Manifestations of systemic disease I Flashcards
what is the leading cause of new blindness age 20-74 years?
diabetic retinopathy
what are the ocular manifestations of diabetes?
- refractive error changes
- cataracts
- retinopathy (most important)
what are the pathogenetic steps of diabetic retinopathy?
- increased glucose
- VEGF
- increased capillary permeability / abnormal vasoproliferation
what are the subgroups of diabetic retinopathy?
- non-proliferative
- proliferative
what are the features of non-proliferative DR?
- retinal blood vessels leak
- leakage into macula reduces vision
- microaneurysms
- leakage of intravascular fluids (hard exudates)
- intraretinal hemorrhages
- retinal ischemia (cotton wool spots)
- retinal blood vessels leak
- leakage into macula reduces vision
- microaneurysms
- leakage of intravascular fluids (hard exudates)
- intraretinal hemorrhages
- retinal ischemia (cotton wool spots)
non-proliferative DR
what are the signs of proliferative DR?
- neovascularization
- vitreous hemorrhage
- fibrous proliferation
- can have all NPDR findings, including macular edema
what are the symptoms of vitreous hemorrhage?
- shower of floaters or cobwebs
- sudden loss of vision may decrease to LP only
macular edema can be associated in any stage of retinopathy while vitreous hemorrhage or traction retinal detachments are seen in ________
PDR
what are the 2 causes of vision loss in NPDR?
- ischemic maculopathy (irreversible)
- macular edema (generally treatable)
what are the goals of photocoagulation?
- involutes neovascular tissue
- prevent further neovascularization
- reduce risk of vitreous hemorrhage and reduce traction retinal detachment
what are the systemic controls to prevent / improve macular edema?
- reduce proteinuria
- diuresis and BP control
- ACE / ARB inhibitors
- control serum lipids
laser photocoagulation is used for what two conditions?
- macular edema (focal macular laser)
- PDR (panretinal photocoagulation)
what are the most sensitive ophthalmoscopic indications for HTN?
- attenuation of arterioles
- focal narrowing
- AV changes
