Retinal and Macular diseases Flashcards
What is VEGF?
Vascular endothelial growth factor
Released when new blood vessels grow in PDR
What treatment is used in proliferative diabetic retinopathy?
Anti-VEGF injections every 8 weeks
LASER
What are the stages of diabetic retinopathy?
- Mild non-proliferative
- Moderate non-proliferative
- Severe non-proliferative
- Proliferative retinopathy
What is seen in pre-proliferative DR?
Microaneurysms (some bleeding)
Cotton wool spots (dead nerve fibres from ischaemic damage)
Can lead to macular oedema (leaking vessels)
Asymptomatic
What is seen in proliferative DR?
New, small, tortuous vessels (preceded by IRMAs) Rarely symptomatic (unless haemorrhage or detachment has occurred)
What are some symptoms of retinal detachment?
Floaters
Flashing lights
Blurred vison
Shadow over visual field
What causes a macular hole?
PVD occurs as a result of ageing
Lining of the vitreous body pulls on the macula and tears a hole in it
What does a vitrectomy do?
Removes vitreous humour
Stops anterior-posterior traction on retina
What does an ILM peel do?
Removes inner limiting membrane layer of retina
Stops tangential traction on retina so hole doesn’t get bigger
How does a retinal detachment occur in proliferative DR?
Scarring of ischaemic vessels creates a traction on the retina, pulling it away
What is AMD?
Gradual loss of central vision
Dry = several years
Wet = weeks
Characterised by early deposits of drusen
Who is more likely to have retinal vein occlusions?
Patients with diabetes, high blood pressure, high cholesterol, cardiovascular disease
What causes papilloedema?
Raised intracranial pressure
Usually bilateral
Brain tumour, CNS inflammation (eg meningitis), IIH
What does papilloedema look like on fundoscopy?
Larger optic disc
Blurred margins
Venous engorgement
What accumulates in dry AMD?
Drusen - pigment epithelial waste products
