41. Retinal detachment. Retinoblastoma Flashcards
what is retinal detachment ?
displacement of the neurosensory retina from the retinal pigment epithelium (base)
what are the most common causes of retinal detachment ?
due to posterior vitrous detachment - natural changes in the vitreous gel - causing holes and tears
tractional - sensory retina pulled away from the
severe myopia retinal tears complication from cataract surgery tumor exudative
when we see retinal tears or holes what should be dine immediately ?
circular laser coagulation in the vicinity of the retinal defect
what is the treatment for retinal detachment ?
needs to be treated surgically
what does the prognosis of vision in retinal detachment depend on ?
depends mainly on the extend of retina involvement especially the macula
and the length of time till the retina is restored
what are the symptoms in retinal detachment ?
visual field defect
distorted vision
flashes of light -not in tractional
floaters - not in tractional
what are the types of retinal detachment ?
rhegmatogenous - break in retina fluid to pass from the vitreous space into the subretinal space between the sensory retina and the retinal pigment epithelium - myopia - vitreous detachment - trauma - cataract surgery
An exudative retinal detachment occurs due to inflammation, injury or vascular abnormalities that results in fluid accumulating underneath the retina without the presence of a hole, tear, or break
- scleritis
- choroiditis
A tractional retinal detachment occurs when fibrous or fibrovascular tissue, caused by an injury, inflammation or neovascularization, pulls the sensory retina from the retinal pigment epithelium.
- proliferative diabetic retinopsthy
what is seen in fundoscopy with retinal detachment ?
detached retina has convex configuration
slightly opaque and corrugated
undulates with eye movement
cause of retina blastoma?
genetic inherited - affects bilateraly
what are the symptoms of retinoblastoma ?
visual deterioration
red and irritated eye
signs of retinoblastoma ?
leukococoria - white reflection through fundoscopy
strabismus
secondary glaucoma
what does the retinoblastoma look like in fundoscopy ?
early - intretinal placoid white lesion
endophytic - white cottages cheese like , no overlying retinal vessels
exophytic - grows outwards into sub retinal space
multilobulsted white mass
retinal vessels seen over it
retinal detachment
ct , mri
treatment for retinoblastoma ?
small tumor - cryotherapy
medium size tumor - brach/ chemotherapy
large - chemotherapy
