Retina

The retina is the layer of cells that covers the back wall of the eye. This layer detects light entering the eye and communicates with the brain. The retina is connected to numerous components of the eye, including the macula, fovea, photoreceptors, rods, and cones, as well as the peripheral retina.

Branch retinal vein occlusion, central retinal vein occlusion, central serous chorioretinopathy, CMV retinitis, and other eye conditions may all affect the structure of the retina. These should be treated by going to the eye doctor when symptoms appear or by eye examination at regular intervals. (1)

Definition and Overview

The retina is a layer of neural tissue that covers the back two-thirds of the eyeball and aids in the start of visual perception when light is stimulated.

This complex tissue is a brain extension that develops from neural tissue in the embryo and joins to the brain through the optic nerve. (2)

Retinal diseases can affect any area of the retina. Some may have only a minor effect on a person's vision, while others may cause blindness. However, most retinal diseases can be avoided if an ophthalmologist diagnoses the disease early and recommends appropriate treatment. If  patients have problems with their retina, they should see a medical professional who specializes in ophthalmology or eye care. (3)

Procedures

Diseases of the retina can cause damage to any part of the retina. Untreated retinal diseases can lead to adverse vision loss and even blindness. With early detection, some retinal diseases can be cured, while others can be controlled or slowed to preserve or even restore vision. Retinal disorders and their treatment procedures are as follows:

•  Retinal tear

When the vitreous gel filling the eye begins to shrink, a retinal tear develops and pulls on the retina with sufficient force to lead the retinal tissue to rupture. A posterior vitreous detachment, or PVD, develops when the vitreous begins to pull away from the retina as people age.

Retinal tears are brought on by the vitreous pulling abnormally away from the retina in some people because their vitreous is more sticky from birth.

A retinal tear may suddenly affect vision, resulting in flashing lights, floaters, or black spots. Cryotherapy or laser surgery are the two most common treatments for retinal tears.

• Retinal detachment

Retinal detachment typically happens when fluid passes through a retinal tear and leads the retina to separate from other tissues at the back of the eye, eliminating blood flow and its ability to function appropriately. 

Based on the severity of the detachment, symptoms of a retinal detachment can range from none at all to seeing floaters, flashing lights, and a shadow that blocks peripheral and occasionally central vision.

Any retinal tears can be repaired and the retina can be reattached to the back of the eye using laser therapy, surgery, or freezing treatments (cryotherapy).

• Diabetic retinopathy

Diabetes has a major eye-threatening condition called diabetic retinopathy that can result in blindness. High blood sugar levels are the underlying cause of this condition, which gradually damages the retina. 

If diagnosed and treated early, diabetic retinopathy patients may regain their eyesight. Diabetic retinopathy comes in three different types including Proliferative Retinopathy (PR), Non-Proliferative Retinopathy (NPR), and Diabetic macular edema (DME). Injections of anti-VEGF or laser surgery are two treatments for diabetic retinopathy.

• Epiretinal membrane

Epiretinal membranes (ERMs), also known as cellophane maculopathy or macular creases. The fibro-cellular, transparent, and avascular epiretinal membranes are. Contains few or no blood vessels.

ERMs usually develop on the macula but can occasionally impact the inner surface of the retina and produce painless visual abnormalities and vision loss. Treatment for epiretinal membranes typically entails a vitrectomy, which is a surgical procedure. 

• Retinitis pigmentosa

Retinitis pigmentosa (RP) is a rare, inherited eye condition that impairs vision and damages the retina. Due to flashing, twinkling, or rotating lights (photophobia) in the visual field, RP progresses to the point where it produces extreme glare and sensitivity to bright lights. 

Most RP sufferers lose a substantial amount of vision during the final stage. There is presently no treatment for RP. Many patients are trained to use devices for low vision that enlarge existing central vision in order to increase the field of vision and reduce glare.

• Central vein occlusion

A disorder known as central retinal vein occlusion (CRVO) occurs when the central vein in charge of draining blood from the retina becomes blocked. Diabetes or glaucoma may possibly be the cause of this disorder. Non-ischemic and ischemic CRVO are the two types. Anti-VEGF injections and laser surgery are frequently used to treat it for more long-lasting treatment.

• Branch retinal vein occlusion

Branch retinal vein occlusion (BRVO) is brought on by an obstruction in a retinal vein branch. It typically results from a blood clot blocking the flow of blood. Scattering laser photocoagulation therapy is performed to inhibit the growth of abnormal blood vessels if this complication occurs. (4)

Candidates

People with the following vision problems in the eye should have a retinal examination immediately:

• Changes in sharpness of vision
• Loss of color perception
• Flashes of light or floaters
• Distorted vision (straight lines look wavy)  (5)

Risks and Side Effects

Risks and complications depend on the procedure used, but may include:

• cataract formation,
• glaucoma,
• Infection,
• bleeding into the vitreous cavity,
• vision loss. (6)

Post-Procedure and Follow-up

After the operation, patients may need to stay in the hospital for one night or sometimes longer. When discharged, it is normal to have discomfort, turbidity, and watering in the eye for a few weeks. All the instructions for the medicines given by the doctor should be followed. (7)

Recovery

During the recovery process, rubbing or pressing the eye should be avoided, eye pads should be worn for protection at night, and all instructions should be followed for medications given by the doctor, such as eye drops.

Results

Most retinal-related operations are successfully completed and the retina is repaired. Whether your vision will return or get better depends not only on the success or failure of the operation but also on the extent of the disease.