Research on the Retina

Unique research conducted by the Ophthalmology Department at Hillel Yaffe Medical Center identified the most common cause of vision loss in diabetics. Meaning: optimizing treatment, to improve the quality of vision in these patients

15/11/2010

Prof. Ophir conducting an examination with the OCT device
Innovative research conducted by the Ophthalmology Department at Hillel Yaffe Medical Center, led by Prof'. Avinoam Ophir, found the cause of visual impairment in diabetics. This will enable better diagnosis and more efficient treatment, improving their quality of life.

The study found that in 54% of patients with macular edema in the center of vision, which is the most common cause of visual impairment among diabetics, the injury is the result of mechanical traction of the retina by membranes surrounding the center of vision, and not as was originally thought.

This indicates the need for a substantial change in the diagnosis and treatment of macular edema, which is the most common cause of impaired vision in patients with diabetes.

Diabetes: one of the leading causes of vision loss

In Israel, approximately 6% of the population develops diabetes. It is one of the world's leading causes of vision loss. These patients often have damaged blood vessels in various organs, such as the eyes, kidneys, heart and brain. One of the most common, complex problems in these patients is damage to the retina and vision, caused by fluid from the damaged blood vessels leaking into the retina; this, in turn, causes accumulation of fluid in the retina, with swelling and edema in the center of vision. This edema is the most common cause of degeneration in visual acuity, to the point of significant vision loss. It develops about 10 to 15 years after the onset of the disease in 10% to 20% of patients with diabetes. About 60% of diabetics develop severe edema.

Until now, when macular edema was diagnosed, because its causes were unknown, routine treatments included injections into the retina, whose influence was temporary, or laser surgery (assuming the problem was discovered in time). But results were disappointing in most cases. The research of Prof'. Ophir and his team proved beyond any doubt that this diagnostic method allows the patient to avoid unnecessary treatment during examination and improve the chances of optimal and effective treatment that will improve the quality of life.

The study: Problematic membranes were identified as the cause of macular edema

In the study, which examined 58 patients, the researchers used an innovative OCT device to produce a three-dimensional scan of the retina, enabling identification of the problematic membranes. These membranes were identified as the main cause of edema and visual impairment.

As mentioned above, this basic data, which provides a simple, unequivocal explanation for which there is a known surgical solution, enables a significant change in the method of treatment.

One conclusion of the study included a suggestion to change the guidelines for treating the disease, so that if the presence of vitreous membranes is diagnosed, surgery for their removal is offered as the first choice. Accurate diagnosis and the appropriate approach to treatment for each case will enable a much better chance of recovery.

It should be noted that this study was based on preliminary research conducted by Prof'. Ophir and his team, published a year and a half ago. The study collected data from 122 patients from 2004 to 2008. Initial study data was similar and indicated that in 24% of the cases macular edema was caused by vitreoretinal traction. The findings were tested based on a unique, comprehensive testing method in which Prof'. Ophir checked the retina and central vision of patients. The results of this study, which was the first to discover that an important cause of edema is vitreoretinal traction, was the basis for the current study. The current study was carried out with more advanced instruments, and its results, as noted, are revolutionary in terms of diagnosis and treatment.

This study was published in June this year in the prestigious journal Eye in London, following which Prof'. Ophir was invited to a large ophthalmology conference in Europe last September. In the past month Dr. Ophir was invited to lecture again on his groundbreaking research to an audience of professionals at Mount Sinai Hospital and Columbia University, where his research was widely acclaimed.