Unit 5 - Miscellaneous retinopathies

Question 1

What is the incidence of hypertensive retinopathy according to Beaver Dam study?

Answer 1

15%

Question 2

What are the 5 grades of hypertensive retinopathy?

Answer 2

0) normal
1) barely detectable arteriolar narrowing
2) widespread focal arteriolar narrowing, A/V crossing changes
3) grade 2 + retinal harems and exudates
4) disc swelling

Question 3

What are the signs of chronic hypertensive retinopathy?

Answer 3

Narrow/irregularity of retinal arteries
A/v nipping
Blot harms
Microaneurysms
CWS

Question 4

What are the signs of malignant hypertensive retinopathy?

Answer 4

Retinal arteriolar spars
Flame shaped haems
CWS
Serous retinal detachment
Macula star
Optic disc oedema

Question 5

What is the differential diagnosis in hypertensive retinopathy?

Answer 5

DR
RVO
Hyperviscosity syndrome
Congenital hereditary retinal arterial tortuosity
OIS
Radiation retinopathy

Question 6

What associated eye conditions are there with chronic hypertensive retinopathy?

Answer 6

1. RVO
2. Neovascularisation
3. Arterial emboli

Question 7

What associated features are there with malignant hypertensive retinopathy?

Answer 7

1. Choroidal ischaemia
2. RPE changes
3. Retinal arterial emboli
4. Optic neuropathy
5. Cortical blindness

Question 8

Radiation retinopathy: what time frame after radiation exposure?

Answer 8

6 months to 3 years

Question 9

What sort of radiation causes radiation retinopathy?

Answer 9

Head/neck tumours
Total body radiation

Question 10

What are the signs of radiation retinopathy?

Answer 10

Haems
Arteriolar narrowing
Perivascular sheathing
Intraretinal and circinate exudation

Question 11

Why do you get reduced vision with radiation retinopathy?

Answer 11

CMO

Question 12

What is the scientific cause of valsalva retinopathy?

Answer 12

Sudden rise in intrathoracic/intraabdominal pressure

Question 13

What are the signs of valsalva retinopathy?

Answer 13

Dumbbell shaped red elevation beneath ILM in or near central macula
Pre-retinal or intra or subretinal bleed

Question 14

What vision would you get in Valsalva retinopathy?

Answer 14

Good v/a

Question 15

What are the stages of proliferative sickle cell disease?

Answer 15

1. Peripheral arteriolar occlusions.
2. Arteriolar-venular anastomoses.
3. Neovascular proliferation.
4. Vitreous haemorrhage.
5. Retinal detachment.

Question 16

What features are there of non-proliferative sickle cell retinopathy?

Answer 16

1. Black sunbursts
2. Salmon patch haem
3. Iridescent spots
4. arteriosclerosis
5. vascular tortuosity
6. occasional CWS
7. microaneurysm,
8. peripheral retinal non-perfusion

Question 17

What causes the black sunbursts in sickle cell retinopathy?

Answer 17

Reactive RPE hyperplasia in response to haem

Question 18

What treatment is there for sickle cell retinopathy?

Answer 18

1. Observation: if patient is middle aged. Many neovasc membranes spontaneously fibrose
2. Laser or cryotherapy ablation: of peripheral non-perfused retain.
3. VR surgery

Question 19

What is the cause of sickle cell disease?

Answer 19

mutations of HbB gene

Question 20

Which mutation gives worse sickle cell systemic disease?

Answer 20

HbSS (2 copies of HbSS gene)

Question 21

Which mutation gives worse ocular features?

Answer 21

HbSC (most common form of disease)
HbSickle Thalassemia