Retina and vitreous

The retina is a thin layer of light-sensitive nerve tissue located at the back of the eye, essential for vision. The vitreous, on the other hand, is a transparent gel that fills most of the inside of the eye, helping to maintain its shape. Diseases that affect the retina and vitreous can cause anything from mild visual disturbances to complete vision loss if not treated properly. Retinal pathologies are usually silent, which underlines the importance of regular ophthalmological check-ups, especially in people with risk factors such as advanced age, diabetes or family history.

Common Retinal Diseases

There are several diseases that affect the retina and vitreous, the most common being the following:

• Age-Related Macular Degeneration (AMD): It is one of the main causes of vision loss in people over 60 years of age. It affects the macula, the central part of the retina, responsible for detailed and central vision needed for activities such as reading or driving. AMD can come in two forms: atrophic and exudative. The atrophic or dry form progresses slowly, while the exudative or wet form is more aggressive and can cause rapid vision loss. Regular check-ups are important as atrophic AMD can become exudative and cause severe loss of central vision.
  
• Diabetic Retinopathy: It is an ocular complication of diabetes that alters the blood vessels of the retina, causing fluid exudation or hemorrhages that gradually compromise vision. In severe cases, it can lead to retinal detachment and blindness. Early detection through fundus exams is crucial to prevent the progression of the disease.
  
• Retinal detachment: It occurs when the retina separates from the back of the eye due, most of the time, to the leakage of a liquefied vitreous humor through tears in the retina. The patient complains of seeing lights and floating flies followed by the sight of a curtain that is closing. Retinal detachment is a medical emergency that requires urgent surgical treatment to prevent permanent vision loss.
  
• Retinal Vascular Occlusions: Obstruction of the blood vessels that supply the retina can lead to sudden loss of vision. They can affect arteries or veins, the former being more serious for vision.
  
• Epiretinal membrane: It is a thin layer of fibrous tissue that forms on the surface of the retina, causing visual distortion and blurred vision. In some cases, surgery may be required if visual quality is significantly impaired.

Diagnosis of Retinal Diseases

At our clinic, we offer a complete and accurate retinal assessment using state-of-the-art technology. Common tests for diagnosing retinal diseases include:

• Optical Coherence Tomography (OCT): This non-invasive technique uses light to obtain detailed images of the retinal layers, allowing the detection of even minimal structural changes in pathologies such as AMD, diabetic retinopathy and vascular occlusions.
  
• Angio-OCT: this is a non-invasive technique that allows the blood vessels in the central area of the retina and choroid to be visualised without the need for contrasts. In addition, it provides us with detailed images of blood flow in different layers of the retina, which is very useful for the diagnosis of diseases such as exudative AMD or diabetic retinopathy.
  
• Fluorescein angiography: This involves injecting a special contrast into the bloodstream and taking pictures of the blood flow in the retina. It is essential for the diagnosis of vascular diseases of the retina, such as diabetic retinopathy and vessel occlusion.
  
• Retinography: Captures detailed images of the retina, allowing ophthalmologists to document retinal changes over time.
  
• Ocular Ultrasound: In cases of opacity of the optical media (for example, dense cataract or vitreous hemorrhage), ocular ultrasound allows the evaluation of the retinal structure, as well as the presence of detachments or masses.

Treatment of Retinal and Vitreous Diseases

The treatment of retinal pathologies depends on the specific disease and its severity. The most common approaches include:

1. Laser Treatment
   -Argon Laser Photocoagulation: it is used to seal tears and holes in the retina by means of small controlled burns. It is also part of the treatment of retinal ischemia that appears in diabetic retinopathy or vascular occlusions, preventing the progression of these diseases.
   
2. Intravitreal Injections
   Injections of medications directly into the vitreous are one of the most effective treatments for diseases such as wet macular degeneration and diabetic macular edema. The most commonly used drugs include:
   -Anti-VEGF (Ranibizumab, Aflibercept, Bevacizumab): They block vascular endothelial growth factor (VEGF), reducing the growth of abnormal blood vessels and the leakage of fluids in the retina.
   -Anti-angiopoietin 2 + anti-VEGF (Faricimab): which provides a greater durability of the exudation-free period in exudative AMD.
   Corticosteroids: In some cases of macular edema that is bulkier or resistant to previous treatments, corticosteroids may be injected into extended-release intraocular devices (Ozurdex) to reduce inflammation and edema><.
3. Vitreoretinal Surgery
   For some pathologies such as retinal detachment, vitreous hemorrhage, macular hole or epiretinal membrane it is necessary to resort to "vitrectomy", in this surgery by cutting and aspirating the vitreous humor we manage to restore the natural anatomy of the retina. This procedure is performed under local anesthesia with deep sedation, and has a high success rate in visual recovery, although the prognosis depends a lot on the condition of the retina at the time of diagnosis.

Advances in the Treatment of Retinal Diseases

In our clinic, we are at the forefront of technological and therapeutic advances in the field of the retina and vitreous. We are proud to offer our patients access to the latest treatments, including the novel Vabysmo® (faricimab) and Eylea® 8mg (high-dose aflibercept). The use of advanced technologies such as high-resolution OCT and OCT angiography allows us to obtain more accurate and detailed images, improving diagnostic accuracy and the personalization of treatments.

Commitment to the Health of Your Retina

If you have symptoms such as sudden blurred vision, floating spots or flashes of light, it is essential that you go for an ophthalmological evaluation to rule out retinal diseases. Early detection and proper treatment are key to preserving your vision in the long term.

In our clinic, we have a team specialized in the diagnosis and treatment of all diseases of the retina and vitreous. We offer customized solutions and the most advanced technology to ensure the best possible results.