Ocular Manifestations

Question 1

Hypertensive Retinopathy

Answer 1

Changes in retina, choroid, optic nerve

Question 2

Diabetic Retinopathy

Answer 2

Types of Retinal Changes:
Nonproliferative diabetic retinopathy
Proliferative diabetic retinopathy
Clinically significant macular edema

Question 3

Presentation of HTN Retinopathy

Answer 3

Branch Retinal Vein Occlusion:
Vein almost completely compressed due to atherosclerosis
…….
Central Retinal Vein Occlusion:
“blood & thunder” = hemorrhages all over
……..
Central Retinal Artery Occlusion:
Cherry red spot, sudden painless loss of vision - Frequently in DM, HTM, hyperlipidemia

Question 4

Presentation of DM Retinopathy

Answer 4

Main causes of vision loss:
Macular edema,
Vitreous Hemorrhage,
Tractional retinal detachment,
Neovascular glaucoma

Question 5

Tx for HTN retinopathy

Answer 5

Laser Panretinal Photocoagulation

Question 6

Tx for DM retinopathy

Answer 6

Treat retina or will continue to worsen to detachment or neovascular glaucoma

Control blood glucose

Question 7

Macular Degeneration

Answer 7

Leading causes of visual impairment in patients > than 50 years old in developed countries

Question 8

Presentation of Macular Degeneration

Answer 8

Symptoms:
Decreased central vision,
Central scotoma,
Metamorphopsia,

Forms
Nonexudative or Dry- 80-90% of patients
Exudative, neovascular, or wet- 10-20%

Question 9

Tx of Macular Degeneration

Answer 9

Geographic atrophy (no Tx)

Question 10

Amaurosis Fugax

Answer 10

loss of vision in one eye due to a temporary lack of blood flow to the retina. It may be a sign of an impending stroke.

Question 11

Etiologies of Amaurosis Fugax

Answer 11

Amaurosis fugax is a symptom of carotid artery disease. Amaurosis fugax occurs when a piece of plaque in an arteries breaks off and travels to an artery in the eye.

Risk factors include:
    Alcohol abuse
    Cocaine use
    Diabetes
    Family history of stroke
    Highblood pressure
    High cholesterol
    Increasing age
    Smoking

Question 12

Grading of HTN retinopathy:

Answer 12

Grade 0 – no changes
Grade 1 – Barely detectable arterial narrowing
Grade 2 – Arterial narrowing with focal irregularities
Grade 3 – Grade 2 + retina hemorrhages &/or exudate
Grade 4 – Grade 3 + disc swelling

Question 13

Leading cause of new blindness in the US:

Answer 13

Diabetic retinopathy

Question 14

Risk Factors of DM retinopathy:

Answer 14

Duration of time with diabetes
Poor metabolic control
Pregnancy
Hypertension
Renal disease
Other
Obesity
Hyperlipidemia
Smoking
Anemia

Question 15

Risk Factors of Macular Degeneration

Answer 15

Risk Factors:
Age
Heredity
Sex (Female)
Race (Caucasian)
Smoking
Nutrition
Photic Exposure
Hypertension
Light Iris Color
Hyperopia

Question 16

Types of DM retinopathy:

Answer 16

–Nonproliferative diabetic retinopathy (cotton wool spots, venous beading, hemorrhaging, exudate)

–Proliferative diabetic retinopathy (→ neovascularization)