Opthalmology

Question 1

Hypertensive retinopathy stages

Answer 1

1. arteriolar narrowing and tortuosity (被压弯了）
2. AV nipping (然后压到vein了）
3. Flame and blot hemorrhage (然后压爆了）, cotton wool exudate (结痂了）
4. Papilloedema （最后一步是压到optic disc)

Question 2

Diabetic retinopathy stages

Answer 2

Non-proliferative then proliferative then maculopathy

1. Non-proliferative

Mild: just some microaneurysm

Moderate: blots and dots, microhemorrhages, cotton-wool exudates, some venous beading

Severe: microaneurysm in all 4 quadrants, venous beading in 2 quadrants, and intraretinal microvascular abnormalities(dilation of vessels to supply infarct areas)

2. Proliferative
   Neovascularisation (new vessels)
3. Maculopathy
   macula involved

Question 3

Wet vs dry macular degeneration

Answer 3

AMD is the leading cause of registered blindness in UK

Central visual loss, visual acuity often <6/60 (what other people can read at 60m, patient can only read at 6m)
also straight lines appear bent (use amsler grid to check)

Dry: geographic atrophy of pigmented retinal epithelium, Drusen seen on slit lamp, no treatment available

Wet: Choroidal neovascularisation seen, anti-VEGF injection