When the clogging of the retina's blood vessels leads to the growth of new blood vessels, we call this proliferative retinopathy. New blood vessels that have formed in the retina and/or at the end of the optic nerve are fragile and can bleed onto the surface of the retina or the vitreous humour filling the back of the eye. This change can pose a threat to the vision and requires treatment. If proliferative retinopathy is left untreated, in the majority of patients it will lead to blindness within 5–10 years.
In order for any neovascularisation to be noticed, it is very important that the backs of the eyes are photographed or examined regularly. This allows for changes that pose a threat to vision to be spotted and treated in good time. This situation always requires an examination by an ophthalmologist and an assessment of the most suitable form of treatment.
The primary treatment for proliferative retinopathy is scattered laser treatment, the urgency and extent of which will depend on the scale and location of the neovascularisation. For severe proliferative retinopathy, panretinal photocoagulation, a large-scale form of laser treatment, must be started without delay. When laser treatment is carried out at the right time, it can be effective in preventing the progression of retinal changes, reducing the need for surgery on the vitreous humour and thus preventing vision deterioration.
Medication injected into the vitreous humour has also been found to help combat retinopathy.
Vitreous haemorrhage
Vitreous haemorrhage associated with proliferative retinopathy often resolves itself after a few weeks or months. Laser treatment improves the provision of oxygen to the retina and circulation in the central area of the retina. It also reduces the formation of factors promoting blood vessel growth, thereby preventing the growth of new blood vessels and thus neovascularisation.
The bleed can also be encouraged to clear faster using a medication that prevents the growth of new blood vessels and that is injected into the vitreous humour, if there are no contraindications for the treatment. Vitreous haemorrhage that does not clear, or new blood vessels with scarring can be treated with surgery on the vitreous humour and retina.