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  • 5/17/2025
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#Endocrine System
Transcript
00:00Light rays enter the eye through the cornea, pupil and lens.
00:16These light rays pass through the vitreous, a clear gel-like substance that fills the
00:21middle of the eye.
00:23The light rays are focused on the retina, a light-sensitive tissue lining the back of
00:27the eye.
00:35The macula is a very small area at the center of the retina that gives us our fine pinpoint
00:41central vision.
00:42The area of retina surrounding the macula gives us our peripheral or side vision.
00:48The retina converts the light rays into signals that are sent through the optic nerve to the
00:53brain.
00:57With non-proliferative diabetic retinopathy, or NPDR, damaged blood vessels in the retina
01:05begin to leak fluids, including small amounts of blood, into the retina.
01:10Sometimes deposits of fats may leak inside the retina.
01:14These deposits are called hard exudates.
01:27With macular edema, fluid leaking from the retina's blood vessels can cause the macula to swell
01:33or thicken.
01:34Because the macula is responsible for our central or pinpoint vision, macula edema interferes with
01:40clear vision.
01:43macular ischemia occurs when small blood vessels close.
01:49In this case, your macula is affected because it no longer receives enough blood to work
01:54properly.
01:59With fluorescein angiography, a small amount of yellow dye is injected into your arm where
02:05it circulates through all the blood vessels in the body, including those in the retina.
02:09A special camera with a blue flash is then used to take a series of pictures of the retina.
02:15Any blood vessels that have been affected by NPDR will show up in these images, as well
02:21as areas of abnormal leakage or ischemia.
02:29With OCT, a special camera is used to photograph your retina.
02:33It measures the thickness of the retina and is also very sensitive at detecting swelling and
02:38fluid.
02:39This diagnostic information helps your doctor determine why your vision is blurred and whether
02:44your treatment should be started.
02:55For macular edema, the laser is focused on the retina outside the center of the macula.
03:01The laser is not applied directly to the center of the macula since this would reduce central
03:06vision.
03:07The main goal of treatment is to prevent more vision loss by sealing off leaking blood vessels
03:12that interfere with the proper function of the macula.
03:24With PDR, many blood vessels in the retina close, preventing adequate blood flow to the
03:30retina.
03:31The retina responds to this problem by trying to grow new blood vessels.
03:35However, these new abnormal vessels do not provide proper blood flow.
03:41They can also bleed as well as lead to scar tissue, which may cause the retina to wrinkle or
03:46even detach.
03:47If similar vessels grow abnormally in the front of the eye, they can block the drainage channels
03:53of the eye and cause high pressure and possibly glaucoma.
03:58Both your central and side vision can be affected by PDR.
04:03Treatment for PDR is often done with laser and it is called PRP or panretinal photocoagulation.
04:11It is also known as scatter photocoagulation.
04:14The treatment is usually performed in an office setting.
04:17For comfort during the procedure, an anesthetic is applied to the eye.
04:22The laser is applied to the peripheral retina, avoiding the central macula.
04:27This causes the blood vessels to shrink and often prevents them from growing again in the
04:31future.
04:32It also decreases the chances of the blood vessels bleeding into the vitreous or causing
04:37a retinal detachment.
04:39In some cases, multiple laser treatments may be necessary.
04:44Anti-VEGF drugs target a specific chemical in your eye.
04:51This chemical, called vascular endothelial growth factor or VEGF, is critical in causing abnormal
04:58blood vessel growth on the surface of the retina as well as in other parts of the eye.
05:03Several drugs have been developed that can block the trouble causing VEGF.
05:07An anti-VEGF drug can help reduce the growth of abnormal blood vessels, which helps to prevent
05:13bleeding, scar tissue, and other problems that can cause vision loss.
05:19The anti-VEGF drug is administered directly to the eye in an outpatient procedure.
05:24After the eye has been numbed with an anesthetic, the anti-VEGF drug is injected into the eye with
05:29a very fine needle.
05:31Some people may need multiple anti-VEGF injections over a period of months.
05:37The abnormal blood vessels can bleed into the vitreous, the clear gel in the middle of
05:44the eye.
05:49This bleeding, called a vitreous hemorrhage, can prevent light rays from reaching the retina.
05:59Inputation imaging is used to create a picture of the retina.
06:03Sound waves are sent through the eye and bounce back.
06:06A computer is used to read the returning waves and build a picture of the retina.
06:11From these images, your ophthalmologist can determine if surgery is necessary.
06:20Vitrectomy surgery is usually performed in the operating room on an outpatient basis.
06:27An operating microscope, and small surgical instruments, are used to enter the inside
06:32of the eye.
06:37Blood and scar tissue are removed.
06:45At the time, a laser may be used to prevent further bleeding and abnormal blood vessel growth.
06:50To help the retina heal in place, the ophthalmologist may place a gas bubble or silicone oil in the
06:56vitreous space.
06:58The gas bubble will gradually dissolve on its own.
07:01Removal of the silicone oil requires an additional procedure.
07:05Use of a gas bubble or silicone oil is reserved for eyes with retinal detachment or advanced scar tissue.
07:13After vitrectomy, the results of your surgery may not be apparent for months.
07:22The doctor may be taken in place.
07:23He has been able to unlock the