Fibrovascular Proliferation is a serious condition affecting retinal health, often leading to vision loss if not treated promptly. Practices listed with Specialty Vision specialize in diagnosing and managing this condition effectively.
Fibrovascular proliferation (FVP) happens when abnormal blood vessels and fibrous tissue grow on or near the retina. It usually develops because of long-term poor blood flow in the retina. As the retina struggles for oxygen, it sends out growth signals that trigger this unwanted tissue buildup. Catching FVP early is important because it can lead to serious vision problems.
In FVP, the retina grows fragile blood vessels and scar-like tissue. This often shows up in advanced stages of retinal diseases, like proliferative diabetic retinopathy (PDR). The body tries to fix oxygen loss by creating new vessels, but they’re weak and poorly formed. Over time, the fibrous tissue that comes with them can pull on the retina, causing traction and possibly detachment.
So even though this process starts as the body’s way of coping with low oxygen, it ends up doing more harm than good. That’s why FVP is a serious threat to vision.
Fibrovascular proliferation starts when the retina doesn’t get enough oxygen. This lack of oxygen triggers the release of growth signals like VEGF (vascular endothelial growth factor), which tell the body to grow new blood vessels. But the process is unregulated, and the vessels that form are often weak and abnormal.
When blood flow drops, certain areas of the retina become hypoxic—they don’t get enough oxygen. This is the starting point for further damage.
To respond to the lack of oxygen, the retina releases VEGF and other signals that push for the growth of new vessels.
These new vessels grow fast but are unstable. They don’t have the normal structure, so they can easily leak or bleed.
As the vessels grow, fibrous (scar-like) tissue forms too. This tissue spreads over the surface of the retina and even into the gel-like center of the eye (the vitreous).
Eventually, the fibrous tissue contracts and pulls on the retina. This can lead to tractional retinal detachment—where parts of the retina lift or peel away from their base. That’s when vision is seriously at risk.
Fibrovascular proliferation can affect several parts of the eye, not just one. Each area plays a key role in vision, so when they’re involved, the risks are serious.
New blood vessels can form on the optic nerve head. This is called neovascularization of the disc (NVD), and it’s a common feature of advanced disease.
In neovascularization elsewhere (NVE), abnormal vessels often show up in the mid-peripheral retina. These areas are harder to examine and monitor.
Fibrovascular tissue can grow along the back surface of the vitreous. This may cause the vitreous to shift or pull on the retina.
Scar tissue may spread across the surface of the retina, forming epiretinal membranes. These membranes can distort vision and cause traction.
When the macula is affected, it’s a major concern. This area controls sharp, central vision, so any pulling or membrane growth here puts central vision at risk.
Understanding the clinical presentation of fibrovascular proliferation is vital for timely diagnosis and intervention. The symptoms and findings can vary depending on the development stage of the disease.
During a detailed eye examination, our retina specialists might observe several important signs indicating fibrovascular proliferation:
These appear on the retina or even on the optic disc, suggesting the presence of fibrovascular tissue.
Abnormal, looping blood vessels may extend toward and even into the vitreous as a part of the proliferation process.
Vitreous or preretinal hemorrhage might be visible, along with retinal folds or other tractional changes that hint at ongoing retinal stress.
Initially, fibrovascular proliferation might not cause noticeable symptoms. In the early stages, patients often remain unaware of any changes in their vision. However, with progression, they might start to experience:
The pulling on the retina distorts the normal architecture, leading to visual distortion.
These small, moving spots in the field of vision are common when abnormal vessels leak blood into the vitreous.
Portions of the visual field might diminish or become obscured due to tractional changes.
Particularly if a retinal detachment occurs, the patient might experience a rapid decline in vision, which is a medical emergency.
Fibrovascular proliferation can lead to serious problems that affect both vision and overall eye health. The growing and contracting scar tissue doesn’t just damage the retina—it can trigger a chain reaction of complications.
When the scar tissue contracts, it pulls on the retina. This traction can cause the retina to lift or detach, especially dangerous if the macula is involved. That can lead to severe vision loss.
The new vessels are weak and prone to bleeding. If they rupture, blood can spill into the vitreous—the clear gel in the center of the eye—blurring or blocking vision.
If you suspect you have fibrovacular proliferation or are experiencing vision disturbances, don't hesitate to consult one of our listed specialists. Their expertise in managing complex retinal issues will guide you to the best care available. Find a top ophthalmologist near you today to get started on the path to preserving your vision!
Sometimes the pulling force is strong enough to tear the retina. These breaks can cause a more complex detachment that needs urgent treatment.
If abnormal blood vessels grow into the front of the eye, they can block fluid drainage and raise pressure inside the eye. This can lead to neovascular glaucoma—a serious, vision-threatening condition.
Managing fibrovascular proliferation involves a multifaceted approach tailored to the severity and complications present in each case. Treatment strategies aim to reduce the progression of abnormal tissue growth, stabilize the retina, and preserve as much vision as possible.
One of the first lines of treatment for managing FVP involves the use of anti-VEGF injections. These medications, such as bevacizumab, ranibizumab, and aflibercept, are designed to slow or reverse the growth of abnormal blood vessels. By targeting the very signals that promote neovascularization, these drugs can help decrease the vascular component of FVP. However, it’s important to approach this treatment with caution. Rapid involution of vessels may cause the fibrous tissue to contract more quickly, increasing retinal traction in cases with extensive fibrovascular proliferation.
Another key treatment option is laser photocoagulation—specifically, panretinal photocoagulation (PRP). This procedure uses laser burns to reduce retinal ischemia, which in turn decreases the production of VEGF. By treating large areas of the retina, PRP effectively lowers the stimulus for further abnormal vessel growth. Often, laser treatment is administered in combination with anti-VEGF injections to maximize the therapeutic effect while minimizing adverse outcomes.
When medical and laser treatments are insufficient, especially in cases where vision is at imminent risk, surgical intervention may be necessary. Pars plana vitrectomy (PPV) is a common surgical option for managing advanced fibrovascular proliferation. During PPV, the surgeon removes the vitreous gel and carefully dissects the fibrovascular membranes, relieving traction and allowing the retina to reattach. This procedure is particularly valuable when there is non-clearing vitreous hemorrhage, tractional retinal detachment threatening or involving the macula, or even combined tractional-rhegmatogenous detachments.
Eliminating the vitreous gel helps reduce the potential for further scar tissue formation and can clear media opacities.
Carefully removing these membranes minimizes the mechanical traction that leads to retinal detachment.
The procedure often involves reattaching the retina using methods such as gas or silicone oil tamponade, thereby improving the chances of restoring vision.
Accurate diagnosis of fibrovascular proliferation involves several imaging and examination techniques. These methods help our retina specialists identify the presence and extent of abnormal tissue growth so that appropriate treatment can be planned.
This is the first step in diagnosing FVP. During the exam, the doctor carefully inspects the retina, looking for signs of abnormal membrane formation, traction lines, or any associated hemorrhage. A reduced red reflex or an obscured fundus view may be noted if there is significant bleeding.
OCT imaging provides a cross-sectional view of the retina. It can reveal features such as the presence of fibrovascular membranes, retinal thickening, macular distortion, and early signs of tractional retinal detachment. This tool is key for appreciating the subtle layers where FVP occurs.
FA involves injecting a fluorescent dye into the bloodstream to better visualize the retinal vessels. The test helps highlight neovascular leakage, areas of capillary non-perfusion, and the extent of retinal ischemia, all of which contribute to the development of FVP.
A non-invasive imaging modality, OCT-A can detect active neovascular components in regions where fibrovascular proliferation has developed. It allows for detailed visualization of the microvasculature without the need for dye injections.
If you suspect you have fibrovacular proliferation or are experiencing vision disturbances, don't hesitate to consult one of our listed specialists. Their expertise in managing complex retinal issues will guide you to the best care available. Find a top ophthalmologist near you today to get started on the path to preserving your vision!
Learn about Fibrovascular Proliferation, its symptoms, complications, and treatment options. Find a top ophthalmologist near you to safeguard your vision.
