40. Vascular disease of the retina. Retinopathy of prematurity.

Question 1

what are the vascular diseases of the retina ?

Answer 1

diabetic retinopathy
hypertensive retinopathy
retinopathy of prematurity

Question 2

what is the pathology in diabetic retinopathy ?

Answer 2

capillary changes - the parasites are lost
there is endothelial damage and proliferation
thickening of the basement membrane

hematological - deformation of rbc
increased platelet sickness and aggregation

Question 3

what are the consequences of diabetic retinopathy ?

Answer 3

leakage of plasma from the retinal capillaries

weakening of muscle wall due to it being thicker - micro aneurysm - may burst or become thromboses

intraretinal edema - hemorrhages

Question 4

what are the two types of diabetic retinopathy ?

Answer 4

non proliferative and proliferative diabetic retinopathy

non proliferative diabetic retinopathy
no neovasculrisation
microaneyrsms , with inraretinal haemorrhages
retinal edema - retinal thickening

proliferative diabetic retinopathy - neovascularisation at optic disc or elsewhere

Question 5

what is a complication of diabetic retinopathy ?

Answer 5

diabetic maculopathy

Question 6

what are the symptoms of diabetic retinopathy ?

Answer 6

progressive blindness

Question 7

in fundoscopy of the retina what does progressive diabetic retinopathy look like ?

Answer 7

microaneurysm - tiny round red spots

flame shaped hemorrhages

yellow lesions with distinct margin - hard exudates

Question 8

in fundoscopy what does proliferative diabetic retinopathy look like ?

Answer 8

cotton wool spots - focal infracts

shunts - from retinal arterioles to venules

venous change - sausage like segmentation

dark blot haemorrhage - retinal infract haemorrhages

Question 9

what are the grades in hypertensive retinopathy ?

Answer 9

grade 1 - barely detecatable arterial narrowing

grade 2 - arterial narrowing , deflection of veins at atrovenous crossing

grade 3 - plus retinal haemorrhages, and retinal exudates , focal infracts

grdae 4 - plus disc swelling

Question 10

what is the pathology of retinopathy of prematurity ?

Answer 10

the retinal vessels may stop growing to the periphery of the retina , due to premature
and abnomral vessels start to grow

these new abnormal blood vessels - can bleed
fibrovascular membranes can be found
there can also be retinal dettcahment
increased vascular tortuosity

Question 11

if there is retinal detachment in any of the cases what happens to the red reflex ?

Answer 11

leukocoria - white reflex