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photoreceptor
RPE
Bruchs membrane
Neuroconduction of retina
Conduct to brain
Supporting tissue:
Mller cell
Vasculature of retina
Metamorphopsia
Vitreous
Flickering traction to
the retina
Macropsia
Retina edema
fewer cones
Micropsia stimulated
micropsia
Signs
Retinal artery occlusion:
Intracellular edema ischemia leads to edema
of bipolar cell,ganglion and RNFL
Hard exudate
Leakage of capillary absorb
deposition of lipid in outer plexiform layer
Cotton-wool spot
neovessels,NV
neovessels membrane,NVM
Arise from small veins of optic disc and retina; grow along
retinal surface and into the vitreous
Neovacularizaton of optic disc
Retinal neovascularization
Blood vessel change
1,Atherosclerosis, stenosis,occlusion
2,Tortuous vein, dilated vein ,bead-like change
A-v cross sign
Microaneurysm
Microaneurysm
Changes of RPE
atrophy
Pigment loss atrophy
Pigment disorder
alteration
alteration
Osteocyte-like pigment deposition
Death
Death or
or proliferation
proliferation
Choroidal neovascularization
Vascular diseases
Macular diseases
Retinal detachment
Retinal degeneration
Retinal tumor
Ocular manifestation of general
diseases
Retinal vascular disease
Diabetic retinopathy
Vasculitis
Coats disease
Central retinal artery
occlusion CRAO
Etiology
Common causes
atherosclerotic thrombosis of cribiform plate
systemic diseases,hemicrania, trauma, blood
coagulation disorder, inflammation, infectious
disease or connective tissue disease
Occasionally seen in
retrobulbar injection retinal detachment or
orbital operation
Clinical manifestation
Sudden painless vision
Symptoms lose of one eye
More common
Extensive retinal
hemorrhage and
tortuous
vein Multiple
cotton-wool spots
Severe VA decrease
Widespread capillary
nonperfusion 60%
cases present iridal
neovascularization.
CRVO CRVO
Nonischemic ischemic
Branch retinal vein
occlusion
BRVO BRVO
FFA
Treatment
Chinese medicine
Anitplatelet or antithrombotic drugs: unknown
therapeutic effects
Systemic examination to find out causes
Corticosteroid if vasculitis exist
anastomosis
Vasculitis
Visual
disturbance strabismus leucoria
Fundus
extensive yellow-white lipid exudation
with faring cholesterol crystal capillary
and vein dilate microaneurysm
capillary nonfusion Secondary
glaucoma, exudative RD, uvitis,
complicated cataract
Rare neovascularization
Differential diagnosis
RB
ROP
FEVR
Treatment
Photocoagulation or
cryocoagulation of capillary dilation
Macular diseases
Anxiety,allergy,infection,
insufficient reflux of choroid
vein,thermal regulation
dysfunction
Clinical manifestation
Metamorphopsia
blurred vision,
micropsia
OCT
serous
detachment of the
sensory retina in
the macular area
Subretinal yellow
deposit in the
macular area
FFA shows dye leakage under RPE
Treatment
80% -90%undergo spontaneous
recovery
Corticosteroid is forbidden
Mechanism:
Decreased phagocytosis of RPE leading to dusen.
Drusen can cause damage of Bruchs membrane CNV and fibrocyte
proliferation
Destruction of choroidal capillary Bruchs membrane RPE and
photoreceptor
Clinical presentation
Visual acuity: decreased VA, metamorphopsia,
micropsia
Fundus:
Dry:
drusen, RPE change
Wet:
gray-yellow CNV under retina of posterior pole
associated with dark red subretinal hemorrhage which
covers CNV sometimes
retinal degeneration
Basis liquified vitreous
retinal holeRD
aging
Incentives high myopia
ocular trauma
Clinical manifestation:
Genetic counselling
Avoiding sunlight and UV
Vasodilator, Vitamins
Suppliment of taurine
Low vision aids
Grid laser coagulation is used with caution
for CME
Retinal tumor
Retinoblastoma
intraocular stage
glaucomatous stage
extraocular stage
metastasis stage
Differential diagnosis
RB Coats disease
Onset age 90%<3 >6-8 yrs
yrs
Eyes involved 30%both 95%single
Microcirculati none Diffuse
on microanuerysm
abnormality
Cholesterol none Subretinal
cystal ,obvious
Calcification + -
B-us Solid Without solid
tumor tumor
RB Coats disease
Treatment
Small tumor localized in central retina
can be effectively treated with
photocoagulation
Small tumor localized in periferal retina
can be treated with cryotherapy
Moderate localized tumor:Plaque
radiation therapy
Big tumor: Enucleation
Extraocular stage: enucleation+
chemotherapy + radiation (bad
prognosis)
Metastasis : no specific treatment
Right afterLaser
photocoagulation
6 moths after
photocoagulation
RB