Decoding Vitreoretinal: Understanding Its Role, Diseases, and Treatments
The term “vitreoretinal” refers to two of the parts that make up the eye: The retina and the vitreous humor.
The retina, located at the back of the eye, is a light-sensitive layer of tissue composed of many types of cells. It converts light into electrical signals and transmits that information via the optic nerve to the brain, which then translates it into images. Photoreceptors in the retina, particularly the rods and cones, work together to provide vision in various light conditions.
Meanwhile, the vitreous humor is a clear, gel-like fluid located in the vitreous chamber or the space between the retina and the lens of the eye. Its primary function is to ensure that the eye retains its shape and stays attached to the retina.
Additionally, the vitreous humor provides nutrients to the eye. It allows light to pass through to the macula, the part of the retina responsible for allowing the brain to recognize and understand specific colors, small details and tiny movements.
Those diagnosed with a vitreoretinal disease have a condition that affects the retina and the vitreous humor.
Common Vitreoretinal Diseases and Their Causes
Many conditions can affect the retina and vitreous humor. Two of the most common vitreoretinal diseases are:
Age-Related Macular Degeneration (AMD)
AMD is a condition associated with aging. Damage to the macula can result in blurry or wavy areas in your central vision, which is the “look ahead” vision you need to see fine details, identify colors, details and shapes as well as recognize faces.
There are two kinds of AMD: Wet AMD and dry AMD.
About 10% of those diagnosed with AMD have wet AMD. It occurs when new, abnormal blood vessels grow under the macula, causing bleeding and scarring. Meanwhile, dry AMD occurs when the blood vessels under the macula start to thin and turn brittle. It typically affects both eyes.
Diabetic Retinopathy
This vitreoretinal disease is a complication of diabetes. Very high blood sugar levels can damage the retina’s blood vessels, which may cause vision loss or blindness.
There are two stages of diabetic retinopathy. The early stage, Non-proliferative Diabetic Retinopathy (NPDR), occurs when blood vessels behind the macula weaken and swell, causing fluid or blood to leak into the retina.
The second stage, Proliferative Diabetic Retinopathy (PDR), occurs when damaged blood vessels close off and new blood vessels grow in the retina in a process called neovascularization. These new blood vessels are weak, leaking blood into the vitreous humor.
This can cause vision loss. Left unaddressed, the new blood vessels can result in scarring and cause the retina to detach.
Other common vitreoretinal conditions include:
- Macular Holes – These occur when the vitreous shrinks and pulls at the retina, causing holes to form in the macula
- Macular Pucker – This rare condition happens when a wrinkle forms on the retina, causing wavy or distorted vision
- Retinal Detachment – Considered an emergency, this condition occurs when the retina detaches from the back of the eye.
- Posterior Vitreous Detachment (PVD) – This occurs when the vitreous membrane that separates the vitreous humor from other parts of the eye pulls away from the retina. It is a common, aging-related condition.
- Vitreomacular Traction Syndrome (VTS) – In some cases of PVD, the vitreous membrane does not completely detach from the retina, causing it to pull on the macula. It may lead to macular holes, macular puckers or edema in the macula, all of which can result in vision loss if left untreated.
Vitreoretinal Surgery: Procedure and Purpose
Depending on the type of vitreoretinal condition you have, your doctor may recommend vitreoretinal surgery.
Vitreoretinal surgery refers to surgical procedures performed on the retina and the vitreous to help improve, preserve or restore vision, thus improving the patient’s quality of life. It is also called vitrectomy, and there are two main kinds: Pars plana vitrectomy (PPV) and anterior pars plana vitrectomy. Anterior pars plana is rarely performed.
A pars plana vitrectomy (PPV) is typically used as a treatment for retinal detachment, macular holes, vitreous hemorrhage, diabetic retinopathy and some other vitreoretinal conditions. During the procedure, the vitreoretinal surgeon makes small incisions into the sclera and inserts special tools to treat the condition. This can involve:
- Removing scar tissue surrounding the retina
- Replacing cloudy vitreous humor with a solution
- Putting the retina into the correct position
- Using a laser to repair a torn retina
PPV is typically an outpatient procedure.
Comprehensive and Compassionate Vitreoretinal Disease Treatment in Texas
If you suspect you have a vitreoretinal disease or have been diagnosed and need treatment, you can rely on the Eye Institute of Texas. We have been caring for the eyes of Texans for over 50 years, providing quality medical care and exceptional customer service.
Our team consists of highly trained and experienced physicians and ophthalmology professionals who are dedicated to the vision health of the communities we serve. To learn more or book an appointment, please get in touch.