Retinopathy Flashcards
The most common cause of legal blindness between 20 - 65
Diabetic retinopathy
Risk factors of Diabetic retinopathy
- Obesity and hyperlepidimua
- Smoking
- Poor control
- anemia
- Age
- cataract surgery
- Complication (hypertension and nephropathy)
Pathogenesis
- Microvascular leakage
- Microvascular occlusion
Classification of Diabetic retinopathy (DRP)
- Background DRP
- pre-prolifrative DRP
- prolifrative DRP
Features of background DRP
- Micro aneurism
- Hard exudate
- Intraretinal hemorrhage
Features of pre proliferative DRP
- Cotton wool spots
- Severe retinal haemorrhage
- IRMA (intra retinal microvascular abnormalities A-V Shunt)
Features of proliferative Diabetic retinopathy
- NVD (neovascularization on the disc) & NVE (elsewhere)
- Tractional retinal detachment
- vitreous hemorrhage
Investigations for Diabetic retinopathy
- Fluorescent angiography
- OCT (optical coherence tomography)
- US 🇺🇸
Treatment modalities for Diabetic retinopathy
- PRP pan-retinal photocoagulation
- PPV pars plana vitrectomy
- antiVEGF (IV)
Pathogenesis of Hypertensive retinopathy
- VC
- arterio sclerosis
- Increase permeability
Features of hypertensive retinopathy
- Attenuation and narrowing
- A-V crossing
- Coper/silver wiring
- Cotton wool spots
- Macular star
- Micro aneurysm
- Flame shaped hemorrhage
Types of arterial and venous occlusion (about retina)
artrial
- Central retinal artery occlusion
- Branch retinal artery occlusion
venous
- Central retinal vein occlusion
- Branch retinal vein occlusion
- Hemi retinal veins occlusion
Causes of occlusion
- Thrombus/embolus
- Atherosclerosis
- Vasculitis
special in veins
- compression by artery
Features of central retinal artery occlusion
- Sudden painless loss of vision
- Marcus gunn pupil (relative afferent pupillary defect)
- Colors:
- White retina.
- Red macula.
- pale optic disc (optic atrophy).
Why some patients have good central vision with CRAO
Due to presence of Cilioretinal artery
Complications of CRAO and CRVO
CRAO
- Optic atrophy 91%
- Retinal a. Attenuation
- Neovascularization
CRVO
- macular edema
- Neovascularization
- vitreous hemorrhage
- 100d glaucoma (neovascular glaucoma)
Sites of neovascularization in CRAO and CRVO
CRAO
NVD>NVE> NVI
CRVO
NVI>NVD>NVE
NV= Neovascularization
D = disc
E = elsewhere
I = iris (robiosis iridis)
Treatment of occlusion
- VD
- Fibrenolytic
- Yag Laser embolysis
- Low IOP
- In case of vetrus hemorrhage Vitrectomy and endolaser
- AntiVEGF and Dexamethason for neovascularization
- Treat the cause
Types of CRVO
- ischaemic
- Non-ishemic
What is the different between ischemic and non ischemic CRVO?
non ischemic
Common (80%) & better: VF, VA, mild RAPD, 50% improve
ischemic
Less (20%) & worse: VF, VA, marked RAPD, 60% neovascularization
