ARMD & Retinal detachment Flashcards
What is seen in fundoscopy in ARMD?
Drusen- yellow protein and lipid deposits betweeen pigmented epithelium and Bruch’s membrane (DRY)
Atrophy of pigmented epithelium
Photoreceptor degeneration
Which has a worse prognosis, wet or dry ARMD?
Wet
Risk factors for ARMD?
Age Smoking White/Chinese FH CV disease
What are vision changes in ARMD?
Central visual field loss (SCOTOMA)
Reduced acuity
Crooked or wavy appearance to straught lines (AMSLER GRID TEST)
Poor night vision
Which is more acute, wet or dry?
Wet
Vision loss over days and progresses to blindness in 2 years, and spread to be bilateral
What investigations are done in ARMD?
Snellen chart acuity
Amsler grid for distortion
Fundoscopy
Slit lamp biomicroscopic fundus examination
Optical coherence tomography (OCT) test for wet AMD
Fluorescein angiography to show oedema and neovascularisation (second line for wet)
How is dry ARMD managed?
Stop smoking
BP control
Vitamin supplements (Zinc, A C E)
How is wet ARMD treated?
Anti VEGF- RANIBIZUMAB or BEVACIZUMAB slow new vessel growth
Injected into vitreous chamber monthly
What is posterior vitreous detatchment?
Vitreous body becomes less able to hold shape with age, so detatches in elderly
How does post vit detachment present?
Painless
Spots of vision loss
Floaters
Flashing lights
How is post vit detachment managed?
None
Symptoms improve as brain adjusts
Can predispose to retinal tears and detachment which presents similarly so always need to see ophthalmologist to exclude this
What is retinal detachment?
Retina separated from choroid underneath and vitreous fluid gets in underneath threatening blood supply and therefore vision
What are risk factors for retinal detachment?
Post vit det DM Trauma Retinal malignancy Age FH
How does retinal detachment present?
Painless peripheral vision loss like a sudden shadow
Blurred or distorted vision
Flashes and floaters
How is retinal detachment managed?
Management or tears aims to create adhesions using laser therapy or cryotherapy
Management of detatchement is using vitrectomy (replace vitreous with oli or gas)
Schleral buckling (silicone to put pressure on sclera so that choiroid indented into contact with retina
Pneumatic retinopexy- injecting gas bubble into vitreous body
