Retino-vitreal disorders Flashcards
Central & branch vein occlusions- Eti
- DM, HTN, Hyperlipidemia & glaucoma
- Estrogen tx
Central & branch vein occlusions- Sx
- No pain or redness
- Sudden monocular loss of vision, noticed upon waking
- Widespread hemorrhages, venous dilation, cotton wool spots
Central & branch vein occlusions- Dx
- Screen for underlying cause
Central & branch vein occlusions- Tx
- Lasar photocoagulation
- VEGF inhibitor
Central & branch artery occlusions- Eti
- Giant cell arteritis
- Carotid & cardiac emboli
Central & branch artery occlusions- Sx
- Sudden, profound monocular visual loss
- Highly reduced visual acuity
- Pallid swelling of retina, cherry red spot on fovea
- Box-car segmentation of veins
Central & branch artery occlusions- Dx
Determine underlying cause:
- ESR & CRP for giant cell arteritis
- DM, hyperlipidemia
- Emboli
Central & branch artery occlusions- Tx
- Lay flat, ocular massage, O2, acetazolamide
- Corticosteroids for GCA
Retinal detachment- Eti
- Spontaneous tears of holes due to degenerative changes
- > 50
- Nearsightedness & cataract extraction most common cause
Retinal detachment- Sx
- Rapid loss of vision with curtain of spreading across field of vision
- No pain or redness
- Detachment seen on ophthalmoscope
- Increase in floaters
- photophobias
Retinal detachment- Tx
- Lasar photocoagulation
- Cryotherapy
Posterior uveitis- Eti
- Sarcoidosis, Tb, toxo, syphallis, alopecia, HIV
Posterior uveitis- Sx
- Gradual loss of vision in quiet eye
- Inflammatory lesion in retina
- Bilateral
- Vitreous haze
Posterior uveitis- Tx
- Systemic corticosteroids and immunosuppression
- Tx underlying antimicrobial infection
Diabetic retinopathy- Eti
- 35% diabetic patients
- 20% type 2 at dx
- Within 3 yrs in type 1
- Leading cause of blindness
Diabetic retinopathy- Sx
- Non-proliferative: Hard exudates, hemorrhage, edema, microaneuryisms, macular ischemia leading to vision loss
- Proliferative: Neovascularization from optic disc. May lead to retinal detachment
Diabetic retinopathy- Dx
Screening is impairative
- Yearly fundal photography, slit lamp examination
- More frequent screening in pregnancy
Diabetic retinopathy- Tx
- Control DM, HTN, renal fxn, lipids
- Lasar photocoagulation
Hypertensive retinopathy- Eti
- Systemic HTN
- Young pts with abrupt changes
- Pheochromocytoma, malignany HTN, pre-eclampsia
Hypertensive retinopathy- Sx
- Atherosclerosis
- Silver/ copper wiring
- AV nicking
- Flame shaped hemorrhages
- Cotton wool spots
Hypertensive retinopathy- Tx
Reduce & control BP
HIV retinopathy- Eti
- Most common opthal abn
HIV retinopathy- Sx
- Cotton wool spots
- Retinal hemorrhages
- Micro-aneurysms
- Reduced contrast sensitivity
- CMV retinitis- progressively enlarging yellowish- white patches
- Other opportunistic infections
HIV retinopathy- Tx
- Valganciclovir & HAART
Ischemic optic neuropathy- Eti
- Anterior most common
- Inadequate perfusion of ciliary arteries
- Giant cell arteritis
- Congenitally crowded disc
- HTN, DM, vasculitis, thrombophelia, apnea
Ischemic optic neuropathy- Sx
- Sudden, painless visual loss
- Optic disc swelling
Ischemic optic neuropathy- Tx
- High dose corticosteroids
Vitreous hemorrhage- Eti
- Retinal tear, DM or sickle cell retinopathy,
- vasculitis, trauma
Vitreous hemorrhage- Sx
- Sudden visual loss
- Abrupt onset of floaters, increasing in severity
- Wide range of visual acuity
- Bleeding in the eye
Vitreous hemorrhage- Dx
- Inability to see fundal details with presence of clear lens
- Collection of blood in front of retina
Macular degeneration- Eti
- Age related, >50 yrs
- Genetically determined variations in complement & lipoproteins
- Wet (90%) or dry
- White, female, cigarettes, aspirin
Macular degeneration- Sx
- Acute or chronic deterioration of central vision
- Atrophic: progressive, bilateral loss
- Neovascular : New vessels, serous fluid, hemorrhage, fibrosis, rapid onset, uni to bilateral
- Retinal drusen- discrete yellow deposits
- No pain, redness
- Distortion/ abn size of images
Macular degeneration- Tx
- Oral antioxidants
- VEGF inhibitors