Unit 5 - Miscellaneous retinopathies Flashcards
What is the incidence of hypertensive retinopathy according to Beaver Dam study?
15%
What are the 5 grades of hypertensive retinopathy?
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
What are the signs of chronic hypertensive retinopathy?
Narrow/irregularity of retinal arteries
A/v nipping
Blot harms
Microaneurysms
CWS
What are the signs of malignant hypertensive retinopathy?
Retinal arteriolar spars
Flame shaped haems
CWS
Serous retinal detachment
Macula star
Optic disc oedema
What is the differential diagnosis in hypertensive retinopathy?
DR
RVO
Hyperviscosity syndrome
Congenital hereditary retinal arterial tortuosity
OIS
Radiation retinopathy
What associated eye conditions are there with chronic hypertensive retinopathy?
- RVO
- Neovascularisation
- Arterial emboli
What associated features are there with malignant hypertensive retinopathy?
- Choroidal ischaemia
- RPE changes
- Retinal arterial emboli
- Optic neuropathy
- Cortical blindness
Radiation retinopathy: what time frame after radiation exposure?
6 months to 3 years
What sort of radiation causes radiation retinopathy?
Head/neck tumours
Total body radiation
What are the signs of radiation retinopathy?
Haems
Arteriolar narrowing
Perivascular sheathing
Intraretinal and circinate exudation
Why do you get reduced vision with radiation retinopathy?
CMO
What is the scientific cause of valsalva retinopathy?
Sudden rise in intrathoracic/intraabdominal pressure
What are the signs of valsalva retinopathy?
Dumbbell shaped red elevation beneath ILM in or near central macula
Pre-retinal or intra or subretinal bleed
What vision would you get in Valsalva retinopathy?
Good v/a
What are the stages of proliferative sickle cell disease?
- Peripheral arteriolar occlusions.
- Arteriolar-venular anastomoses.
- Neovascular proliferation.
- Vitreous haemorrhage.
- Retinal detachment.
What features are there of non-proliferative sickle cell retinopathy?
- Black sunbursts
- Salmon patch haem
- Iridescent spots
- arteriosclerosis
- vascular tortuosity
- occasional CWS
- microaneurysm,
- peripheral retinal non-perfusion
What causes the black sunbursts in sickle cell retinopathy?
Reactive RPE hyperplasia in response to haem
What treatment is there for sickle cell retinopathy?
- Observation: if patient is middle aged. Many neovasc membranes spontaneously fibrose
- Laser or cryotherapy ablation: of peripheral non-perfused retain.
- VR surgery
What is the cause of sickle cell disease?
mutations of HbB gene
Which mutation gives worse sickle cell systemic disease?
HbSS (2 copies of HbSS gene)
Which mutation gives worse ocular features?
HbSC (most common form of disease)
HbSickle Thalassemia
