Retinal vascular diseases

Dr Nitish

CRAO

• ETILOGY• EMBOLI FROM CAROTID ARTERY• VALVULAR HEART DISEASES• THROMBUS FROM ARTERIO SCLEROSIS• HYPERTENSION• ARTERITIS.

SYMPTOMS

• PAINLESS SUDDEN UNILATERAL LOSS OF VISION.

• AMAUROSIS FUGAX

SIGNS

• LARGER ARTERIES THREAD LIKE AND ARTERIOLES ARE INVISIBLE.

• VEINS NORMAL .• FEW HOURS THE RETINAL LOSES ITS

TRANSPARENCY AND BECOME MILKY WHITE.• CHERRY RED SPOT

CHERRY RED SPOT

• CRAO• BERLIN’S EDEMA• TAY SACH’S S DISEASE• NIEMANN PICK DISEASE• SANDHOFF’S DISEASE• QUININE AMBLOPIA.

SIGN’S CONT’D

• CATTLE TRUCK APPEARANCE.• AFTER A WK OR SO THE RETINA RESUMES

NORMAL APPEARNECE AND ON BECOMES ATROPHIC AND APPEARS WHITE.

• NO PL

BRAO

• AT BIFURCATION.• ATHEROMATOUS EMBOLI SEEN INSIDE THE

ARTERY- HOLLENHORST PLAQUE.

TREATMENT

• DIGITAL MASSAGE.• IV ACETAZOLAMIDE.• 5% CO2 AND 95% O2 MIXTURE OF 10 MIN.• PARACENTSIS.• RETROBULBAR INJECTION OF ACETYLCHOLINE.• ANTI COAGULANTS.

PROGNOSIS

• > 6HRS NO RETURN OF MACULAR VISION.

CRVO

• CENTRAL/ BRANCH RETINAL VEIN.• AGE: 6th/7th decade.• Systemic hypertension: compressed by a

thickened artery where the 2 share common adventitia.

• Raised IOP• Diabetes • Hyperviscosity syndrome.

Pathogenesis

External compression on the vein

Venous stasis

Degenerative disease of the venous endothelium.

Types

• Non ischaemic• Ischaemic

Non ischaemic

• VA • RAPD

FUNDUS

• MILD TORTUOSITY AND DILTATION .• H’AGES-DOT n BLOT , FLAME SHAPED H’ GES.• COTTON WOOL EXUDATES ABSENT• MILD TO MODERATE DISC EDEMA.• MACULAR EDEMA

ISCHAEMIC CRVO

• VA DECREASED.• SUPERFICIAL AND DEEP HAEMORRHAGES.• CW.• OPTIC DISC EDEMA• BLOOD AND THUNDER FUNDUS

COMPLICATIONS

• RUBEOSIS IRIDIS• NEOVASCULAR GLAUCOMA.• VH.• NVD.• NVE.

TREATMENT

• PRP