Retinopathy Flashcards
What is hypertensive retinopathy
Damage to the small blood vessels in the retina relating to systemic hypertension
What is silver or copper wiring
walls of arterioles become thickened and sclerosed causing increased reflection of light
What is AV nicking
Arterioles cause compression of the veins where they cross. Due to sclerosis and hardening of the arteriole
What are cotton wool spots
Ischaemia and infarction in the retina causing nerve fibre damage. Sign of systemic disease.
What are hard exudates
Damaged vessels leaking lipids into retina (yellow/white deposits)
What are retinal haemorrhages
damaged blood vessels rupturing and releasing blood into retina
Papiloedema
Ischaemia to the optic nerve resulting in optic nerve swelling and blurring of disc margins
What is the Keith-Wagener classification
Stages of 1 - 4 to classify hypertensive retinopathy
What is stage 1 of Keith-Wagener classification
Mild narrowing of the arterioles
What is stage 2 of Keith-Wagener classification
Focal constriction of blood vessels, AV nicking
What is stage 3 of Keith-Wagener classification
Cotton-wool patches, exudates, haemorrhages
What is stage 4 of Keith-Wagener classification
Papiloedema
Management of hypertensive retinopathy
Controlling BP and other risk factors such as smoking blood lipids levels
What is diabetic retinopathy
Blood vessels in the retina are damaged by prolonged exposure to high blood sugar levels causing progress deterioration in the health of the retina
What are microaneurysms
weakness in the wall causes small bulges
What is venous bleeding
Where the wall of the veins are no longer straight and parallel and look more like a string of beads or sausages
Signs of mild non-proliferative diabetic retinopathy
Microaneurysms
Signs of moderate non-proliferative diabetic retinopathy
Blot haemorrhages, hard exudates, cotton wool spots, venous bleeding
Signs of severe non-proliferative diabetic retinopathy
Blot haemorrhages, microaneurysms in 4 quadrants, venous bleeding in 2 quadrants, intraretinal microvascular abnormality in any quadrants
Signs of proliferative diabetic retinopathy
Neovascularisation, vitreous haemorrhage, new vessels at the disc, elsewhere on the retina and on the iris
Signs of diabetic maculopathy
Macular oedema, ischaemic maculopathy, focal, diffuse or ischaemic
Complications of diabetic retinopathy
Retinal detachment, vitreous haemorrhage, rebeosis iridis, optic neuropathy, cataracts
Management of diabetic retinopathy
Glycaemic control, BP control, annual eye test for diabetic patients
What are intravitreal injection for diabetic retinopathy
Anti-VEGF medications are given such as ranibizumab and bevacizumab
Laser options for diabetic patients
Panretinal photocoagulation and macular laser
What can be used in severe cases of diabetic retinopathy
Vitreoretinal surgery
Symptoms of thyroid eye disease
Exophthalmos, swollen extraocular muscles, lid retraction and eyelid lag on downward gaze, lagophthalmis, conjunctival hyperaemia and exposure keratopathy
Major complications of thyroid eye disease
Optic nerve damage, corneal perforation
Why are the eyes effected in thyroid disease
Autoimmune antibodies against TSH receptors are also found in orbital tissue - eye are orbital changes are usually in association with hyperthyroidism (Graves’)
