Retinal disease Flashcards
Epiretinal membrane
- Definition
- Cause/ associations
- Symptoms
Occurs when a layer of fibrocellular tissue forms on the inner surface of the retina.
Associations
- Posterior vitreous detachment
- Idiopathic
- Secondary to other disease: diabetic retinopathy, retinal vein occlusion, retinal tear/ detachement.
Symptoms
- Metamorphopsia (distorted vision)
- Blurred vision
- Monocular diplopia
- Micropsia (objects appear smaller than normal)
Epithelial membrane
- Diagnosis
- Management
Fundoscopy
- Wrinkling of retinal surface
- Blunting of fovea contour
OCT
- Thickening of retina
Management
- Vitrectomy
- Membrane peel
Age-related macular degeneration
- Definition
- Classifications
Degradation of the retinal pigmented layer due to age associated mechanisms.
Classifications
- Dry (most common)= drusen deposits, geographical atrophy.
- Wet= intraretinal oedema, choroidal neovascularisation, retinal pigment epithelial detachement.
AMD
- Presentation
- Investigations
Presentation
- Sudden onset, decreased/loss of central vision
- Poor night vision
- Metamorphopsia
Investigations
- Amsler grid: visual distortion
- Snellen chart: loss of central acuity
- OCT= choroidal neovascularisation, intra/subretinal fluid, pigment epithelial detachement, scarring
- OCT angiography= choroidal neovascularisation
AMD
- Management
Risk factor modification
- Smoking cessation
- BP control
- Reduction of LDLs in diet
Wet AMD
- Anti-VEGF injections for neovascularisation
- Thermal laser photocoagulation
AMD
- Management
Risk factor modification
- Smoking cessation
- BP control
- Reduction of LDLs in diet
Wet AMD
- Anti-VEGF injections for neovascularisation
- Thermal laser photocoagulation
Characteristic features in the fundus appearance of retinitis pigmentosa
Optic disc
- Temporal pallor
Blood vessels
- Retinal vessel attenuation
Retina
- Bone-spicule hyperpigementation
Clinical features of retinitis pigmentosa
Loss of night vision (nyctalopia)
Loss of peripheral vision
Genetics of retina hyperpigmentosa
Can be inherited in 3 forms
- Autosomal dominant/ recessive
- X-linked
Autosomal dominant retinitis pigmentosa is most commonly caused by mutations in what gene?
RHO
- rhodopsin gene, responsible for translating light into phototransduction signals
Risk factors for the progression of diabetic retinopathy
Lack of exercise
Poor glycaemic control
Poor BP control
Pregnancy
Infrequent eye check up
Risk factors for the progression of diabetic retinopathy
Lack of exercise
Poor glycaemic control
Poor BP control
Pregnancy
Infrequent eye check up
Indication for intravitreal anti-VEGFs injections
Macular oedema
Fundoscopy findings of branch retinal vein occlusion
Most commonly affects the superotemporal region
Cotton wool spots
- Ischaemic regions located in the region drained by affected branch
Superficial haemorrhages (flame haemorrhages)
Retinal oedema
Fundoscopy findings of a branch retinal artery occlusion
Yellow/ Pale spot in a branch of the central retinal artery
