Retinopathy and laser vision correction

What is retinopathy?

Retinopathy is a condition leading to damage to the retina. Factors that increase the risk of retinopathy include: prematurity, advanced diabetes, hypertension or genetic predispositions. If untreated, retinopathy may cause permanent blindness.

What are the types of retinopathy?

The typical symptoms of every type of retinopathy are gradual vision deterioration, so-called blind spots (scotoma), distortion of image and lesions within the blood vessels in the eyes, e.g. broken vessels. Retinopathy may often coexist with a chronic disease (e.g. diabetes or hypertension), therefore its treatment should be complex and include both the care of the internal medicine specialist and an ophthalmologist.

Diabetic retinopathy

It affects those who suffer from diabetes and it is its most common complication. It can be divided into two types:

- Non-proliferative diabetic retinopathy (NPDR): a mild form of the disease, with relatively few complications. It may be asymptomatic, but the changes will be noticeable during an ophthalmological examination.

- Proliferative retinopathy (PDR): characterised by a more serious course and complications. It may even lead to a complete loss of vision. In this type of retinopathy, new, abnormal blood vessels with weakened walls form in the retina. This, in turn, may result in numerous retinal hemorrhages.

Hypertensive retinopathy

Directly related to elevated arterial blood pressure, resulting in changes in blood vessels. Patients with this type of retinopathy usually do not notice any characteristic symptoms, which is why the disease may remain undiagnosed for a long time.
As the condition progresses, foci of retinal ischemia and hemorrhages occur, which leads to the appearance of various lesions in the retina.

Retinopathy of prematurity (ROP)

It affects premature babies, i.e. babies born before the 37th week of fetal life. Retinal vessels in those babies are not fully developed, and their further development will be abnormal.

Retinopathy of prematurity leads to the formation of fibrous lesions in the retinal vessels and in the vitreous body. This causes retinal detachment, which may result in impaired vision or blindness.

Retinitis pigmentosa

It begins in adolescence. Pigment is deposited in the retina, which results in circulatory disorders in the retina and progressive vision deterioration. Retinitis pigmentosa is genetically determined – it is a hereditary disease.

Is every type of retinopathy a contraindication to performing the laser vision correction?

Not every type of retinopathy need to be an absolute contraindication to the procedure. In the case of non-proliferative diabetic retinopathy, hypertensive retinopathy, retinopathy of prematurity or retinitis pigmentosa, it is possible to consider conducting the procedure.b during the qualifying examination the extent of changes in the retina has to be assessed and their possible development should be observed.

In the case of a chronic disease (diabetes, hypertension), the patients should provide a medical certificate from a specialist (e.g. diabetologist or cardiologist) specifying the kind of disease they have, the medications they take and their dosage, as well as attesting to the fact that the disease is stable and regularly monitored.

As for retinopathy of prematurity or retinitis pigmentosa, the laser vision correction procedure is possible only in the case of insignificant retinal lesions. At the qualification stage, an ophthalmic surgeon also takes into consideration the severity of the refractive error the patient has. Advanced myopia (above -6 dioptres) may be a disqualifying factor.

Unlike the other types of retinopathy, proliferative diabetic retinopathy is an absolute contraindication to performing the laser vision correction surgery.

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