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Published byPhilip Henry Modified over 9 years ago
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Thrombus (stationary clot) occludes a branch of the central retinal vein Blockage causes bleeding from that branch Concerned about neovascularization afterward (due to ischemia)
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Like a branch retinal vein occlusion, but the whole central retinal vein is occluded Bleeding all over retina
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Embolus (traveling clot) occludes a branch of the central retinal artery
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Like BRAO, but the whole central retinal artery is occluded Ischemia of entire retina Macula is spared due to its dual blood supply (choroid)
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Biggest risk factor = number of years with diabetes Caused by damage to retinal capillaries Non-proliferative DR = ischemia, hemorrhages, but no neovascularization Proliferative DR = neovascularization
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Bilateral, asymmetric Narrowing of arterioles A/V nicking (vein presses on artery) Ischemia Swelling of optic nerve head Macular star (exudates)
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Focal dilation of retinal artery Causes hemorrhage when aneurysm ruptures
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Ischemia (cotton wool spots) Retinal hemorrhages Asymptomatic Not infectious
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Looks like HIV retinopathy Caused by use of interferon (usually for hepatitis)
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Bilateral IV drug use Deposits near macula May occlude capillaries and cause ischemia
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Babies born <36 weeks Nasal vessels form first, young ROP patients don’t have temporal vessels formed Neovascularization can occur due to ischemia
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#1 intraocular malignancy in children Tumor of developing retinal cells Leukocoria
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Benign Non-progressive
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Present at birth Non-progressive (usually) May progress to melanoma Use red-free filter (green light) to distinguish from CHRPE
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Dry ARMDWet ARMD
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Central serous choroidopathy (CSR) Histoplasmosis Pathological myopia Epiretinal membrane (ERM) / Macular pucker Macular hole Albinism
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Plasma underneath the macula Young men, high stress May significantly reduce VA Usually improve without treatment
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“Histo belt” (Ohio- Mississippi River Valley) Fungus infection Atrophy of optic nerve Lesions in peripheral retina Maculopathy with possible neovascularization Clear vitreous
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Rx >6D OR Axial length >26mm Problems come from the eye stretching to large size #1: Posterior staphyloma = posterior retinal thinning/bulging
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Posterior vitreous detachment (vitreous detaches from retina) pulls on retina, detaches, and leaves glial cells behind Shiny membrane (cellophane)
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Hole caused by vitreous pulling on retina Round red spot Significantly reduces VA if full- thickness hole
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Melanin not produced properly Oculocutaneous (skin + eyes) Cutaneous (skin only) VA reduced by foveal hypoplasia (lack of development of fovea) Photophobia
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Retinitis Pigmentosa (RP) Stargardt’s disease Choroideremia Cone Dystrophy Best’s Disease (vitelliform dystrophy) Gyrate atrophy Lattice Degeneration
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#1 retinal dystrophy Loss of function of photoreceptors & RPE Nigh blindness, peripheral vision loss Triad of signs: Bone-spicule pigmentation Arteriolar attenuation Waxy pallor of optic disc
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#1 hereditary macular dystrophy Autosomal recessive “Beaten bronze” macula in late stages Reduction of VA & color vision
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X-linked recessive Atrophy of the RPE & choriocapillaris See through to sclera Night blindness, peripheral vision loss
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Young patients Usually autosomal dominant Loss of cone photoreceptors Decreased VA, photophobia, color vision loss Geographic atrophy of RPE, vessel attenuation, optic nerve pallor
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Autosomal dominant Material accumulates in RPE (“egg yolk”) No symptoms early on, later reduced VA Bilateral
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Retinal detachment caused by a hole or tear Vitreous fluid gets into subretinal space and retina detaches
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Exudative RDs Damage to RPE causes fluid accumulation below the retina detachment Ex: ARMD RD caused by traction Ex: proliferative retinopathy (neovascularization) Tractional RDs
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Peripheral retinal thinning Sometimes pigmented Firmly adhere to vitreous can cause retinal detachment if vitreous starts to pull away Bilateral
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Age-related Degenerative Retinoschisis Toxocariasis
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Splitting of retina between the outer plexiform layer & inner nuclear layer Looks like a retinal detachment, but doesn’t move No symptoms Visual field defect
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Intestinal nematode Unilateral inflammation Chorioretinal scars
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