Blood-retina barrier

Question 1

Which eye structure IS NOT clear

Answer 1

Retinal pigment epithelium

Question 2

What supplies the inner 2/3 of the retina?

Answer 2

Retinal vascular system - large blood vessels

- diabetes/hypertension affect

Question 3

what supplies the outer 1/3 of the retina

Answer 3

CHOROID - supplies retinal pigment epithelium and photoreceptors

Question 4

Inner BRB

Answer 4

• Arterioles, venules, capillaries
• DOES NOT LEAK
• Endothelial, tight junctions
• pericytes 1:1 ratio

Question 5

What is the clinical pathology associated with the inner BRB

Answer 5

Diabetic retinopathy - BREAK down oft the Inner bRB,

tight junctions, get fluid/exudate into retina.

Question 6

What is the clinical pathology associated with the OUTER BRB

Answer 6

Age-related macular degenration -

Question 7

What is the pathophysiology of diabetic retinopathy

Answer 7

1. capillary BM thickening
2. Pericyte loss
3. Break down of BRB
   MICROVASCULAR - neuropathy, nephropathy, retinopathy

Question 8

Describe the 2 types of diabetic retinopathy

Answer 8

1. Non-proliferative diabetic retinopathy (NPDR)
   - retinal vessel closure
   - altered vascular permeability
   - dilated capillaries
2. Proliferative D R (PDR)
   - abnormal growth of extraretinal fibrovascular tissue - exaggerated response to retinal ischemia

Question 9

MOST COMMON CAUSE OF VISION LOSS IN NPDR

Answer 9

MACULAR EDEMA

Question 10

How is macular edema seen?

Answer 10

1. Most common visual loss
2. Retinal thickening +/- exudate
   - laser treatment decrease rate of loss by half

Question 11

3 things causing Peripheral Diabetic Retinopathy

Answer 11

• Tractional retinal detachment
• Vitreous hemorrhage
• neovascular glaucoma

Question 12

When does PDR occur

Answer 12

Secondary to retinal ischmia - expression of VEGF

Question 13

If you are diabetic, have sudden vision loss - with FLOATERS

Answer 13

Likely diagnosis is vitreous hemorrhage due to PDR

Question 14

what is the retinal pigment epithelium?

Answer 14

Metabolic monolayer responsible for photoreceptor maintenance

Question 15

Features of age related macular edema

Answer 15

1. Chronic, degenerative macular degeneraton
2. SPARES PERIPHERAL vision
   3.

Question 16

ARMD can be wet or dry…%? and how do you treat?

Answer 16

Wet (~15%) - blood, choroidal neovascular membrane- blood, hemorrahge, exudate - treat with ANTI-VEGF
DRy (~85%) - drusen