Retinal Disorders Flashcards
A RD is the separation of the ___ from the _____
RPE; neurosensory retina
Whhich fo the following artery does not branch off of the ophthalmic artery? A. Superficial temporal artery B. Muscular artery C. Supraorbital artery D. Lacrimal artery
A
The retinal vessels are innervated by sympathetic nerves, T or F?
False
Autoregulation
Which of the following has the tight junction between endothelial cells?
A. Choriocapilaris
B. Retinal vessles
Retinal vessles
Outer blood retinal barrier
- Tight junctions between RPE cells
2. Tight connections between RPE and Bruch’s membranes
Inner blood retinal barrier
- Pericytes and tight junctions between endothelial cells
2. Glial cells (astrocytes and muller cells)
Macular bloood supply
Choriocapilaris
Does not get blood from the retinal blood vessels
Examples Breakdowns of outer blood retinal barrier
ARMD
Drusen builds up and disrupts RPE layer, poor job with transportioan and the outer part of the retina does not get the oxygen and nutrition.
• if not getting nutrients, induces growth of small vessel growth and they leak
• This is wet AMD
CSCR
- water cannot be transported into the choroid and it builds up
Example of inner blood retinal barrier
Diabetes and hypertension
If CSCR is not better after 3 months then what
Can do any of the following
- photodynamic therapy
- laser treatment
- trimepranol 5mg
Most common risk factors for CSCR
Corticosteroids
Main causes of CME
Cataracts and DM
How to treat CSM
Bromfenac 0.09% QID (NSAID)
CRAO
- Whitening of the retina
- Cherry red spot (macula supplied by the choriocapilaris)
- attenuation of the artery
- boxcarring
Prognosis low
In CRAO, when can the patient have preserved vision
If they have a cilioretinal artery (short posterior ciliary artery)
How do you manage CRAO patients
CBC ESR, CRP and platelet Carotid artery eval Cardiac eval Follow up with eye exam in 2 weeks
What do we look for in CRAO patients when they come back for follow up
NVI, NVE, NVD
-20% will develop these in 2-4 weeks
How do you manage CRVO pateitns
CBC
Cardiac eval
Amsler grid to take home and follow up in 1 month
Difference between CRVO and NPDR
CRVO • this one is nonischemic ◦ Mild symptoms ◦ Can induce CRAO eventually ◦ Tortuous veins ‣ In DR, beading of the veins, but they are tortuous here ◦ This guys left eye looks totally normal, if it was DR, it would be bilaterall, he is also well controlled, so unlikely this will be DR • Ischemic ◦ More bleeding in this one ◦ Sometimes macular edema
Difference between OIS and CRVO
Miderpierhal dot nad blot hemorrhages is typical findgins in OIS
• CRVO will be different because OIS will not have tortuous veins like CRVO
• OIS has anterior seg involved
Difference one amsler grid in ON and maculopathy
ON: missing portions or gray spits
Mac: distorted or bent lines
