helps it keep its round shape.

The retina is the layer on the back of your eye that is sensitive to light. It focuses images you see and transmits that information to the brain.

When these two structures are damaged for any reason, your eye health and vision can be compromised.

Types of vitreoretinal diseases include:eye anatomy

  • Age-related macular degeneration.
  • Diabetic retinopathy.
  • Flashes and floaters (posterior vitreous detachment).
  • Macular holes.
  • Macular pucker.
  • Retinal tears or detachments.
  • Retinoblastoma.
  • Stargardt disease.
  • Uveitis.

Many of these vitreoretinal diseases get progressively worse with age. Weakening of structures in the eye can lead to complications, such as retinal detachments or holes. Likewise, the vitreous in the eye tends to shrink as you get older, and this can cause problems like macular pucker.

Age-Related Macular Degeneration

Macular degeneration, formally known as age-related macular degeneration (AMD), is a loss of central vision stemming from damage to a part of your retina called the macula. There are two types of AMD: Dry AMD and Wet AMD.

diagram of Macular Degeneration

Dry AMD is the more common of the two, accounting for about 80 percent of AMD cases. Dry AMD is characterized by the existence of drusen, miniscule protein bundles, in a thinned-out macula. Doctors have no treatment for Dry AMD.

Wet AMD is less common but more serious than Dry AMD. The hallmark of Wet AMD is the growth of irregular blood vessels under the retina. When they leak, the blood vessels can scar the macula. This condition affects vision quickly and significantly.

Posterior Vitreous Detachment

Posterior Vitreous Detachment (PVD) is a condition indicated by a separation between the posterior vitreous cortex and the neurosensory retina. Unfortunately, you can easily have this condition and not know it because symptoms are non-specific.

Symptoms include the presence of floaters or a change in existing floaters, the seeming presence of hairs within vision and a light shadow.

Your eye doctor will be concerned about you having a detached retina – or about you detaching your retina accidentally before treatment.

Retinal Tears or Detachment

Retinal tears are small tears that form in the retina. Not only do they negatively affect your vision, they’re also an indicator that immediate action is needed. Tears can turn into detachments, and detachments threaten a major loss of vision – possibly permanently, if untreated.

Treatment for an early stage tear is low risk, and the two typical methods are cryotherapy and laser surgery.

Traditional surgery, laser surgery and cryotherapy are the treatments for a detachment.

Giant Retinal Tears

Retinal tears of any kind are eye injuries that threaten overall eyesight. And giant retinal tears (GRTs) are major tears that hasten the loss of sight. Doctors put them into one of three classifications:

  • GRT without detachment
  • GRT with detachment with a posterior flap, with a rolled posterior flap or with an inverted posterior flap
  • GRT with detachment with radial rips at or near the tear margin

Vitreoretinal Surgery

Vitreoretinal surgery refers to surgical procedures conducted deep in the eye to preserve or restore sight. Any number of conditions can be a reason to have one of these surgeries:laser eye surgery

  • Macular holes
  • Macular pucker
  • Retinal tears and detachments
  • Floaters
  • Diabetic retinopathy

While serious, these procedures are fast, are usually performed with a local anesthetic and have a quick recovery period. Technological advances have also made this surgery faster and safer. Eye surgeons, like surgeons in every other field, enjoy enhanced visualization: better magnification and depth of field. This is only going to get better with improved cameras and resolution.

Surgical Treatment Options

There are many different surgical options available for treating vitreoretinal diseases.

Experts from the UT Southwestern Medical Center explain how different surgical procedures can be used, depending on which vitreoretinal disease you have.

Surgical treatment options include:

  • Traditional surgery. Traditional eye surgery can be performed to repair retinal detachment or retinal tears.
  • Vitrectomy. In order to better reach the retina, the vitreous is removed from the eye and replaced with an artificial gel-like substance.
  • Laser therapy. In order to treat damaged blood vessels in the eye, laser therapy offers a blade-free surgical option.
  • Cryotherapy. Targeted cold therapy is used to freeze cells in order to repair damaged areas in the eye.
  • Photodynamic therapy. Abnormal blood vessels in the retina are sealed off with photodynamic therapy through the use of a laser and special light-sensitive medication.

Preventing Vitreoretinal Diseases

While most vitreoretinal diseases have comprehensive treatment procedures, sometimes prevention is better than cure.

One thing to note is that vitreoretinal diseases refer to a broad range of conditions, so there’s no one-size-fits-all approach to preventing them.

Before rolling out the prevention regimen, it helps to examine the factors causing the diseases. Doing so could shine a light on what’s needed to formulate an effective preventative process.

Here are some of the vitreoretinal diseases risk factors:

  • Eye trauma
  • Smoking
  • Obesity
  • Diabetes or other diseases

With that in mind, these are some of the most effective ways of preventing vitreoretinal diseases:

  • Avoid smoking
  • Regular exercising
  • Maintain healthy weight levels
  • Maintain normal blood pressure
  • Prevent eye injuries using protective goggles
  • Consistent eye check-ups, at least once every two years
  • Regular medical checkups to control medical conditions
  • Eat a balanced diet rich in vitamins, carotenoids, and omega-3 fatty acids, such as tuna, green leafy vegetables, oranges, and oysters.

Although it’s not conclusive, some research shows a connection between prolonged sun exposure and age-related macular degeneration. Wearing hats and sunglasses when you step out should help avoid it.

To prevent retinal detachment, your eye surgeon may recommend repairing retinal tears using laser technology.

Is Vitreoretinal Surgery for Me?

A discussion between you and your ophthalmologist will help you decide if vitreoretinal surgery is right for you. Depending on your condition, there are many different treatment options available that come with varying degrees of risks and potential side effects.

Ophthalmologist doctor with the snellen chartMedical, nonsurgical treatment options are also available for some vitreoretinal diseases. Anti-VEGF therapy, for example, utilizes medications to treat conditions in the eye by reducing swelling and the growth of blood vessels.

If you are experiencing symptoms of any kind of vitreoretinal disease, it is important to see your ophthalmologist as soon as you can. Many vitreoretinal diseases are relatively harmless at first and can be successfully addressed with minimal surgical intervention.

Some conditions, such as retinal detachment, can progress quickly and lead to more serious complications, like vision loss. If detected and treated early, serious eye and vision complications can be avoided. With prompt care, you can quickly return to your daily life with healthy and clear vision.

 

References:

Posterior Vitreous Detachment. (2016). American Society of Retina Specialists.

Retinal Detachment. (June 2019). National Eye Institute.

Retinal Tears. (2016) American Society of Retina Specialists.

Vitreoretinal Disease. Milford Eye Clinic.

Vitreoretinal Diseases and Surgery. UT Southwestern Medical Center.

Vitreo Retinal Diseases. (June 2018). National University Hospital.

What Is Macular Degeneration? (February 2020). American Academy of Ophthalmology.

Age-Related Macular Degeneration. (August 2019). National Eye Institute.

Chapter 19 - Diet and Supplements in the Prevention and Treatment of Eye Diseases. (2017). ScienceDirect.

What Is Macular Degeneration? (January 2021). American Academy of Ophthalmology.

Posterior Vitreous Detachment. (August 2021). American Academy of Ophthalmology.

Retinal Detachment. (June 2021). American Academy of Ophthalmology.

Are You Ready for the Future of Vitreoretinal Surgery? (November-December 2018). Retina Today.

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