Retinal vasculopathies Flashcards
The retinal blood vessels supply only the?
Inner retina
The choriocapillaris supplies?
The outer retina including the photoreceptors
What shoud be expect in a normal optic disk?
- Well defined margin
- Colour of neuro-retina should be pink
- Cup must be pale,round,central.regualr and C/D<0.6
The amount of pigment in the fundus depends on?
It depends on the retinal pigment epithelium and the choriocapillaries
How do you describe superficial haemorrhages?
They are flame shaped or striated and run parallel to the nerve fibres
What does a deper haemorrhage present with?
Dots and blot appearance because it runs perpendicular to the surface
What does the picture depict?
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.
What does the image depict?
It depicts a hard exudate which is as a result of lipid depositions- a true sign of intraretinal exudation
Describe this image?
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
What causes reactive retinal pigment epithelial change?
Any damage to the retinal pigment epithelium which subsequently causes hypertrophy,hyperplasia,atrophy,and migration of the pigment epithelium
What is this?
White and black marks due to reactive pigment epithelial change
What are the 3 manifestations of severe hypertension on fundoscopy?
- cotton wool spots
- nerve fibre layer haemorrhages
- hard exudates
What is malignant hypertesion?
Maignant hypertension is a diastolic pressure of 130-140mmHG and optic disc swelling
What to look for in arteriosclerosis?
Copper wiring and eventually silver wiring because the blood vessel wall becomes more paler
What does VEGF stand for?
vascular epithelial growth factor
How do you describe neovascularisation?
Neovascularisation is when the retina produces VEGF to produce new vessels because the new vessels leads to leakage and haemorrhage
What are the complications of neovascularisation?
- neovascular glaucoma
- intraretinal exudation
- vitreous haemorrhage which leads to retinal detachment
Describe backgroound extramacular retinopathy:
- It is described as micro-aneurysms
- hard exudates
- haemorrhages particularly deep (dots and blots)
What are the signs we look for in preproliferative extramacular retinopathy?
- We look for : cotton wool spots
- venous beading and looping
- extensive deep haemorhages
- vascular occlusions
Proliferative extramacular retinopathy?
Neovascularisaton
What is the treatment for diabetic retinopathy?
Control blood glucose
argon laser photocoagulation
How does central retinal arterial occlusion occur?
It occurs as a result of thrombpsis or embolism
In older patients-carotid artherosclerotic plaques
Younger patients-vardiac valvar lesions
What is amourosis fugax?
Temporary loss of vision that is less than 24 hours
What are the signs of central retinal arterial occlusion?
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
What is the management of central retinal arterial occlusion?
- Digital globe massage to dislodge the thrombus and embolus
- Inhalation of a mixture of 95% oxygen to deliver it to the ischemic retina and 5% of carbon dioxide to cause vasodilation
- Systemic vasodilators such as isosorbide dinitrate
What is central venous retinal occlusion?
It is the sudden and uniltaeral loss of vision in a comfortable white eye
What are 5 signs of central venous retinal occlusion:
- Visual acuity and visual field vary form almost normal to very severe-6/9 to Hand movements
- Optic disc swelling
- cotton wool spots
- hard exudates
- nerve fibre layer haemorrges if not severe
- dots and blots in very severe cases
What does this depict?
Central retinal venous occlusion
Which babies are high risk for developing retinopathy of prematurity?
- Babies born at a gestational age< 30 weeks
- Babies less than 1500 g
- Babies less than 2500 g with an unsable clinical course
- High saturation of oxygen therapy
