Disease Profiles: Retina and Choroid Flashcards
What is a stage I macular hole?
Foveolar detachment
Which patient group is most likely to be affected by chorioretinitis?
Immunodeficient patients e.g. HIV/AIDS
What is indicated by the arrows?
Posterior vitreous detachment
Which patient group is most likely to develop central serous chorioretinopathy?
Men 30-50 years
Describe the pathophysiology of a exudative non-rhegmatogenous retinal detachment
Subretinal fluid accumulation without retinal tears
Can be caused by e.g. choroidal tumours, intraocular inflammation etc.
What is a retinal hole?
Hole in the retina caused by chronic retinal atrophy
How would you investigate chorioretinitis?
Swab - culture (bacterial/viral), serology for toxoplasma and toxocara
Describe the management of posterior vitreous detachment
No treatment necessary - symptoms improve as brain as brain adjusts
Describe the clinical presentation of an epiretinal membrane
Metamorphopsia
Decreased acuity
What causes a macular hole?
Idiopathic
Secondary e.g. due to vitreous detachment, trauma
Describe the management of retinal tears
Management of retinal tears aims to create adhesions between the retina and the choroid to prevent detachment
This can be done using laser therapy or cryotherapy
What is toxocaranis (roundworm)?
Form of chorioretinitis involving ingestion of toxocara eggs (parasite hosted by cats and dogs) - leads to systemic and ocular infection
Reactive inflammatory processes lead to the organism’s encapsulation and the formation of eosinophilic granulomas, which can cause irreversible visual loss if the egg has migrated to the eye
Describe the fundoscopy findings associated with central serous chorioretinopathy
Roundish detachment of central retina
Define pathological myopia
Type of myopia that begins during childhood and progressively worsens, resulting in severe myopia by adulthood with an axial length >/= 26mm or refractive error >/= -6.00D)
Define non-rhegmatogenous retinal detachment
Detachment without any retinal tears - can be tractional or exudative
Describe the findings associated with pathologic myopia on fundoscopy
Lacquer cracks
Subretinal haemorrhage
Fuschs’ spot
Posterior staphyloma
RPE/choroid atrophy
Degeneration - cystoid, paving stone, lattice
Describe the management of chorioretinitis
May involve observation or antimicrobials ± topical steroid treatment - depends on causative pathogen and other criteria
Describe the clinical presentation of central serous chorioretinopathy
Hyperopia
Metamorphopsia
What causes chorioretinitis?
Usually a response to viral, bacterial, fungal or protozoal infection
What is an epiretinal membrane?
Scar tissue formation across the inner surface of the retina which can cause visual problems
What is a stage II macular hole?
Full-thickness defect <400µm
What causes pathologic myopia?
Environmental and genetic influences cause increased axial growth of the eyeball so image focus is too far ahead of the retina - blurred vision
Often accompanied by degenerative changes in the retina
What is a stage III macular hole?
Full thickness defect >/=400µm with no posterior vitreous detachment
Name two complications of posterior vitreous detachment
Can predispose to patients developing retinal tears and retinal detachment
What causes the formation of an epiretinal membrane?
Scar tissue most commonly forms due to age-related vitreous retraction
Can also form following eye surgery or inflammation inside the eye
What causes floaters in posterior vitreous detachment?
Collection of deposits in the vitreous body of the retina perceived as spots or strings drifting through the visual field