Ophthalmology Case Reports

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Opinion Article - Ophthalmology Case Reports (2025) Volume 9, Issue 3

Vascular Leakage: A Key Factor in Retinal Disease and Vision Loss

Cordero Soodabeh*

Department of Eye Clinic Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany

*Corresponding Author:
Cordero Soodabeh
Department of Eye Clinic Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum Germany
E-mail: Cordero.soodabeh@charite.de

Received:02-Jun-2025,Manuscript No.OER-25-166242; Editor assigned:04-Jun-2025, PreQC No.OER-25-166242; Reviewed:18-Jun-2025,QC No.OER-25-166242; Revised:25-Jun-2025,Manuscript No.OER-25-166242(R); Published: 30-Jun-2025, DOI:10.35841/ 10.35841/oer-9.3.279

Citation: Soodabeh C. Vascular Leakage: A Key factor in retinal disease and vision loss. Ophthalmol Case Rep. 2025;9(3):279

Visit for more related articles at Ophthalmology Case Reports

Abstract

  

Introduction

Vascular leakage refers to the abnormal escape of fluid and plasma components from blood vessels into surrounding tissues. In the eye, particularly within the retina, vascular leakage is a central pathological event that contributes to tissue swelling, inflammation, and ultimately, visual impairment. Understanding the mechanisms and consequences of vascular leakage is crucial for diagnosing and managing various retinal disorders, many of which are major causes of blindness worldwide [1, 2].

The retina depends on a finely regulated blood-retinal barrier that controls the passage of substances between the bloodstream and retinal tissue. This barrier, formed by tightly joined endothelial cells lining the retinal blood vessels and the retinal pigment epithelium, maintains an optimal environment for retinal function. However, when this barrier is compromised due to disease or injury, the vessels become abnormally permeable, allowing proteins, lipids, and fluid to leak into the retinal layers. This results in retinal edema, or swelling, which distorts the normal architecture of the retina and interferes with visual processing [3, 4].

Several ocular diseases are characterized by vascular leakage. Diabetic retinopathy is perhaps the most well-known, where chronic high blood sugar damages retinal capillaries, making them fragile and leaky. This leakage causes macular edema, the accumulation of fluid in the central retina responsible for sharp vision, leading to blurred or distorted vision. Similarly, retinal vein occlusion causes increased venous pressure and damage to vessel walls, resulting in leakage and swelling. Age-related macular degeneration, particularly the "wet" form, involves abnormal new blood vessels that leak fluid and blood into the retina. Other inflammatory or infectious conditions can also disrupt the vascular barrier and cause leakage [

At the molecular level, vascular endothelial growth factor (VEGF) plays a pivotal role in promoting vascular permeability. Elevated levels of VEGF, often triggered by retinal ischemia or hypoxia, increase the permeability of blood vessels, exacerbating leakage and edema. This understanding has driven the development of targeted therapies that inhibit VEGF, reducing leakage and improving visual outcomes [

Clinically, vascular leakage is detected through specialized imaging techniques. Fluorescein angiography is a key diagnostic tool that highlights areas of leakage by tracking the flow of a fluorescent dye through retinal vessels. Optical coherence tomography (OCT) allows non-invasive, highresolution imaging of retinal layers, revealing the presence and extent of retinal swelling. These imaging modalities guide treatment decisions and help monitor response to therapy [

Management of vascular leakage focuses on addressing the underlying cause and directly reducing the leakage. Anti-VEGF agents administered via intravitreal injections have revolutionized the treatment of diseases like diabetic macular edema and wet age-related macular degeneration by stabilizing blood vessels and decreasing permeability. In addition, corticosteroids may be used to reduce inflammation and leakage in certain cases. Laser photocoagulation, once the standard treatment, is now often reserved for specific situations or used adjunctively.Despite advances in treatment, vascular leakage remains a challenging problem, particularly in advanced disease stages or cases resistant to therapy. Regular monitoring and timely intervention are essential to prevent irreversible damage and preserve vision [

Conclusion

Vascular leakage is a fundamental pathological process underlying many vision-threatening retinal diseases. Its occurrence signifies a breakdown in the retinal blood barrier and heralds the onset of retinal edema and tissue damage. Early detection through advanced imaging and targeted treatments, particularly anti-VEGF therapies, have dramatically improved the prognosis for affected patients. Continued research into the mechanisms of vascular leakage and novel therapeutic approaches holds promise for further enhancing outcomes and reducing the global burden of retinal vascular diseases. Recognizing vascular leakage as a critical factor in retinal health is vital in the ongoing effort to preserve sight and improve quality of life for millions worldwide..

References

  1. Khong JJFM, Hardy TGFM, McNab AAFM. Prevalence of Oculo-auriculo-vertebral Spectrum in Dermolipoma. Ophthalmology (Rochester, Minn). 2013;120(8):1529-32.

    2. Indexed at, Google Scholar, Cross Ref

  2. Fry CL, Leone CR. Safe Management of Dermolipomas. Archives of ophthalmology (1960). 1994;112(8):1114-6.

    3. Indexed at, Google Scholar, Cross Ref

  3. Jakobiec FA, Pineda R, Rivera R, et al. A review of the literature revealed no link between central corneal lesions and goldenhar syndrome in epicorneal polypoidal lipodermoid. Surv Ophthalmol. 2010;55(1):78-84.

    4. Indexed at, Google Scholar, Cross Ref

  4. Mansour AM, Wang F, Henkind P, et al. Ocular findings in the facioauriculovertebral sequence (Goldenhar-Gorlin syndrome). Am J Ophthalmol 1985;100:555-59.

    5. Indexed at, Google Scholar, Cross Ref

  5. Choong YF, Watts P, Little E, et al. J AAPOS. 2003;7(2):22627.

    6. Indexed at, Google Scholar, Cross Ref

  6. Stoll C, Viville B, Treisser A. A dominant oculoauriculovertebral spectrum family. Am J Med Genet 1998;78:345-9.

    7. Indexed at, Google Scholar, Cross Ref

  7. Vinay C, Reddy RS, Uloopi KS, et al. Goldenhar syndrome has cranial-facial characteristics. J Indian Soc Pedod Prev Dent. 2009;27:121-4.

    8. Indexed at, Google Scholar, Cross Ref

  8. Ghafouri A, Rodgers IR, Perry HD. A caruncular dermoid with contiguous eyelid involvement: Embryologic implications. Ophthal Plast Reconstr Surg. 1998;14:375-7.

    9. Indexed at, Google Scholar, Cross Ref

  9. Hill JA, Kimani K, White A, et al. Achieving optimal cancer outcomes in East Africa through multidisciplinary partnership: a case study of the Kenyan National Retinoblastoma Strategy group. Glob Health. 2016;12(1):23.

    10. Indexed at, Google Scholar, Cross Ref

  10. Nentwich MM, Schaller UC, Klauss V. Reasons reported by African ophthalmologists for staying in Africa and for considering migrating. Int Ophthalmol. 2014;34(4):887-92.

    11. Indexed at, Google Scholar, Cross Ref

Get the App