At Louisville Retina, Dr. Anupa Mandava provides an extensive list of services to treat the retinal diseases her patients may encounter. Below you can find some information about these diseases and the services Dr. Mandava may provide to her patients to treat them.
MACULAR DISEASE
AGE-RELATED MACULAR DEGENERATION (ARMD)
Age Related Macular Degeneration (ARMD) is the most common cause of vision loss in patients above the age of 65 in the US. Though there is not a definitive cure, there are certain aspects of this disease that can be treated and risks that can be minimized. We at Louisville Retina are here to help you to better understand the disease and to create a plan that will maximize your vision.
show moreAge Related Macular Degeneration is the most common cause of vision loss in patients above the age of 65 in the US. Though there is not a definitive cure, there are certain aspects of this disease that can be treated and risks that can be minimized. We at Louisville Retina are here to help you to better understand the disease and to create a plan that will maximize your vision.
AMD is a disease process that affects a part of the eye called the Retina. The Retina is a structure in the eye that is responsible for processing light information. AMD may progressively break down the center of the retina, which is responsible for our central vision.
What are the 2 Types of ARMD?
There are two forms of macular degeneration: Dry (or nonexudeative) and Wet (or exudative). Though both forms have crossovers they should be thought of as two different diseases.
Dry AMD is the most common of the two classifications. About 90% of AMD cases are dry AMD. The hallmark of dry macular degeneration are pigment in very specific patterns known as drusen, pigment changes in the outer layer of the retina called the RPE (retinal pigment epithelium) and geographic atrophy.
Wet AMD also may have pigment changes (drusen, RPE changes), but the hallmark of wet AMD are abnormal vessels called choroidal neovascularization. We are unable to tell that AMD is wet until signs of these abnormal vessels are present – either on imaging or on examination we will see signs of fluid or blood. When present, the patient might notice sudden changes in vision such as black spots, distortions, blurry patches or wavy lines. These vessels can also cause scar tissue to form that can permanently impact vision.
How is ARMD Treated?
The progression of AMD may be slowed down with lifestyle changes, (ie: discontinuing cigarette use) and nutritional supplements. The goal is to maximize your vision and to minimize vision loss.
If someone has active signs of bleeding or leaking of CNV this may be treated with anti-VEGF injections or laser surgery depending on the location and severity of the vessels
For a complete evaluation, diagnosis or intervention please do not hesitate to contact out office at (502) 873-0900 to make an appointment. We are happy to answer any questions.
In the office we will have a discussion to come up with a plan that will maximize your vision despite having this disease. We will be with you every step of the way and to answer any questions that you and/or your loved ones might have.
show lessVASCULAR DISEASE
DIABETIC RETINOPATHY
Non-Proliferative Diabetic Retinopathy
Damage to the walls of the blood vessels due to elevated blood sugars cause the vessels to leak. If they leak into the center of the macular it will cause central vision loss. This is called macular edema.
This can cause blurry vision that may be treated. However, if the damage progresses it can eventually lead to permanent damage to the retina from tissue damage and progression to proliferative diabetic retinopathy.
Proliferative Diabetic Retinopathy
This occurs when damage to the blood vessels is so severe that abnormal blood vessels begin to grow. These blood vessels are brittle and disorganized and can leak and cause significant vision loss. If left untreated, they can lead to scar tissue growth, retinal detachments and permanent vision loss.
show moreHow is Diabetic Retinopathy Treated?
Adequate blood sugar control is crucial. We recommend careful monitoring with your PCP.
Laser procedures and intraocular injections of anti-VEGF may treat macular edema depending on the severity and location.
For proliferative Diabetic Retinopathy laser treatments in portions of the retina not responsible for central vision can prevent abnormal vessels from progressing and bleeding. Intra-ocular anti-VEGF treatment can also help to slow down progression and prevent regrowth of these abnormal vessels.
Severe cases of Diabetic Retinopathy might call for a surgery called vitrectomy. During this surgery the Louisville Retina specialist with attempt to clear the blood and fluid from the vitreous gel that fills the inside of your eye. If there is scar tissue this might have to be peeled.
If you would like a full evaluation please contact us at Louisville Retina, PLLC. We are happy to answer any and all of your questions about how Diabetes can affect the eye. We will also take pictures of your eye and develop a specific plan that is best for you.
show lessPERIPHERAL RETINAL PATHOLOGY
RETINAL DETACHMENT
What is a Retinal Detachment?
With age, the vitreous gel inside the eye breaks down. During this process it can occasionally tug on the retina and cause sudden symptoms such as flashes and floaters. In more severe causes it can tug on the retina and cause retinal tears, retinal holes, bleeds and retinal detachments.
If the vitreous tugs hard enough on the retina, it can cause a retinal tear. If fluid enters that tear, it can separate the layers of the retina – causing a retinal detachment. This can lead to a progressive loss of vision and ultimate blindness if left untreated.
show moreHow is it repaired?
Unfortunately retinal detachments cannot heal by themselves. We will either need to provide laser to prevent it from progressing or perform surgery to remove fluid, block the hole or tear and ultimately flatten the retina.
In general surgery is required to repair a retinal detachment. This is generally an outpatient procedure that is done in a surgery center with anesthesia.
The surgeon will remove some of the vitreous gel, laser the portions of the retina that is damaged and then fill the eye with a substance that will help to keep the retina flat as it heals. This substance can either be a gas, oil or liquid depending on the appearance of the detachment. Sometimes a band will be placed around the eye to help to keep the retina flat.
The patient might have to position a certain way following the surgery to ensure that the fluid does not return and to make sure the retina heals properly. We will monitor the patient throughout the postoperative period to ensure that the retina is healing adequately.
When should this be treated?
Retinal detachments are an ocular emergency and must be treated quickly. If you notice any symptoms of flashes, floaters or curtains coming over portions of your vision if is imperative that you follow with a retinal doctor immediately.
If you or someone you know has sudden changes in your vision as mentioned above please contact Louisville Retina, PLLC. We will be able to provide support and if needed, schedule you for treatment as soon as possible.
show lessUVEITIS
Endophthalmitis
Infectious Retinitis
Toxoplasmosis
Histoplasmosis
Sarcoidosis
HLA B27 (Reiters)
Ankylosing Spondylitis
White Dot Syndromes
Optic Neuritis
ONCOLOGY
Lymphoma
Choroidal Nevus
Choroidal Melanoma
Radiation Retinopathy
PROCEDURES
Vitrectomy
Scleral Buckle
Laser Photocoagulation
Cryopexy
Intravitreal Injections