Retinal Detachment and Artery Occlusion: Treatment and Prognosis

Q: Retinal Detachment and Artery Occlusion: Treatment and Prognosis

Hello, sir： In response to your question, I would like to provide some advice： There is no specific treatment for retinal artery occlusion itself; unless immediate intervention is performed at the time of occurrence, there are no medications available for treatment. <br>The possi

Blindness

My cousin had a retinal detachment in his right eye last September and underwent surgery at the Veterans General Hospital.
After the surgery, his vision improved from 0.05 to 0.3, but he experienced distorted vision.
Unexpectedly, in March of this year, he suddenly lost vision in his left eye and was taken to the emergency room, where it was discovered that he had a retinal artery occlusion.
The doctor only mentioned that he would need to be monitored and prescribed eye drops for supportive treatment.

Could you please explain what supportive treatment is? Does it imply permanent disability due to retinal artery occlusion? How much vision can potentially be restored? Will the distorted vision from the retinal detachment return to normal? Thank you very much.

dà xiàng, 20~29 year old female. Ask Date: 2007/05/10

Dr. Wang Ziyang reply Ophthalmology

Hello, sir: In response to your question, I would like to provide some advice: There is no specific treatment for retinal artery occlusion itself; unless immediate intervention is performed at the time of occurrence, there are no medications available for treatment.
The possibility of visual recovery often depends on whether the condition is ischemic or non-ischemic; if the patient is ischemic, the prognosis for visual recovery is very poor.
As for the distortion of the visual field after retinal detachment, it is caused by the formation of a thin membrane in front of the retina post-surgery, and sometimes it is also due to macular edema.
If it is the former, recovery is unlikely; if it is the latter, gradual recovery may be possible with medication treatment.
If you have any questions, feel free to ask.

Reply Date: 2007/05/10

More Info

Retinal detachment and retinal artery occlusion are two serious ocular conditions that can significantly impact vision. Understanding their treatment options and prognosis is essential for patients and their families.

Retinal Detachment:
Retinal detachment occurs when the retina, the light-sensitive layer of tissue at the back of the eye, separates from its underlying supportive tissue. This can lead to vision loss if not treated promptly. The treatment for retinal detachment typically involves surgical interventions, which may include:
1. Scleral Buckling: A procedure where a silicone band is placed around the eye to push the wall of the eye against the detached retina.

2. Vitrectomy: This involves removing the vitreous gel that is pulling on the retina and may include the injection of gas or silicone oil to help reattach the retina.

3. Laser Surgery: Sometimes, laser photocoagulation is used to create scars that help seal the retina back to the underlying tissue.

The prognosis after surgery can vary. In your case, the improvement from 0.05 to 0.3 indicates a positive response to treatment. However, the presence of distorted vision (metamorphopsia) is not uncommon after retinal detachment surgery. This can be due to residual changes in the retina or the way the brain processes visual information. While some patients may experience improvement over time, others may have persistent visual distortions.

Retinal Artery Occlusion:
Retinal artery occlusion occurs when there is a blockage in one of the arteries supplying blood to the retina. This can lead to sudden vision loss and is often caused by emboli (blood clots) or atherosclerosis. The treatment for retinal artery occlusion is more limited compared to retinal detachment. Supportive treatment may include:
1. Medications: These may include medications to lower intraocular pressure or improve blood flow. However, there is no definitive treatment that can reverse the damage caused by the occlusion.

2. Observation: In many cases, especially if the occlusion is not complete, doctors may recommend monitoring the condition, as some patients may experience partial recovery of vision over time.

The prognosis for retinal artery occlusion is generally less favorable than for retinal detachment. If the occlusion is complete and there is significant damage to the retina, the chances of restoring vision are slim. The degree of vision recovery can vary widely among individuals, and some may experience permanent vision loss.

Supportive Treatment:
Supportive treatment refers to measures taken to manage symptoms and improve quality of life rather than directly addressing the underlying cause of the condition. In the case of retinal artery occlusion, this may involve using eye drops to manage intraocular pressure, regular follow-ups to monitor the condition, and lifestyle modifications to reduce the risk of further vascular events.

In conclusion, while surgical intervention for retinal detachment can lead to significant improvements in vision, the prognosis for retinal artery occlusion is more guarded, and supportive treatment is often the mainstay. It is essential to maintain regular follow-ups with an ophthalmologist to monitor any changes in vision and to discuss any concerns regarding visual distortions or potential further complications.

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