Webinar Recap: Retinal Vascular Conditions Explained

Medylex recently hosted an educational webinar featuring Dr. Marko Popovic, Medical Retina Specialist and Assistant Professor at the University of Toronto. 

The session offered a practical, clinician-led overview of retinal vascular conditions - some of the most common causes of vision loss in adults - and how they are diagnosed, managed, and interpreted in clinical and Independent Medical Examination (IME) contexts. 

For those who couldn’t attend live, here’s a recap of the key takeaways. 

Understanding the Retina: Why It Matters 

Dr. Popovic began with a foundational overview of eye anatomy, focusing on the retina, the light-sensitive tissue lining the back of the eye. The retina plays a critical role in converting light into electrical signals that the brain interprets as vision. 

• The macula and fovea control sharp, central vision and colour perception 

• Damage to these structures typically affects reading, driving, and fine visual tasks 

• Peripheral vision is often preserved, even in advanced retinal diseases that affect the macula

This distinction is especially important when assessing functional impact rather than assuming total vision loss. 

How Retinal Conditions Are Diagnosed 

Modern ophthalmology relies on a combination of clinical examination and advanced imaging. Dr. Popovic highlighted several key diagnostic tools commonly referenced in ophthalmology and IME reports: 

• Visual acuity testing (Snellen chart) as a core “vital sign” of eye health 

• Fundus photography to document retinal appearance, and to track changes over time 

• Optical coherence tomography (OCT) - a high-resolution imaging tool that allows clinicians to see retinal layers and detect fluid or structural damage 

• Fluorescein angiography, which evaluates retinal blood flow and vessel leakage 

These tools allow for objective measurement of disease severity, progression, and treatment response. 

Three Common Retinal Vascular Conditions Explained 

1. Age-Related Macular Degeneration (AMD)

AMD is the leading cause of vision loss in adults over 50 in developed countries. 

• Dry AMD (≈90% of cases): gradual progression, often monitored without injections 

• Wet AMD (≈10% of cases): more severe, caused by abnormal blood vessel growth and leakage 

Dr. Popovic emphasized that while wet AMD can significantly affect central vision, timely treatment with anti-VEGF injections can dramatically improve outcomes, often restoring functional vision. 

2. Diabetic Macular Edema (DME)

DME is the most common cause of vision loss in people with diabetes. 

• Caused by leaky retinal blood vessels damaging the macula 

• Can affect colour vision, clarity, and contrast 

• Strongly influenced by systemic diabetic control 

Sequential anti-VEGF treatment was shown to reduce retinal swelling and improve vision, reinforcing the importance of coordinated medical care. 

3. Retinal Vein Occlusion (RVO)

RVO occurs when blood flow out of the retina is blocked, leading to swelling and hemorrhage. 

• Can be central (entire retina affected) or branch (localized impact) 

• Often associated with hypertension, diabetes, and vascular disease 

• Can cause sudden, significant vision loss 

Despite severe initial presentations, Dr. Popovic shared case examples where vision improved substantially with treatment, even in those approaching legal blindness. 

Treatment Advances: Anti-VEGF Therapy 

Across all three conditions, anti-VEGF medications have transformed retinal care. 

These therapies reduce abnormal blood vessel leakage, limit inflammation, and prevent harmful new vessel growth 

Dr. Popovic noted that advancements in drug design now allow for longer treatment intervals reducing patient burden while improving outcomes. 

Relevance to Independent Medical Examinations 

During the Q&A, Dr. Popovic addressed retinal conditions most commonly encountered in IMEs, particularly in trauma-related cases. 

Key points included: 

• Retinal tears, detachments, and vitreous changes are frequently associated with trauma 

• Ophthalmologists can often assess neuro-ophthalmic concerns using in-clinic tools such as OCT and visual field testing 

• Collaboration with other specialties may be appropriate in complex cases, but many determinations can be made through comprehensive ophthalmic evaluation 
  
  

Why This Matters for Medico-Legal Assessments 

This webinar reinforced the importance of specialist-led, evidence-based ophthalmology insight when retinal conditions are relevant to a claim. As Dr. Popovic demonstrated, modern retinal imaging and treatment outcomes allow for nuanced, objective interpretation of visual impairment, prognosis, and functional impact. 

For insurers, legal professionals, and case managers, this level of clinical clarity is essential to informed decision-making - particularly in complex or high-stakes files involving vision loss, trauma, or systemic disease. 

Book an Ophthalmology Assessment with Medylex 

Medylex works with leading medical specialists, including Dr. Marko Popovic, to deliver timely, defensible ophthalmology assessments across Canada. 

If you are managing a file involving retinal vascular disease, vision loss, or ophthalmic concerns and would like to discuss an assessment or referral: 

Get in touch with the Medylex team to book an assessment with Dr. Popovic or to learn more about our independent ophthalmology assessment services. 

Medylex. National Network. Local Insight. Trusted Results.