Rubeosis iridis- simplified explanation for understanding
Rubeosis iridis is a conditon of the iris in which new vessels formation on the iris takes place. This process occur as a response to ischemia in the eye. Rubeosis means to turn red and iridis is iris, the pigmented part of the eye which gives the natural color to our eyes.
How rubeosis iridis takes place?
When there is a conditon which can compromise the normal blood supply of retina then retinal cells i.e. muller and glial cells respond to this by releasing the vascular endothelial growth factors (VEGF). They trigger the process of angiogenesis by stimulating endothelial cells of the blood vessels already present in the iris.
These endothelial cells migrate and start making new weak and leaky blood vessels on the surface of iris. This process mostly start at the level of pupillary margin.
Fibrous membrane formation
There is a possibility that new fibrous membrane start developing at the anterior iris surface due to neovascularization. Since the fibrotic layer is composed of myofiroblasts, it has the tendency to contract.
Iris contraction and pupil dilation
Its contraction is the iris contraction which leads to pupil dilation process. The pupil becomes dilated and the reaction of pupil to light worsens with the severity of this condtion.
Anterior chamber angle blockage
This leads to partial to complete blockage of anterior chamber angle resulting in intractible glaucoma in which patient presents with pain, vision loss and very high IOP.
Treatment and therapies
The treatment of rubeosis includes the treamtment of ischemia. If there is a leakage in retina then PRP laser is the treatment. Other than that, anti-VEGF therapies and trabeculectomy need to be done to manage IOP as well.
Causes of rubeosis iridis
Following conditions can be the potential cause of rubeosis iridis:
- Reinal detachment
- Central retinal artery/vein occlusion
- Diabetic retinopathy
- Injury or trauma
- Retinoblastoma
- Anterior chamber uveitis
- Choroidal melanoma
- Coat’s disease
Other then these conditions, any ocular conditon leading to retinal ischemia due to lack of oxygen supply can lead to the rubeosis iridis.
Founder of EyesMatterMost- an optometry student who loves talking about eyes. I tend to cover topics related to optometry, ophthalmology, eye health, eyecare, eye cosmetics and everything in between. This website is a medium to educate my readers everything related to eyes.
