The eye in systemic disease Flashcards
What is the pathogenesis of diabetic retinopathy?
Chronic hyperglycemia
Glycosylation of protein/ /basement membrane
Loss or pericytes
Formation of microaneurysm - leads to leakage and ischaemia
What is a pericyte?
Contractile cells that wrap around the endothelial cells that line the capillaries and venules throughout the body
What are signs of non proliferative retinopathy?
Microaneurysms Dot and blot haemorrhages Hard exudate Cotton wool patches Abnormalities of venous calibre Intra-retinal microvascular abnormalities
What are the different types of neovascularization in diabetic retinopathy?
Growth on disc (NVD)
Growth in periphery (NVE)
Growth on iris if ischaemia severe
What is rubeosis iridis?
Neovascularization of the iris
Can cause secondary glaucoma
Why will diabetic patients lose vision?
Retinal oedema
Vitreous haemorrhage
Retinal scarring
Retinal detachement
What is the classification of maculopathy?
No maculopathy
Observable maculopathy
Referable maculopathy
Clinically significant maculopathy
How is diabetic retinopathy managed?
Optimise medical management
Laser: PRP, macular grid
Vitrectomy
Rehab
What are common features of hypertensive retinopathy?
Attenuated blood vessels - copper or silver wiring Cotton wool spots Hard exudates Retinal haemorrhage Optic disc oedema
What are the causes of anterior uveitis?
Infective: TB, herpes zoster, toxoplasmosis, candidiasis, syphillis, lyme disease
Non-infective: idiopathic syndromes, ankylosing spondylitis
Juvelline arthritis
Psoriatic arthritis
Enteropathic arthritis
Sarcoidosis
Behcet’s disease
What are extraocular symptoms of thyroid eye disease?
Proptosis
Lid lag
Restrictive myopathy
What are ocular symptoms of thyroid eye disease?
Chemosis Injection Exposure Glaucoma Choroidal folds Optic nerve swelling
What ocular features can RA have?
Keratoconjunctivitis sicca
Scleritis
Corneal melt
What ocular symptoms will sjogren’s syndrome have?
Keratoconjunctivitis sicca
Xerostomia
RA
Infiltration of lacrimal and parotid glands
What ocular features does marfans syndrome have?
Spontaneous lens dislocation