Murray Ocular Oncology & Retina

Retina Center

Topics:

  • Age-Related Macular Degeneration
  • Epiretinal Membrane
  • Vitreomacular Traction
  • Diabetic Retinopathy

Age-Related Macular Degeneration

The inner layer of the back of the eye is called the retina. Among other cells, the retina is composed of light-sensing cells called photoreceptors (rods and cones). Photoreceptors are responsible for detecting light, and sending that detection of light to our brains, allowing us to see. Although photoreceptors line the entire retina, they are extremely numerous in the center of the retina, called the macula. This is why our central vision is normally much clearer than our peripheral (side) vision. Age-related macular degeneration, or AMD, is a disease caused by cellular damage to the macula. AMD is categorized as either Dry AMD or Wet AMD. Dry AMD is diagnosed when yellow, extracellular waste, called drusen, start to deposit in the macula. In dry AMD, there is no associated vascular leakage in the macula. Wet AMD is what results when new blood vessel formation (neovascularization) causes vascular leakage, which disrupts and damages the photoreceptors. Although both dry and wet macular degeneration may lead to permanent vision loss, wet macular degeneration is usually much more severe.

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Epiretinal Membrane

This extremely thin layer of transparent scar tissue may slowly form over the retina. This tissue may create tension on the retina, which can sometimes lead to macular edema. Often this results in distortions of vision (metamorphopsia) or vision loss.

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Vitreomacular Traction

The gel inside the eye, called the vitreous, may slowly turn into liquid as the eye ages. This results in pockets of liquid forming within the vitreous cavity. This liquefaction predisposes the vitreous to pull away from the back of the eye, usually causing a posterior vitreous separation. Sometimes, parts of the vitreous stay adhered to the retina. An incomplete posterior vitreous separation at the center of the retina (the macula) may lead to tractional retinal distortion and macular edema, which may result in metamorphopsia (distorted vision) or vision loss

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Diabetic Retinopathy

One major complication from diabetes is damage to the retina inside the eye. This retinal damage, or retinopathy, is caused by an over accumulation of sugar in the tiny blood vessels in and around the retina. The walls of these small blood vessels become more permeable, allowing vascular leakage. These vascular changes may damage the eye in more ways than one. Diabetic macular edema (DME) results from vascular leakage accumulating in the macular, disrupting and damaging the photoreceptors. In addition, areas of the retina that are not obtaining oxygen may develop delicate, new blood vessels that proliferate, bleed, and ultimately scar and cause traction on the retina. Without intervention, this may lead to a tractional retinal detachment and blindness.

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