A diabetic vitreous hemorrhage refers to bleeding into the vitreous humor, which is the gel-like substance that fills the center of the eye. This condition is specifically associated with diabetes, a chronic metabolic disorder characterized by elevated levels of blood glucose (sugar).
In individuals with diabetes, the blood vessels throughout the body, including those in the eyes, may be affected by the long-term effects of high blood sugar levels. Diabetic retinopathy is a common complication of diabetes that involves damage to the blood vessels in the retina, the light-sensitive tissue at the back of the eye.
When the blood vessels in the retina are weakened or damaged, they may leak blood into the vitreous humor, leading to a vitreous hemorrhage. The severity of the hemorrhage can vary, and it may cause symptoms such as floaters (dark spots or lines that float in the field of vision), blurred vision, or even complete vision loss, depending on the extent of the bleeding.
Management of diabetic vitreous hemorrhage often involves addressing the underlying diabetic retinopathy and may include interventions such as laser therapy or surgery to stop the bleeding and preserve or restore vision. Regular eye examinations for individuals with diabetes are crucial for early detection and management of diabetic retinopathy and its complications. If you suspect you have any issues with your eyes, it’s important to consult with an eye care professional for a comprehensive eye examination and appropriate management.
The treatment for diabetic vitreous hemorrhage depends on the severity of the condition, the underlying diabetic retinopathy, and the specific circumstances of the individual patient. Here’s an overview of the potential treatments, including observation, injection therapy, laser treatment, and vitrectomy surgery:
It’s crucial to note that the choice of treatment depends on various factors, and decisions should be made in consultation with an ophthalmologist or retinal specialist who can assess the specific characteristics of the vitreous hemorrhage, the severity of diabetic retinopathy, and the overall health of the patient’s eyes. Regular eye examinations for individuals with diabetes are essential for early detection and timely management of diabetic retinopathy and its complications.
Intravitreal injection of medication, particularly anti-VEGF (vascular endothelial growth factor) agents, is a treatment option for diabetic vitreous hemorrhage, especially when there is significant bleeding that makes it challenging to visualize the retina for other treatments like laser therapy. Here’s a more detailed look at this treatment approach:
Intravitreal Injection:
It’s important to note that while intravitreal injections can be effective in managing diabetic vitreous hemorrhage, the decision to pursue this treatment, as well as the frequency of injections, is individualized and based on the assessment of the ophthalmologist or retinal specialist. Regular follow-up appointments are crucial to monitor the response to treatment and adjust the management plan as needed. Additionally, potential risks and benefits should be discussed thoroughly between the patient and the eye care professional.
Laser treatment for diabetic vitreous hemorrhage is a therapeutic approach aimed at managing the underlying diabetic retinopathy and preventing further complications, including recurrent bleeding into the vitreous humor. This laser therapy is commonly known as panretinal photocoagulation (PRP).
Panretinal Photocoagulation (PRP):
It’s essential for individuals with diabetes to undergo regular eye examinations to monitor for the development of diabetic retinopathy, and if diagnosed, to discuss appropriate treatment options with their eye care professional. The choice of treatment, including laser therapy, will depend on the specific characteristics of the retinopathy and the overall eye health of the patient.
Vitrectomy is generally considered a safe and effective procedure for managing severe diabetic vitreous hemorrhage when indicated. However, like any surgery, it carries certain risks, and the decision to undergo vitrectomy should be made in consultation with an experienced retinal surgeon who can assess the specific circumstances of the patient.
It’s crucial for individuals with diabetes to maintain regular eye examinations to detect and manage diabetic retinopathy early, potentially preventing complications that could lead to the need for surgical intervention.
This case illustraites a surgery for a diabetic with a dense bleed in the vitreous. Toward the end of the surgery, the small 25 gauge cutter becomes blunt and needs to be replaced. The outcome was excellent.
65 Year Old woman with vision loss for almost 2 years. Her vision was light perception when she presented. Her fellow eye had mild proliferative diabetic retinopathy. This eye had a normal ultrasound (except for the vitreous hemorrhage). Her cataract was removed about 2 weeks prior to this surgery. Diabetic vitrectomies have slightly better outcomes if done subsequent to cataract surgery. This video shows the dense vitreous hemorrhage looks yellow white.