Dot blot hemorrhage eye12/5/2023 ![]() Penetrating trauma - this will cause bleeding throughout the eye.Blunt trauma - suddenly compressing the eye - for example, if hit by a squash ball.Retinal macroaneurysms - swollen blood vessels on the retina, usually related to high blood pressure, atherosclerosis and smoking.Posterior vitreous detachment, often because it causes a retinal tear (see below).Normal blood vessels which are damaged.Damage to the back of the eye in very premature babies who have been on oxygen in special care baby units.Diabetic eye disease (the most common cause).Conditions in which this can occur include: Abnormal blood vessels which grow because the back of the eye is short of oxygen.Trauma to the eye (the most common cause in younger people).Bleeding from tears in the retina caused by vitreous detachment (see below).Bleeding from abnormal new blood vessels forming in advanced diabetic eye disease.The most common causes, accounting for about 90% of all cases of vitreous haemorrhage, are: In the near future, we have a plan to introduce sub-threshold photocoagulation to macular edema-one of the latest management of DME.What are the causes of vitreous haemorrhage? We try to perform the most proper therapy for each patient, using the most advanced imaging modalities and treatment options. Surgical treatment (vitrectomy) is another choice of the diabetic retinal complication. In addition to conventional direct/grid laser therapy, administrations of anti-VEGF drug (Ranibizumab) or steroid (Triamcinolone acetonide) are effective in many cases. Variable therapeutical tools are recently available for DME treatment. In case of retinal ischemia, laser photocoagulation is indicated. In addition to routine examination including visual acuity examination, ophthalmoscopic evaluation or intraocular pressure measurements etc, FA or optical coherent tomography (OCT) are performed to assess retinal ischemic change or edema. Our strategy to treat DR starts from appropriate evaluation and diagnosis. As macula is critical area for vision, DME is the most frequent cause of visual impairment in DR. The causes of diabetic macular edema are leakage from microaneurysm, damaged vessels or RPE dysfunction. DME is still troublesome complication in this stage.ĭME is found in any stage of DR. Surgical treatment?vitrectomy is often required for anatomical repair of retinal detachment or removal of vitreous hemorrhage. Pan retinal laser photocoagulation (PRP) is required following evaluation of ischemia by FA. Significant vision loss is not rare due to these severe complications. Additionally, NV forms fibrovascular membrane, which cause tractional retinal detachment. NV is abnormal, fragile vessels, resulting in severe hemorrhage to vitreous cavity. Treatments for macular edema are required in more cases than earlier stage.ģ.Proliferative diabetic retinopathy (PDR)Īs a result of vast ischemic changes of retinal vessels, new vessels (NV) on retina vessels or optic disc develop. In the eyes with NPA shown by fluorescein angiography (FA), focal laser photocoagulation onto retinal NPA is considered to prevent further progression. Cotton-wool like exudates reflecting retinal ischemia are frequently found in this stage, as well as increased amount of retinal hemorrhages. Progressive microvascular damage leads to loss of microvascular capillary network (non perfusion area: NPA) at this stage. The treatment for DME is necessary when clinically significant macula edema is found.Ģ.Pre-proliferative diabetic retinopathy (PPDR) Hard yellowish exudates or retinal edema, derived from aneurysmal leakage, are frequently found in the retina.Įven in this early stage, the diabetic macular edema (DME) occurs and impairs the central vision. Microvascular injury by high blood glucose level results in multiple microaneurysms (MA) or intra-retinal dot/blot hemorrhages from damaged microvessels. The therapeutic strategies are different in each stage, and variable in each patient. One of the grading systems of diabetic retinopathy is as follows. Retinal microvasculature is specifically affected in DR, and the fundus shows characteristic features. This outpatient clinic provides the accurate diagnosis using various imaging modalities and the advanced treatment of DR by retinal specialists. DR is the second most common cause of blindness in Japan, next to glaucoma1). Diabetic retinopathy(DR)is one of the leading causes of adult blindness worldwide, together with an increased rate of the patients having diabetes mellitus (DM).
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