Retina

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Branch Retinal Vein Occlusion (BRVO)Thrombus (stationary

clot) occludes a branch of the central retinal vein

Blockage causes bleeding from that branch

Concerned about neovascularization afterward (due to ischemia)

Central Retinal Vein Occlusion (CRVO)Like a branch

retinal vein occlusion, but the whole central retinal vein is occluded

Bleeding all over retina

Branch Retinal Artery Occlusion (BRAO)Embolus

(traveling clot) occludes a branch of the central retinal artery

Central Retinal Artery Occlusion (CRAO)Like BRAO, but

the whole central retinal artery is occluded

Ischemia of entire retina

Macula is spared due to its dual blood supply (choroid)

Diabetic Retinopathy (DR)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

Hypertensive RetinopathyBilateral,

asymmetricNarrowing of

arteriolesA/V nicking (vein

presses on artery)IschemiaSwelling of optic

nerve headMacular star

(exudates)

Retinal Artery MacroaneurysmFocal dilation of

retinal arteryCauses

hemorrhage when aneurysm ruptures

HIV RetinopathyIschemia (cotton

wool spots)Retinal

hemorrhagesAsymptomaticNot infectious

Interferon RetinopathyLooks like HIV retinopathyCaused by use of interferon (usually

for hepatitis)

Talc RetinopathyBilateralIV drug useDeposits near

maculaMay occlude

capillaries and cause ischemia

Retinopathy of Prematurity (ROP) / Retrolental FibroplasiaBabies born <36

weeksNasal vessels

form first, young ROP patients don’t have temporal vessels formed

Neovascularization can occur due to ischemia

Retinoblastoma#1 intraocular

malignancy in children

Tumor of developing retinal cells

Leukocoria

Congenital Hypertrophy of the RPE (CHRPE)BenignNon-progressive

Choroidal NevusPresent at birthNon-progressive

(usually)May progress to

melanomaUse red-free

filter (green light) to distinguish from CHRPE

Dry ARMD

Age-Related Macular Degeneration (ARMD)

Wet ARMD

Acquired MaculopathiesCentral serous

choroidopathy (CSR)

HistoplasmosisPathological

myopia

Epiretinal membrane (ERM) / Macular pucker

Macular holeAlbinism

Central Serous Choroidopathy (CSR)Plasma

underneath the macula

Young men, high stress

May significantly reduce VA

Usually improve without treatment

Histoplasmosis“Histo belt” (Ohio-

Mississippi River Valley)

Fungus infectionAtrophy of optic

nerveLesions in

peripheral retinaMaculopathy with

possible neovascularization

Clear vitreous

Pathological MyopiaRx >6D ORAxial length >26mmProblems come

from the eye stretching to large size

#1: Posterior staphyloma = posterior retinal thinning/bulging

Epiretinal Membrane (ERM) / Macular PuckerPosterior vitreous

detachment (vitreous detaches from retina) pulls on retina, detaches, and leaves glial cells behind

Shiny membrane (cellophane)

Macular HoleHole caused by

vitreous pulling on retina

Round red spotSignificantly

reduces VA if full-thickness hole

AlbinismMelanin not

produced properlyOculocutaneous

(skin + eyes)Cutaneous (skin

only)VA reduced by foveal

hypoplasia (lack of development of fovea)

Photophobia

Hereditary Fundus DystrophiesRetinitis

Pigmentosa (RP)Stargardt’s

diseaseChoroideremiaCone Dystrophy

Best’s Disease (vitelliform dystrophy)

Gyrate atrophyLattice

Degeneration

Retinitis Pigmentosa (RP)#1 retinal dystrophyLoss of function of

photoreceptors & RPENigh blindness,

peripheral vision lossTriad of signs:

Bone-spicule pigmentation

Arteriolar attenuation

Waxy pallor of optic disc

Stargardt’s Disease#1 hereditary

macular dystrophyAutosomal

recessive“Beaten bronze”

macula in late stages

Reduction of VA & color vision

ChoroideremiaX-linked

recessiveAtrophy of the

RPE & choriocapillaris

See through to sclera

Night blindness, peripheral vision loss

Cone DystrophyYoung patientsUsually autosomal

dominantLoss of cone

photoreceptorsDecreased VA,

photophobia, color vision loss

Geographic atrophy of RPE, vessel attenuation, optic nerve pallor

Best’s Disease (Vitelliform Dystrophy)Autosomal

dominantMaterial

accumulates in RPE (“egg yolk”)

No symptoms early on, later reduced VA

Bilateral

Rhegmatogenous Retinal Detachments (RDs)Retinal

detachment caused by a hole or tear

Vitreous fluid gets into subretinal space and retina detaches

Exudative RDsDamage to RPE

causes fluid accumulation below the retina detachment

Ex: ARMD

RD caused by traction

Ex: proliferative retinopathy (neovascularization)

Non-Rhegmatogenous RDs

Tractional RDs

Lattice DegenerationPeripheral retinal

thinningSometimes

pigmentedFirmly adhere to

vitreous can cause retinal detachment if vitreous starts to pull away

Bilateral

Age-related Degenerative Retinoschisis

Toxocariasis

Choroidal/Retinal Degenerations

Age-Related Degenerative RetinoschisisSplitting of retina

between the outer plexiform layer & inner nuclear layer

Looks like a retinal detachment, but doesn’t move

No symptomsVisual field defect

ToxocariasisIntestinal

nematodeUnilateral

inflammationChorioretinal

scars