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Retinopathy
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Types and causes
- Retinopathy of prematurity: Retinopathy of prematurity occurs in some premature or low-birth-weight infants. In healthy babies, the blood vessels grow outward, covering the retina. However, this process is not yet finished in infants who are born prematurely. Although the blood vessels continue to grow after birth, they grow in abnormally into the clear gel that fills the back of the eye. The abnormal blood vessels are fragile and may leak, causing bleeding in the eye.
- Babies are typically at risk for retinopathy of prematurity if they are born before the end of the 29th week of pregnancy, or if the baby weighs less than 1,200 grams at birth.
- In up to 85% of cases, the abnormal blood vessels disappear and the condition gets better without any treatment. However, serious cases may lead to permanent vision loss or blindness. Babies with this form of retinopathy have an increased risk of cataracts, glaucoma (increased fluid pressure inside the eyeball), crossed eyes, lazy eyes, nearsightedness, and retinal detachment. Retinal detachment occurs when the retina separates from its attachments to the back of the eyeball.
- Diabetic retinopathy: About 80% of patients with type 1 or type 2 diabetes who are treated with insulin or have had diabetes for longer than 20 years develop retinopathy. This is because chronic high blood sugars levels damage sensitive blood vessels in the eye. Diabetic retinopathy is the leading cause of blindness in Americans between the ages of 20 and 64. There are two stages of diabetic retinopathy: nonproliferative and proliferative retinopathy.
- Nonproliferative retinopathy, the most common type of diabetic retinopathy, is an early stage of the disease. This condition causes the blood vessels in the retina to weaken and tiny bulges (called microaneurysms or outpouchings) to develop. These microaneurysms may leak fluid and blood into the part of the retina that is responsible for sharp vision.
- Proliferative retinopathy is a more advanced form of the disease. This condition occurs when abnormal blood vessels grow (proliferate) inside the retina or the optic disc. In some cases, the blood vessels may also grow inside the clear, jelly-like substance (called vitreous) in the center of the eyes. When this occurs, the blood vessels eventually leak blood into the vitreous, which clouds or impairs vision. The abnormal blood vessels may also cause irritation and lead to the formation of scar tissue. When scar tissue forms, patients have an increased risk of experiencing retinal detachment, which occurs when the layers of the retina separate. Without prompt treatment, retinal detachment may lead to permanent vision loss. Individuals may also develop a type of glaucoma, called neovascular glaucoma, which is associated with the growth of abnormal blood vessels on the colored portion of the eye (called the iris).
- Either stage of diabetic retinopathy may lead to macular edema, a condition that occurs when the central part of the retina (called the macula) swells and impairs fine vision, which is necessary for reading and other detail work.
- The prognoses for patients with diabetic retinopathy depends on how well blood sugar is managed, how well the condition is monitored, and how far the disease has progressed. Treatment is available to repair retinal damage and slow the progression of the disease. However, severe cases may lead to permanent blindness.
- Hypertensive retinopathy: Hypertensive retinopathy occurs in some people who have high blood pressure (called hypertension). High blood pressure can cause a variety of problems with the blood vessels, including blocked retinal blood vessels, leaking blood vessels, and thickened blood vessels. All of these changes may lead to hypertensive retinopathy. Patients with hypertensive retinopathy who experience sudden and severe high blood pressure may develop swelling of the optic nerve, a condition called papilledema.
- In most cases, symptoms of hypertensive retinopathy go away once the patient's blood pressure has been lowered. Patients with papilledema may also benefit from corticosteroid medications.
- Central serous retinopathy: Central serous retinopathy occurs when fluid from one or more areas of the eye builds up in the membrane behind the retina, called the choroid. When the fluid leaks between the tissue layers in the retina, it causes them to separate, which may lead to poor night vision and/or blurred vision.
- Central serous retinopathy occurs for unknown reasons. However, researchers believe that steroid medicines, antihistamines, antibiotics, alcohol abuse, pregnancy, nasal allergies, asthma, autoimmune disorders, and untreated high blood pressure may trigger symptoms of the disease. However, their relationship to retinopathy is not clearly understood. It has also been suggested, but not proven, that emotional stress may trigger central serous retinopathy.
- For unknown reasons, central serous retinopathy is most common among males who are 20-50 years old.
- In most cases, symptoms of central serous retinopathy start to go away without treatment in three to four months. For most patients, vision returns back to normal within six months. However, some individuals may experience long-term symptoms, which may include decreased contrast sensitivity, poor night vision, and distortion. It is common for this condition to return in the future.
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Copyright © 2011 Natural Standard (www.naturalstandard.com)
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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
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