What is retinal fibrosis

Written By The HealthMeth Team - Updated On Thursday, April 22, 2021 3:01 AM

Retinal fibrosis

Cirrhosis of the retina or membrane over the network , or wrinkling degeneration , or cirrhosis of the eye network , all terms calling fibrous tissue or scar , which is formed in the retina of the eye, specifically in the known class specific class intaglio ( in English Internal limiting membrane, which is the deepest layer of the retina, and this tissue is usually above the macula. [1] [2] It is a special area located in the middle of the retina and is responsible for the highest degrees of vision and clarity, and its damage and disturbance leads to blurring of the eye and vision, [3]According to a study published in the Journal of Ophthalmology in 2016, the chance of developing retinal fibrosis varies according to the nature of the cause, in addition to that approximately 7% of cases are of unknown cause. The study showed that approximately 30% of cases diagnosed with retinal fibrosis were in both eyes of the affected person. [4] [5]


Causes and risk factors for developing retinal fibrosis

The inner part of the eye is formingPrimarily from the vitreous, or what is known as vitreous. It is a gelatinous substance that helps to maintain the shape of the eye, and with age there are some changes in the structure of this substance that lead to its slowly shrinking and moving away as a result from the surface of the retina of the eye, and this condition is known as the detachment of the vitreous body , and in fact this condition is considered It is a normal thing that accompanies aging in many people, and it may not be accompanied by any side effects, except in some cases in which a person may notice an increase in the percentage of eye floaters. They are very small spots or strings that may appear in the field of vision in the eye, and do not cause any problems or health damage.Hole degeneration ( in English: Macular hole). [6]


Accordingly, it can be said that the separation of the vitreous is not the main cause of retinal fibrosis, as it does not cause any disturbance to the eye or the retina in most people, but the problem appears with the presence of risk factors for it, and perhaps the most important of them is advancing age and the accompanying changes, so most cases of injury With retinal fibrosis, it is diagnosed in people over the age of fifty years, in addition to many cases of unknown cause, and secondary cases caused by retinitis as a result of some disorders such as retinal detachment, undergoing previous eye surgery, and vascular disease Hematomas of the retina of the eye, eye injuries, [7] [8] and other risk factors: puffiness or swelling in the eye, exposure to a previous injury to the retina, and injuryDiabetes because of the high chance of some eye disorders spot as well as the effect of diabetic retinopathy in raising the risk of form scar tissue in the retina. [9] [10]


Symptoms of retinal fibrosis

Often the person with retinal fibrosis does not suffer from any obvious symptoms, or the symptoms may be limited to only mild symptoms, and most people maintain their normal visual acuity, in addition to that the injury is often limited to one eye, but it may affect the other eye later in some cases , [8] [1] The following is an explanation of some of the symptoms of retinal fibrosis that may appear in some patients:

  • Blurred eye. [8]
  • Vision disturbance; It is represented by the appearance of some straight lines in a curve when you look at them. [8]
  • Seeing a gray or cloudy area in the center of your vision. [11]
  • Difficulty focusing on small details, and small print pages. [8]
  • Small flashes of light. [7]
  • Some bodies appear unnatural. [7]
  • Vision loss in some small areas of the center of vision in advanced cases of the disease. [8]


It should be noted that it is necessary to see a specialist immediately in the event of suffering from any of the aforementioned symptoms. [12]


Diagnosis of retinal fibrosis

To diagnose retinal fibrosis, an eye examination is carried out and evaluated the symptoms that the victim suffers from, and in the event of a suspicion of retinal fibrosis, a number of tests are performed to confirm the diagnosis, including the following: [10]


Ophthalmoscopy

During the ophthalmoscopy test, a special drop is often used to help widen the pupil and thus facilitate detection of the inner eye components, then a strong light is shed and a magnifying lens is used to evaluate the retina and the macula of the eye by the doctor to detect the formation of scar tissue in it. The doctor may also take pictures of different parts of the eye to help make the diagnosis. [10]


Optical coherence tomography

The doctor may conduct a test known as optical coherence tomography (OCT), to assess the condition of retinal fibrosis, evaluate the severity of the injury, measure the thickness of the scar tissue, and look for the presence of a bulge in the eye, and the principle of this test is based on the use of a special type of light To reveal the different layers of the retina, and to reveal the extent of the impact of the damaged layer on the macula of the eye, and this test is performed and obtained its results within a few minutes. Increase or improve it. [7] [13]


Other tests

There are a range of other tests that may be done to help diagnose retinal fibrosis, including the following:

  • Visual acuity test: A visual acuity test is performed to help detect the progression of retinal fibrosis. Vision in the affected person. [14]
  • Angiographic chromosome: may resort to the angiographic chromosome test in some cases to help detect cause cirrhosis of the retina of the infected person, and this includes the test injection , especially in the eye pigment, and photographing the eye parts of different. [13] [15]


Treatment of retinal fibrosis

Most cases of retinal fibrosis do not need treatment, and the affected person can cope with the slight changes associated with retinal fibrosis in some cases, especially if the ability to continue practicing normal daily activities such as reading and driving, but the progression of the patient's condition must be monitored periodically to ensure He does not suffer from any vision disturbances, and the explanation for the lack of treatment in most cases of retinal fibrosis is that most cases go through a stable phase after the initial growth of scar tissue in the retina, and that this tissue may separate from the retina in some rare cases, which leads to restoration Normal vision and get rid of tension in the retina. As for cases that require treatment, it should be noted that eye dropsMedicines and nutritional supplements do not contribute to restoring normal vision in people with retinal fibrosis, but for the treatment of severe cases of the disease in which the doctor notices deterioration of vision or worsening of symptoms, eye surgery may be resorted to. [6] [15]


Non-surgical treatments

As we have previously shown, most cases of retinal fibrosis do not require treatment, especially in simple cases, and in the event that unpleasant symptoms are felt, some auxiliary tools such as magnifying glasses , medical glasses , and reading lamps may be satisfied , but for cases with severe symptoms, some options may be resorted to. The other treatment, if the retinal fibrosis is caused by friction between the vitreous in the eye and the macula, a one-time injection is used that contains an enzyme that destroys and digests the small fibers of the vitreous, which may contribute to eliminating friction between it and the eye spot. [14]


Surgery

In severe cases of retinal fibrosis, which may be accompanied by significant visual distortion in the central visual area, a surgical procedure known as vitrectomy may be used.Vitrectomy), and the need to perform this operation is determined by the doctor based on the person’s condition, as well as the importance of taking the opinion of the injured person and knowing his desires. Normally through it, and in the event of choosing to perform the operation, the doctor makes some small holes in the eye to remove the vitreous body of the eye, then the fibrous tissue is gently removed from the retina, and special stitches are used that can dissolve or dissolve on their own, as these stitches dissolve within a period that ranges from Between 4-6 weeks approximately from the time of the operation, and a special bandage is placed on the eye after the operation is completed, and then it is removed the next morning of the operation.[16]


The results of the surgery

Usually the results of this surgery are satisfactory, as vision improves significantly and blurred vision, but the vision does not return to its normal state, and the degree of success of the operation varies from person to person, but in general it is recommended to adhere to the treatment plan prescribed by the doctor, and to see the doctor regularly Periodically and adhering to appointments, in addition to following the advice of the attending physician to avoid vision disturbances as much as possible, in order to increase the chance of restoring the largest possible amount of normal vision. [17] [1]


Risks of surgery

Vitrectomy may be associated with a number of risks in some cases, and these risks are discussed by the attending physician before performing the surgery, and among these risks are the following: [18]

  • Internal bleeding in the eye.
  • Retinal fibrosis again after the operation.
  • Eye infection .
  • Retinal detachment; It is the detachment of the retina from the back of the eye.
  • Cataract, cataract, or cataract.


References

  1. ^ A b t "Macular Pucker" , Www.nei.nih.gov , Retrieved 1-9-2020. Edited.
  2. "Premacular Fibrosis" , www.dovemed.com , 8-3-2018, Retrieved 1-9-2020. Edited.
  3. "Macular Pucker" , www.northshoreeye.com.au , Retrieved 1-9-2020. Edited.
  4. "Idiopathic Epiretinal Membrane" , reference.medscape.com , Retrieved 1-9-2020. Edited.
  5. "Epiretinal Membrane" , emedicine.medscape.com , 2-1-2020, Retrieved 1-9-2020. Edited.
  6. ^ A b "Macular Pucker" , Www.columbiaeye.org , Retrieved 1-9-2020. Edited.
  7. ^ A b t w of Troy Bedinghaus, "Epiretinal Membrane condition Condition And Your retina" , Www.verywellhealth.com , Retrieved 1-9-2020. Edited.
  8. ^ A b t w c h "Macular Pucker - External : Internal And Eye 's " , Www.visualdx.com , Retrieved 1-9-2020. Edited.
  9. Kierstan Boyd (29-8-2019), "Macular Pucker Causes" , www.aao.org , Retrieved 1-9-2020. Edited.
  10. ^ A b t "Macular Pucker" , Mydoctor.kaiserpermanente.org , Retrieved 1-9-2020. Edited.
  11. "What is a Macular Pucker" , www.aao.org , Retrieved 1-9-2020. Edited.
  12. "MACULAR EDEMA & MACULAR PUCKER" , healthcare.utah.edu , Retrieved 1-1-2020. Edited.
  13. ^ A b "Macular Pucker Diagnosis" , Stanfordhealthcare.org , Retrieved 1-9-2020. Edited.
  14. ^ A b "Macular Pucker" , Www.brightfocus.org , Retrieved 1-9-2020. Edited.
  15. ^ A b "Epiretinal Membranes" , Www.asrs.org , Retrieved 1-9-2020. Edited.
  16. "Epiretinal membrane" , www.moorfields.nhs.uk/ , Retrieved 1-9-2020. Edited.
  17. “Macular Pucker: Management and Treatment” , my.clevelandclinic.org . , Retrieved 1-9-2020. Edited.
  18. Kierstan Boyd (29-8-2019), "Macular Pucker Treatment" , www.aao.org , Retrieved 1-9-2020. Edited.