Intraretinal fluid is the accumulation of fluid within the retina, the light-sensitive tissue at the back of the eye. This condition can disrupt the retina’s normal function, potentially leading to vision changes. Its presence often signals an underlying issue requiring medical attention.
Understanding Intraretinal Fluid
The retina is composed of multiple layers. Intraretinal fluid collects within these layers, distinct from subretinal fluid or vitreous hemorrhage. This accumulation typically occurs due to compromised retinal blood vessels.
Retinal blood vessels can become leaky, allowing fluid and blood components to seep into the surrounding tissue. This leakage often stems from damage to the endothelial cells lining the vessels, which normally form a tight barrier. When this barrier is breached, fluid exchange is disrupted, leading to pooling. This fluid causes swelling and distorts the retina’s architecture, impacting light processing.
Recognizing the Signs
Individuals with intraretinal fluid may notice various vision changes. Blurred vision is common, as the fluid distorts light pathways to photoreceptors, making tasks like reading challenging.
Metamorphopsia, where straight lines appear wavy, is another symptom. This occurs because fluid causes uneven retinal swelling, disrupting photoreceptor arrangement. Patients might also report scotomas (blind spots) or reduced central vision, especially if the fluid affects the macula, the retina’s center for sharp sight.
Common Underlying Causes
Intraretinal fluid often results from eye conditions compromising retinal blood vessels. Age-related Macular Degeneration (AMD), especially the “wet” form, is a significant cause. In wet AMD, abnormal blood vessels grow under the retina, leaking fluid and blood, which damages the macula.
Diabetic Retinopathy, a complication of diabetes, is another prevalent cause. High blood sugar damages retinal blood vessels, making them weak and prone to leakage. This can lead to diabetic macular edema, characterized by macular swelling. Retinal Vein Occlusions (RVOs) also commonly cause intraretinal fluid. When a retinal vein blocks, blood and fluid back up, causing vessels to swell and leak.
Inflammatory conditions like uveitis or vasculitis can also cause intraretinal fluid. These involve eye inflammation, damaging retinal blood vessels and increasing permeability. The underlying cause dictates treatment.
Diagnosis and Treatment Approaches
Diagnosing intraretinal fluid relies on specialized imaging. Optical Coherence Tomography (OCT) is the main diagnostic tool, providing high-resolution cross-sectional images of the retina. OCT scans identify fluid location, extent, and quantify retinal thickness. This non-invasive imaging helps monitor progression and treatment response.
Treatment aims to reduce fluid leakage and promote reabsorption, preserving or improving vision. Anti-VEGF (vascular endothelial growth factor) injections are a widely used approach for fluid associated with wet AMD, diabetic macular edema, and RVOs. These medications (e.g., aflibercept, ranibizumab, bevacizumab) are injected into the eye, blocking VEGF, a protein promoting leaky blood vessel growth. This reduces fluid leakage and swelling.
Laser therapy, including focal laser photocoagulation or panretinal photocoagulation (PRP), may be used. Focal laser seals specific leaking blood vessels, often in diabetic macular edema. PRP is used for proliferative diabetic retinopathy to prevent new, leaky vessel growth, indirectly reducing fluid. In complex cases like non-clearing vitreous hemorrhage or retinal detachment, vitrectomy surgery may be considered. This procedure removes vitreous gel, relieving retinal traction and allowing direct treatment of underlying issues.
Living with Intraretinal Fluid
Living with intraretinal fluid requires ongoing medical management and consistent monitoring. Regular follow-up appointments with an ophthalmologist assess fluid levels and retinal health using OCT imaging. Adherence to prescribed treatment plans, including scheduled injections, is important for controlling the condition and preventing recurrence.
While treatment can reduce or eliminate intraretinal fluid, recurrence is possible, especially with chronic conditions like diabetes or AMD. Patients are advised on lifestyle modifications, such as strict blood sugar control for diabetics, to manage contributing factors. Understanding the condition and actively participating in care can help maintain vision and quality of life.