Laser Treatment for Retinal Vascular Diseases
Macular edema and neovascularization can be secondary problems associated with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). If macular edema persists and your vision is impacted, your doctor may recommend a focal laser treatment. If neovascularization is substantial, your doctor will consider segmental / grid or pan-retinal photocoagulation.
What Is Focal Laser Treatment?
This treatment uses a laser to apply small laser burns in the areas of leakage around the macula. The fluorescein angiogram test helps determine whether the laser will be applied in a grid pattern or directly to microaneurysms. By treating the leaky areas in the retina, focal laser treatment reduces the edema or swelling in the macula.
Focal laser treatment stabilizes your vision. In fact, the National Eye Institute (NEI) notes that this type of treatment reduces the risk of vision loss by 50 percent. Often though, once your vision is lost, it is may not be improved by laser treatment.
What Is Laser Photocoagulation?
If BRVO impacts a large area of the retina and there is substantial neovascularization, placing the eye at risk for vitreous hemorrhage, your doctor may recommend a treatment called segmental laser photocoagulation, where a segment or section of your retina is treated. In this procedure, done at all of our offices, a special laser is used to make tiny burns in the retina. These burns seal leaky vessels and prevent the formation of the chemicals that cause neovascularization or new blood vessels to be created.
The treatment of central retinal vein occlusion (CRVO) sometimes includes laser therapy as well. If the neovascularization occurs on the iris, it can lead to neovascular glaucoma, the most serious complication of CRVO. If this occurs, your doctor may recommend pan-retinal laser photocoagulation or PRP, where all the peripheral retina is treated with the laser. PRP may also be performed in cases where neovascularization occurs in the retina and there is a high risk of secondary vitreous hemorrhage.
Cryotherapy is another method to treat the peripheral retina in cases where there is neovascularization and the view of the retina is impaired by vitreous hemorrhage or advanced cataract.
Both BRVO and CRVO can lead to a detached retina, although it is less common in CRVO. If these complications occur, laser photocoagulation may be used to seal the tear. Cryopexy, the use of extreme cold, is an alternative treatment to repair the tear.
Although macular edema can be a result of central vein occlusion, studies have shown that laser photocoagulation in older patients does not improve vision. This may be a result of the long term impact of the underlying systemic disease. No studies have yet been done on the affect of laser treatment on younger CRVO patients with secondary macular edema.
Laser treatments are done at all of our offices. During the treatment, your eye will be numbed with anesthetic eyedrops. A special lens will focus the beam of light onto your eye. You will feel little or no pain, although you will notice flashes of bright light.
A special holder will keep your eye from moving while the laser is being used. The laser treats the macula or your peripheral retina, and the ophthalmologist takes special care to avoid the fovea, the part of the macula responsible for central vision. Your vision may be blurry following the treatment, which can take between 10-15 minutes. The doctor can only work on one eye at a time. You may require more than one treatment in each eye.
Following the surgery, your vision may be blurry but gradually improve. You will not be able to drive home following the treatment. Therefore, you should make transportation arrangements. In addition, you may want to bring your sunglasses, as your eyes will be dilated for this procedure.
Retinal vein occlusions can be vision-threatening. Therefore, your doctor will want to closely monitor your condition. In some cases, this may require monthly, bi-monthly or even weekly examinations. Once your vision is lost, it often cannot be restored. It is important that you closely follow your doctor’s recommendations to protect your sight.
