Retinal vasculopathies

Question 1

The retinal blood vessels supply only the?

Answer 1

Inner retina

Question 2

The choriocapillaris supplies?

Answer 2

The outer retina including the photoreceptors

Question 4

What shoud be expect in a normal optic disk?

Answer 4

1. Well defined margin
2. Colour of neuro-retina should be pink
3. Cup must be pale,round,central.regualr and C/D<0.6

Question 5

The amount of pigment in the fundus depends on?

Answer 5

It depends on the retinal pigment epithelium and the choriocapillaries

Question 6

How do you describe superficial haemorrhages?

Answer 6

They are flame shaped or striated and run parallel to the nerve fibres

Question 7

What does a deper haemorrhage present with?

Answer 7

Dots and blot appearance because it runs perpendicular to the surface

Question 8

What does the picture depict?

Answer 8

By convention, small, perfectly round, red spots on the retina, with a diameter smaller than that of the large vein at the disc margin, are referred to as microaneurysms.

Question 9

What does the image depict?

Answer 9

It depicts a hard exudate which is as a result of lipid depositions- a true sign of intraretinal exudation

Question 10

Describe this image?

Answer 10

This is cotton wool spots the white spots are poorly circumscribed and are often striated and fluffy

They represent areas of severe nerve fibre ischamia or infarction

Question 11

What causes reactive retinal pigment epithelial change?

Answer 11

Any damage to the retinal pigment epithelium which subsequently causes hypertrophy,hyperplasia,atrophy,and migration of the pigment epithelium

Question 12

What is this?

Answer 12

White and black marks due to reactive pigment epithelial change

Question 13

What are the 3 manifestations of severe hypertension on fundoscopy?

Answer 13

1. cotton wool spots
2. nerve fibre layer haemorrhages
3. hard exudates

Question 14

What is malignant hypertesion?

Answer 14

Maignant hypertension is a diastolic pressure of 130-140mmHG and optic disc swelling

Question 15

What to look for in arteriosclerosis?

Answer 15

Copper wiring and eventually silver wiring because the blood vessel wall becomes more paler

Question 16

What does VEGF stand for?

Answer 16

vascular epithelial growth factor

Question 17

How do you describe neovascularisation?

Answer 17

Neovascularisation is when the retina produces VEGF to produce new vessels because the new vessels leads to leakage and haemorrhage

Question 18

What are the complications of neovascularisation?

Answer 18

1. neovascular glaucoma
2. intraretinal exudation
3. vitreous haemorrhage which leads to retinal detachment

Question 19

Describe backgroound extramacular retinopathy:

Answer 19

1. It is described as micro-aneurysms
2. hard exudates
3. haemorrhages particularly deep (dots and blots)

Question 20

What are the signs we look for in preproliferative extramacular retinopathy?

Answer 20

1. We look for : cotton wool spots
2. venous beading and looping
3. extensive deep haemorhages
4. vascular occlusions

Question 21

Proliferative extramacular retinopathy?

Answer 21

Neovascularisaton

Question 22

What is the treatment for diabetic retinopathy?

Answer 22

Control blood glucose

argon laser photocoagulation

Question 23

How does central retinal arterial occlusion occur?

Answer 23

It occurs as a result of thrombpsis or embolism

In older patients-carotid artherosclerotic plaques

Younger patients-vardiac valvar lesions

Question 24

What is amourosis fugax?

Answer 24

Temporary loss of vision that is less than 24 hours

Question 25

What are the signs of central retinal arterial occlusion?

Answer 25

loss of visual acuity to HM and PL Loss of visual field cherry red spot-the macula seems to be more red than it is because of the pale background milky white retina Narrowed arterioles and venules

Question 26

What is the management of central retinal arterial occlusion?

Answer 26

1. Digital globe massage to dislodge the thrombus and embolus 2. Inhalation of a mixture of 95% oxygen to deliver it to the ischemic retina and 5% of carbon dioxide to cause vasodilation 3. Systemic vasodilators such as isosorbide dinitrate

Question 27

What is central venous retinal occlusion?

Answer 27

It is the sudden and uniltaeral loss of vision in a comfortable white eye

Question 28

What are 5 signs of central venous retinal occlusion:

Answer 28

1. Visual acuity and visual field vary form almost normal to very severe-6/9 to Hand movements 2. Optic disc swelling 3. cotton wool spots 4. hard exudates 5. nerve fibre layer haemorrges if not severe 6. dots and blots in very severe cases

Question 29

What does this depict?

Answer 29

Central retinal venous occlusion

Question 30

Which babies are high risk for developing retinopathy of prematurity?

Answer 30

1. Babies born at a gestational age\< 30 weeks 2. Babies less than 1500 g 3. Babies less than 2500 g with an unsable clinical course 4. High saturation of oxygen therapy