Ophthalmology Manchester Ophthalmology Manchester

Diseases Treated

Dr. Gold treats all diseases of the retina and vitreous. Below are descriptions of the more common diseases he treats.

Retinal Vein Occlusion

Retinal Vein Occlusion Treatment | Retinopathy of Prematurity Treatment | ManchesterThe retina is a thin sheet of nerve tissue in the back of the eye where light rays are focused and transmitted to the brain. Tiny blood vessels supply the retina with oxygen and other nutrients. Arteries deliver the blood and the retinal veins carry it out. Sometimes one of these arteries hardens or swells and presses on a nearby vein. The vein can then become blocked, or occluded, making it difficult for blood to leave the eye. This is called a retinal vein occlusion (RVO). The blocked circulation can led to swelling, bleeding, growth of abnormal blood vessels, and vision loss.

Retinal vein occlusion is the second most common cause of blood vessel-related vision loss (the first is diabetic retinopathy). The condition occurs most often in men and women over the age of 50, particularly those in their 60s and 70s. Risk factors include high blood pressure, high cholesterol, diabetes, smoking, glaucoma, and rarely, blood clotting and inflammatory conditions.

If the largest vein leaving the eye is affected, the condition is known as a central retinal vein occlusion, or CRVO; otherwise it is called a branch retinal vein occlusion, or BRVO.

Retinal vein occlusions are detected during a retinal eye exam. An optical coherence tomogram and fluorescein angiogram may be performed to confirm the diagnosis and/or aid in treatment planning.

Retinal Vein Occlusion Treatment | Retinopathy of Prematurity Treatment | ManchesterMacular swelling or edema can result from a retinal vein occlusion. In patients with branch retina vein occlusion, macular edema is treated with laser or injection of medications to reduce the macular swelling. Macular edema in patients with a central retinal vein occlusion is treated with injection of medications to reduce the macular swelling. Sometimes abnormal vessels called neovascularization develop as a result of a vein occlusion. These abnormal vessels can result in bleeding into the vitreous and are treated with laser. Severe cases of CRVO can result in abnormal vessels on the iris which can lead to neovascular glaucoma. This is managed with laser and injection of medications into the eye.

Dr. Gold is an expert in the diagnosis and treatment of retinal vein occlusion. Retinal vein occlusion is diagnosed with a detailed eye examination. He may recommend fluorescein angiography to better assess the circulation in the retina. Fluorescein angiography involves injection of fluorescein dye into a vein in the arm followed by a series of photographs. As the dye flows through the eye, the retinal circulation can be evaluated. In addition, an OCT (optical coherence tomogram) may be recommended. An OCT measures the thickness of the macula to assess for macular edema.

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Retinopathy of Prematurity

Retinal Vein Occlusion Treatment | Retinopathy of Prematurity Treatment | ManchesterRetinopathy of prematurity (ROP) is a sight-threatening condition that affects the retinas of premature infants, as a result of incomplete development of the blood vessels within the eye. While retinal blood vessels usually finish developing by the time of birth, premature infants may be born before this occurs. Improperly developed retinal blood vessels may be exposed to high levels of oxygen, which can in turn lead to abnormal blood vessel growth on the surface of the retina. This proliferation of abnormal vessels can lead to retinal detachment and visual loss.

ROP is one of the most common causes of childhood visual loss and occurs most often in infants who weigh less than three pounds or who were born before the 31st week of pregnancy. If diagnosed, frequent monitoring is required to determine if the condition will regress on its own or require treatment to reduce the risk of vision loss and other complications.

The extent of abnormal blood vessel growth can be evaluated to classify the patient’s condition into one of five stages, raging from mild to severe. About 90 percent of infants with ROP are diagnosed with mild cases which will improve without treatment. More severe cases that involve significant growth of abnormal blood vessels may lead to retinal detachment and cause vision loss.

In its early stages, ROP does not require any treatment. As the condition advances, laser surgery is often effective in destroying the peripheral areas of the retina in order to slow or reverse the growth of abnormal blood vessels. Additional treatment options for later-stage ROP may include scleral buckle or vitrectomy, both of which are surgical procedures.

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