Some Vascular disorders of retina

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Vascular Disorders Vascular Disorders Of RetinaOf Retina

Retinal Artery OcclusionRetinal Vein Occlusion

Retinopathy Of Prematurity

Prepared By: Zain SalehRoll No: 97

Retinal Vein OcclusionRetinal Vein Occlusion

Retinal Vein OcclusionRetinal Vein Occlusion• Definition:

o It is a common vascular disorder characterized by retinal vein occlusion resulting in edema and hemorrhages on retina in the affected region with potential blinding complications

• Types:o Central retinal vein occlusiono Branch Retinal vein occlusion

• Etiology and Risk Factors:o Age of age of above 50 yearso Systemic diseases like hyperlipidemia, Diabetes, Chronic

Renal Failureo Chronic Open Angle Glaucoma

Retinal Vein OcclusionRetinal Vein Occlusion• Clinical Presentation:

o Sudden painless loss of visiono Persistent decreased central vision

• Clinical Examination:o Visual Acuity- Severe visual loss, up to 20/200o Intra Ocular Pressure- Raisedo Fundus Examination- dilated, tortuous veins, retinal and

macular edema, flame shaped hemorrhages, and cotton wool spots

Retinal Vein OcclusionRetinal Vein Occlusion

( Central Retinal Vein Occlusion)

Retinal Vein OcclusionRetinal Vein Occlusion

(Branch Retinal Vein Occlusion)

Retinal Vein OcclusionRetinal Vein Occlusion• Investigations:

o Fluorescein Angiographyo ECGo Blood CPo ESRo Blood Glucose level

• Complications:o Chronic Macular Edemao Conversion from Non-Ischemic to Ischemic typeo Retinal Neovascularizationo Neovascular Glaucoma

Retinal Vein OcclusionRetinal Vein Occlusion• Treatment:

o Macular Laser Photocoagulationo Intra Vitreal injections anti-VEGF and steroidso Intra Vitreal triamcinolone injections

Retinal Artery Retinal Artery OcclusionOcclusion

Retinal Artery Retinal Artery OcclusionOcclusion

• Definition:o Vascular disorder of retina resulting in sudden painless

loss of vision, with antecedent transient visual loss

• Types:o Central Retinal Artery Occlusiono Branch Retinal Artery Occlusion

• Etiology:o Thrombosis due to atherosclerosiso Embolismo Raised Intra Ocular Pressureo Giant Cell Arteritiso Angiospasm- Retinal Migraine

Retinal Artery Retinal Artery OcclusionOcclusion

• Clinical Presentation:o Sudden painless severe loss of visiono Repeated transient episodes of decreased vision or

blindness

• Clinical Examination:o Visual Acuity-Severely reduced, between counting finger

and light perceptiono Direct Pupillary Light Reflex- Absento Fundus Examination- Whitish appearance of retina, thin

retinal arteries, segmented blood column in retinal vessels, cherry red spot at macula, pale appearance of optic disc

Retinal Artery Retinal Artery OcclusionOcclusion

(Central Retinal Artery Occlusion)

Retinal Artery Retinal Artery OcclusionOcclusion

(Branch Retinal Vein Occlusion)

Retinal Artery Retinal Artery OcclusionOcclusion

• Treatment:o Intraocular pressure lowered immediately by anterior

chamber paracentasis or I.V Acetazolamideo Inhaled oxygen and carbon dioxide mixture to improve

oxygen delivery to retinao Thrombolytic therapy

Retinopathy Of Retinopathy Of PrematurityPrematurity

Retinopathy Of Retinopathy Of PrematurityPrematurity

• Definition:o It is a bilateral vasoproliferative retinopathy occurring in

premature infants with low birth weight and exposed to high concentration of oxygen

• Etiology and Risk Factors:o Low birth weighto Exposure to high concentrations of oxygeno Premature birth

• Pathology:o Interference with normal vascularization process

Retinopathy Of Retinopathy Of PrematurityPrematurity

Stage 1- Changes at junction of vascular and avascular retina as demarcation line

Retinopathy Of Retinopathy Of PrematurityPrematurity

Stage 2- Formation of distinct ridge

Retinopathy Of Retinopathy Of PrematurityPrematurity

Stage 3- Extra retinal fibrovascular proliferation

Retinopathy Of Retinopathy Of PrematurityPrematurity

Stage 4- Severe retinal detachment

Retinopathy Of Retinopathy Of PrematurityPrematurity

Stage 5- Total retinal detachment seen as whitish mass (leukocoria) behind iris

Retinopathy Of Retinopathy Of PrematurityPrematurity

• Treatment:o Peripheral retinal laser in stage 2o Ablation of avascular retina in stage 3o Vitreotomy in stage 4 & 5