Neovascularization of the eye (NVE) describes the irregular formation of new blood vessels within the eye. These abnormal vessels grow in areas where they typically do not belong, such as the retina, cornea, or iris. NVE can significantly impact vision, potentially leading to impairment or blindness if left unaddressed.
Understanding Neovascularization in the Eye
Neovascularization occurs when the body attempts to compensate for a lack of oxygen in ocular tissues. These newly formed vessels are often fragile and prone to leakage, releasing fluid and sometimes blood into surrounding eye structures. This leakage can cause swelling, scarring, and disruption of the eye’s normal architecture, impairing vision.
This process is associated with several underlying eye conditions. Age-related macular degeneration (AMD), specifically its “wet” form, involves the growth of abnormal blood vessels under the retina and macula, leading to fluid leakage and vision loss. Diabetic retinopathy, a complication of diabetes, is characterized by new, abnormal vessel growth in advanced stages. Retinal vein occlusion, a blockage in the retinal blood vessels, can also trigger neovascularization due to oxygen deprivation.
Identifying NVE: Symptoms and Diagnosis
Individuals experiencing NVE may notice changes in their vision. Common symptoms include blurred or distorted vision, where straight lines might appear wavy. Dark spots or “floaters” in the field of vision can also indicate NVE. In more severe instances, a sudden and noticeable loss of vision may occur.
Eye care professionals diagnose NVE through a comprehensive eye examination. A dilated eye exam allows for a detailed view of the retina and other internal structures. Optical coherence tomography (OCT) provides cross-sectional images of the retina, helping to detect fluid accumulation or abnormal vessel growth. Fluorescein angiography, which involves injecting a dye into the bloodstream, highlights leaky or abnormal blood vessels and their extent.
Managing NVE: Treatment Options
The primary approach to managing NVE involves medications that target vascular endothelial growth factor (VEGF). These anti-VEGF injections, administered directly into the eye, work by blocking the protein responsible for promoting the growth and leakage of abnormal blood vessels. Common anti-VEGF medications include bevacizumab, ranibizumab, aflibercept, and brolucizumab.
Beyond anti-VEGF injections, other treatments are available. Laser photocoagulation can seal off or destroy abnormal blood vessels, preventing further leakage and damage. In some complex situations, a vitrectomy, a surgical procedure to remove blood or scar tissue from the vitreous gel inside the eye, may be necessary to restore vision.
Prognosis and Living with NVE
The outcome for individuals with NVE is influenced by early detection and adherence to treatment. Prompt diagnosis and regular medical intervention can help preserve vision and prevent severe complications. Without treatment, NVE can progress, potentially leading to severe vision loss or even permanent blindness due to continued leakage, bleeding, and scarring within the eye.
Long-term management of NVE involves regular follow-up appointments with an eye care professional. These visits allow for monitoring the condition and adjusting the treatment plan. Adhering to the prescribed treatment regimen is important for controlling the growth of abnormal vessels and maintaining visual function over time.