heyasat 2082017 Department of endocrine 2082017 Diabetic retinopathy Two phenomena PDR NON PDR VITROUS BLEEDING FIBROSIS 1 2 DME Secondary glaucoma Diabetic macular edema DIABETIC RETINOPATHY ID: 775400
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Slide1
RETINOVASCULAR DISEASE
Ammar
heyasat
20/8/2017
Slide2Department of endocrine20/8/2017
Slide3Diabetic retinopathy
Slide4Two phenomena
PDR , NON PDR , VITROUS BLEEDING , FIBROSIS
1-
2- DME
Slide5Slide6Slide7Slide8Secondary glaucoma
Slide9Diabetic macular edema
Slide10DIABETIC RETINOPATHY
FACTORS AFFECTING the retinopathy
1-duration
2-controlling
3-other illnesses
Slide11Central and branch retinal artery occlusion
Sudden , partial or complete vision loss
Explore the under lying cause
EMBOLI
Three types of emboli
1- platelet – fibrin
2- cholesterol emboli (
hollenhorst
plaque)
3-clacefic emboli( from heart origin)
Slide12fundoscopy
1-emboli
2-edema around it
3-pallor and optic disc atrophy
4-red-cherry spot
Slide13Slide14MANAGEMENT
1-ORBITAL MASSAGE
2-deceasing IOL
3- vasodilators
Slide15prognosis
Platelet – fibrin…..can be transient visual loss )
amaurosis
fugax
)
Cholesterol and calcified embolus …irreversible damage
Slide16Central and branch vein occlusion
Risks
1- hyper viscosity state
2-inflammation in venous wall
3-elevated IOP
Slide17presentation
Sudden partial or complete vision loss .. But less acute than retinal artery
Central and branch
Slide18Types of venous occlusion
1- non ischemic …Dilated and tortuous vein ,, Marked retinal hemorrhage and optic disc swelling .
2-ischemic ….. NV ….. Neovascular glaucoma .. Vitreous bleeding
Slide19Slide20Investigation
Investigation of a CRVO includes vascular and
haematological
work - up to exclude increased blood viscosity. CRVO is also associated with raised ocular pressure, diabetes and hypertension and smoking.
Treatment
Retinal laser treatment is given if the retina is
ischaemic
, to prevent the development of retinal and iris new vessels may improve vision by reducing macular
oedema
which may also be treated with
intravitreal
steroid therapy.
There is also increasing interest in the use of anti-VEGF agents.
Prognosis
The vision is usually severely affected in central, and often in branch, vein occlusion and usually does not improve. Younger patients may fare better, and there may well be some visual improvement.
Slide21Roth spots
Slide22Hypertensive retinopathy
4
steges