Villegas MD specializes on complex vitreoretinal diseases that oftentimes require multidisciplinary services in San Juan, Puerto Rico. Early diagnosis and treatment are the most important steps to minimize visual loss. Our staff and state of the art facilities are designed to assist your care. Let us change your life for the better.
Retinopathy of prematurity (ROP) is the most common cause of childhood blindness in developed countries and in Puerto Rico. Neonates born before 3o weeks of gestational age or with low birth weight have higher risk for developing ROP. In preterm infants the peripheral retina is not fully mature and may develop abnormal vasculature after premature birth. Without treatment, abnormal retinal development may lead to retinal detachment and blindness.
Other pediatric retinal conditions such as persistent hyperplastic primary vitreous (PHPV), Norrie's disease, familial exudative vitreoretinopathy (FEVR), retinoschisis, may have features similar to ROP. A complete ophthalmologic exam including photography, optical coherence tomography (OCT), and ultrasound may be necessary for diagnosis.
Age-Related Macular Degeneration (ARMD) is one of the most common causes of acquired visual loss after the age of 60. The hallmark of the disease is the presence of drusen. Drusen may vary in quantity, size, and location. Mayor risks factors associated to development of ARMD include increasing age, Caucasian race, smoking, and family history.
ARMD is categorized as either Dry ARMD or Wet ARMD. Both can cause visual impairment. The primary treatment of Wet ARMD is anti-VEGF intravitreal therapy.
An epiretinal membrane is a fibrotic tissue found on the surface of the retina. Epiretinal membranes are typically associated to a history of posterior vitreous detachment, intraocular inflammation, trauma, intraocular surgery, intraocular tumors or retinal detachment. Most cases are asymptomatic. However, epiretinal membranes can cause distortion of vision (metamorphopsia) and/or vision loss. If visual acuity is affected, surgically removing the membrane may be considered.
As we mature, the gel inside the eye, called vitreous, slowly becomes liquefied. This results in pockets of liquid forming inside the eye. In some cases, as the vitreous separates from the inner retinal surface, an incomplete separation may occur. When the area of incomplete separation is located at the macula, distortion of vision (metamorphopsia) and/or vision loss may occur.
Diabetic retinopathy is the leading cause of blindness in working-age adults. The common pathway that leads to diabetic retinopathy is longstanding damage to the small blood vessels in the retina. The walls of these small blood vessels become more permeable, allowing vascular leakage.
Diabetic macular edema (DME) results from vascular leakage accumulating in the macula, disrupting and damaging the central photoreceptors. In addition, areas of the retina that are not obtaining oxygen may develop abnormal new blood vessels (neovascularization) that proliferate, bleed, and ultimately scar. These changes may cause traction on the retina. Without intervention, this may lead to a tractional retinal detachment and blindness.
A retinal detachment occurs when the retina separates from the inner wall of the eye. Most commonly this is due a tear in the retina. When a tear is present in the retina, fluid can migrate from the inside of the eye to under the retina. Untreated, most retinal detachments will lead to permanent visual loss.
Retinal detachments are almost always treated with surgery. Surgical options include pneumatic retinopexy, scleral buckling, and/or vitrectomy with gas or silicone oil tamponade.
