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Rubeosis
It is the formation of abnormal new
blood vessels (neovascularization) and
connective tissue on the iris surface. It may give
the iris a reddish cast. It is commonly associated
with late stages of diabetic retinopathy and
central vein occlusion. Also, it may cause a
hard-to-manage form of glaucoma.
Rubeosis is also caused when weak and
unstable blood vessels emerge because other
diseases have lowered the blood vessel count.
This is usually common after surgery has been
performed and the eye is trying to heal and
repair itself.
Visual System that is Affected
A person with rubeosis might have a
gradual loss of peripheral vision that is related
to the secondary problem of glaucoma. This is
usually undetectable with the naked eye. It is
also adventitious and more commonly
regressive than progressive. The extra blood
vessels are formed to provide nutrients to the
eye but cut off the flow of aqueous to the outer
layer of the eye. It tends to be more stable.
(Gravlee)
Functional Implications
This particular condition is often linked
to diabetes in advance proliferative diabetic
retinopathy. Other conditions that may cause
this are central retinal vein occlusion, chronic
retinal detachment, and ocular ischemic
syndrome.
Treatments
If this is caught early enough, the
neovascularization can be reversed with prompt
pan retinal photocoagulation or PRP, or an
injection of anti-VEGF medications with
subsequent pan retinal photocoagulation (PRP).
This injection will block the direct effect of
vascular endothelial growth factor or VEGF and
will act more quickly. However, it will wear off
in about six weeks.
The PRP has a much slower onset of
action but it can last permanently. One the
neovascularization has been longstanding, the
new vessels recruit fibrous tissue, and as this
forms and contracts, the angle can be
permanently damaged, and will not respond to
treatment. If this does occur, then surgical
intervention is required to reduce the pressure
like a glaucoma drainage implant.
References:
(Dembinski) (“Conditions: Rubeosis,” 2010)
(Cassin & Rubin, 2006, p. 234)
(“Rebeosis”) (“Rubeosis
iridis”)Dembinski, A. (2008, June).
Avastin obliterates rubeosis iridis
membrane but has little effect on
IOP. Retrieved from
http://www.escrs.org/Publications/E
UROTIMES/08June/Avastinobliterat
esrubeosis.pdf
Conditions: Rubeosis. (2010). Retrieved
from
http://www.stlukeseye.com/condition
s/rubeosis.html
Cassin, B., & Rubin, M. (Eds.). (2006).
Dictionary of eye terminology (p.
234). Gainesville, Fl: Triad
Publishing Company. Retrieved from
http://www.faslink.org/fasmain.htm
Rebeosis. (n.d.). Retrieved from
http://library.thinkquest.org/C005949
/diseases/rubeosis.htm
Rubeosis iridis. (2010, March 5). Retrieved
from
http://www.mrcophth.com/glaucoma
/rubeosisiridis.html
Gravlee, J. (n.d.). Diabetic retinopathy.
Retrieved from
http://www.1800clearly.com/diabetic
retinopathy1.htm
Created by: Ben Davisson