Retina Conditions Flashcards
pathophysiology of diabetic retinopathy
non proliferative > proliferative > diabetic macular oedema
how does hyperglycaemia cause retinopathy
inc glucose causes damage to renal small vessels & endothelial cells > inc leakiness
non-proliferative DR rundown
mild- microaneurysms
moderate- MAs, blot haemorrhages, hard exudates, cotton wool spots, venous bleeding
severe- signs in all 4 quadrants, venous beading in 2
proliferative DR rundown
neovascularisation, vitreous haemorrhage
s/s of diabetic retinopathy
asymptomatic, blurred vision
intraretinal haemorrhages can be ___ or ____
dot or flame
cotton wool spots show damage to..
nerve fibres in retina
mx for diabetic retinopathy
laser, anti VEGF, SCREEN!!
what do anti-VEGF do
reduced oedema, reduce neovascularisaiton
T/F: NPDR is a leading cause of visual loss
F: PDR is
Diabetic retinopathy is associated to
argyll-robertson pupil, cataracts, rubeotic glaucoma
what is posterior vitreous detachment
when vitreous comes away from retina
PVD causes a 70% chance of…
retinal tear
s/s of PVD
painless spots of vision loss, floaters, flashing light
what is a retinal detachment
retina separates from choroid
what are the 2 types of retinal detachment
rhegmatogenous: retinal tear so vitreous fluid gets under retina making tear worse
non-rhegmatogenous: tractional- scar tissue pulls retina off wall
s/s of retinal detachment
painless visual loss- like curtain coming across vision, flashes and floaters (tadpoles)
T/F: RAPD is present with retinal detachment
T
mx of retinal tear/detachment
tear: aim is to create adhesions between retina and choroid to prevent detachment
detachment: reattach retina and reduce traction- vitrectomy, scleral buckling, pneumatic retinoplexy
why is retinal detachment emergent
retina rellies on choroid for blood supply
aetiology of CRAO
carotid artery emboli, giant cell arteritis
types of CRAO
branch- does less damage
transient (amaurosis fugax)- curtain, pre-stroke sign
s/s of CRAO
sudden visual loss, pain
signs-RAPD, PALE retina*
ix for CRAO
fluorescein angio, funds copy, temporal artery biopsy
mx for CRAO
immediate- ocular massage, inhaling carbogen, isosorbide dinitrate
long term- treat RFs
CRVO aetiology
virchow’s triad
s/s of CRVO
sudden painless visual loss
signs- retinal haemorrhage, macular oedema, tortuous vessels, disc/macular swelling
DARK
what are classic findings of CRVO fundoscopy
flame/dot haemorrhages, optic disc oedema, macular oedema
mx of CRVO
laser, intra-vitreal steroids, anti-VEGF
