Eye in Systemic Disease Flashcards
What is the pathogenesis of diabetic retinopathy?
Chronic hyperglycaemia > glycosylation of protein/basement membrane> loss of pericytes > microaneurysm. Microaneurysm then causes leakage and ischaemia
What are the signs of non proliferative retinopathy?
Microaneurysms/ dot + blot haemorrhages. Hard exudate, cotton wool patches, abnormalities of venous calibre, intra-retinal micovascular abnormalities (IRMA)
Where do new vessels grow in diabetic retinopathy?
On disc (NVD), in periphery (NVE), on iris if ischaemia is severe
Why do diabetics lose vision?
Retinal oedema affecting fovea, vitreous haemorrhage, scarring/tractional retinal detachment
What is the management of diabetic retino/maculopathy?
Optimise medical management, laser-(PRP, macular grid), surgery-vitrectomy, rehab
What correlates to the severity of HT and state of retinal arterioles?
Appearance of fundus
What are the features of hypertensive retinopathy?
Attenuated blood vessels-copper or silver wiring. Cotton wool spots, hard exudates, retinal haemorrhage, optic disk oedema
What can accelerated HT cause?
Decreased vision
What are the ocular manifestations of sarcoidosis?
Uveitis, conjunctivitis, keratoconjunctivitis sicca, glaucoma, lacrimal gland enlargement
What are the extraocular features of thyroid eye disease?
Proptosis, lid signs (retraction, oedema, lag, pigmentation), restrictive myopathy
What are the ocular features of thyroid eye disease?
Anterior segment- chemosis, injection, exposure, glaucoma. Posterior segment-choroidal folds, optic nerve swelling
What ocular feature can SLE cause?
Ocular inflammation
What ocular features can RA cause?
Dry eyes (keratoconjunctivitis sicca), scleritis, corneal melt
What ocular features can Sjogren’s syndrome cause?
Keratoconjunctivitis sicca, xerostomia, infiltrates lacrimal glands
What ocular features can Stevens-Johnson syndrome cause?
Symblepharon, occlusion of lacrimal glands, corneal ulcers
