RETINAL DISEASES AND SURGERY
The retina is the innermost layer at the back of our eye. It contains visual cells (cone and bacillus). 95% of vision occurs in the yellow spot (macula) in the center of the retina. In particular, diabetic retinopathy and macular degeneration can damage the yellow spot. The vitreous layer, which has a gelatinous consistency, fills the large space in the middle.
Diagnostic methods
Ocular angiography (FFA and ICG)
OCT
Treatments applied in the retinal section
Treatment of retinal tears and detachments,
Treatment of retinal haemorrhages (intraocular haemorrhages),
Traumatological surgery-removal of intraocular foreign bodies,
Treatment of intraocular inflammation and uveitis.
Diabetic eye disease
Diabetes is the systemic disease that causes the most damage to the eyes. It is the most important cause of blindness in society. It damages the retinal layer the most (diabetic retinopathy). In addition, it facilitates the formation of cataracts, dry eye and glaucoma. Modern instruments such as ocular angiography (FFA) and optical coherence tomography (OCT) are used in the diagnosis of diabetic retinopathy. With prompt intervention, it can be treated and blindness is largely avoided.
In the treatment; Argon laser therapy is an important treatment. Applications for intraocular drugs are made in cases where edema develops in the visual center. In advanced cases, vitreoretinal surgery is performed.
Macular degeneration (yellow spot disease)
Yellow spot age-related damage. It is the most common cause of blindness in people over 45. The vascular lump that occurs under the macula can be treated with the application of a special medication in the eye. Before treatment, the type of disease, size and stage of the vascular bundle should be determined by ocular angiography (FFA, ICGA) and OCT. Photodynamic therapy (PDT) can also be performed in required patients.
Vitreoretinal surgery (vitrectomy surgery)
It is a microsurgical method used in the treatment of retinal detachment and tears, intraocular bleeding, intraocular foreign bodies and intraocular inflammation. It helps patients regain sight, especially in cases of advanced diabetes. It is done by opening 3 holes of about 1 mm in the eye. After the surgery, a liquid, gas or silicone is placed in the eye depending on the state of the disease. Most of the time, no stitches are used.
Retinopathy of prematurity (ROP examination) – (eye examination of premature infants)
PDR is a condition seen in low birth weight premature infants that can lead to blindness.
What are the risk factors for ROP?
All babies born under 1300 g or less than 30 weeks
Babies born under 1500 g and less than 32 weeks receiving oxygen therapy in intensive care
Babies born prematurely with recurrent apnea, severe sepsis, blood or exchange transfusion, intracranial hemorrhage, bronchopulmonary dysplasia, respiratory distress syndrome, or open ductus arteriosus are at risk of developing ROP.
How is POR reviewed and tracked?
The ROP exam is an exam performed by widening babies’ pupils under topical anesthesia and examining the nerve layer of the eye, which we call the retina. The first ROP exam in premature babies should be done 4 to 6 weeks after birth. Then, depending on the presence and level of the disease, the examination is repeated at intervals of 1 or 2 weeks until the baby is full term (time of birth).
What are the treatment alternatives in ROP?
The most important step in the treatment of ROP is regular follow-up. Statistically, 80% of patients who develop ROP regress spontaneously and 8% of babies followed require treatment. However, detecting the level of disease, which we call threshold disease, in time and applying laser treatment urgently (within 3 days) is an important factor in preventing babies developing ROP from going blind. Vitrectomy surgery is performed in cases that cannot be detected in time and whose disease progresses despite laser treatment.
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