Retinopathy

Question 1

What is hypertensive retinopathy

Answer 1

Damage to the small blood vessels in the retina relating to systemic hypertension

Question 2

What is silver or copper wiring

Answer 2

walls of arterioles become thickened and sclerosed causing increased reflection of light

Question 3

What is AV nicking

Answer 3

Arterioles cause compression of the veins where they cross. Due to sclerosis and hardening of the arteriole

Question 4

What are cotton wool spots

Answer 4

Ischaemia and infarction in the retina causing nerve fibre damage. Sign of systemic disease.

Question 5

What are hard exudates

Answer 5

Damaged vessels leaking lipids into retina (yellow/white deposits)

Question 6

What are retinal haemorrhages

Answer 6

damaged blood vessels rupturing and releasing blood into retina

Question 7

Papiloedema

Answer 7

Ischaemia to the optic nerve resulting in optic nerve swelling and blurring of disc margins

Question 8

What is the Keith-Wagener classification

Answer 8

Stages of 1 - 4 to classify hypertensive retinopathy

Question 9

What is stage 1 of Keith-Wagener classification

Answer 9

Mild narrowing of the arterioles

Question 10

What is stage 2 of Keith-Wagener classification

Answer 10

Focal constriction of blood vessels, AV nicking

Question 11

What is stage 3 of Keith-Wagener classification

Answer 11

Cotton-wool patches, exudates, haemorrhages

Question 12

What is stage 4 of Keith-Wagener classification

Answer 12

Papiloedema

Question 13

Management of hypertensive retinopathy

Answer 13

Controlling BP and other risk factors such as smoking blood lipids levels

Question 14

What is diabetic retinopathy

Answer 14

Blood vessels in the retina are damaged by prolonged exposure to high blood sugar levels causing progress deterioration in the health of the retina

Question 15

What are microaneurysms

Answer 15

weakness in the wall causes small bulges

Question 16

What is venous bleeding

Answer 16

Where the wall of the veins are no longer straight and parallel and look more like a string of beads or sausages

Question 17

Signs of mild non-proliferative diabetic retinopathy

Answer 17

Microaneurysms

Question 18

Signs of moderate non-proliferative diabetic retinopathy

Answer 18

Blot haemorrhages, hard exudates, cotton wool spots, venous bleeding

Question 19

Signs of severe non-proliferative diabetic retinopathy

Answer 19

Blot haemorrhages, microaneurysms in 4 quadrants, venous bleeding in 2 quadrants, intraretinal microvascular abnormality in any quadrants

Question 20

Signs of proliferative diabetic retinopathy

Answer 20

Neovascularisation, vitreous haemorrhage, new vessels at the disc, elsewhere on the retina and on the iris

Question 21

Signs of diabetic maculopathy

Answer 21

Macular oedema, ischaemic maculopathy, focal, diffuse or ischaemic

Question 22

Complications of diabetic retinopathy

Answer 22

Retinal detachment, vitreous haemorrhage, rebeosis iridis, optic neuropathy, cataracts

Question 23

Management of diabetic retinopathy

Answer 23

Glycaemic control, BP control, annual eye test for diabetic patients

Question 24

What are intravitreal injection for diabetic retinopathy

Answer 24

Anti-VEGF medications are given such as ranibizumab and bevacizumab

Question 25

Laser options for diabetic patients

Answer 25

Panretinal photocoagulation and macular laser

Question 26

What can be used in severe cases of diabetic retinopathy

Answer 26

Vitreoretinal surgery

Question 27

Symptoms of thyroid eye disease

Answer 27

Exophthalmos, swollen extraocular muscles, lid retraction and eyelid lag on downward gaze, lagophthalmis, conjunctival hyperaemia and exposure keratopathy

Question 28

Major complications of thyroid eye disease

Answer 28

Optic nerve damage, corneal perforation

Question 29

Why are the eyes effected in thyroid disease

Answer 29

Autoimmune antibodies against TSH receptors are also found in orbital tissue - eye are orbital changes are usually in association with hyperthyroidism (Graves’)