fundus in clinical medicine
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Takayasu arteritisMikito takayasu – Japanese ophthalmologistHe reported the asssociation of retinal
arteriovenous anastamoses with absent upper extremity pulses
Chronic inflammatory disease of aorta and branches
Called as pulseless disease.
Fundoscopic features1.Retinal hemorrhaghes2.Cotton wool exudates3.Venous dilatation and beading
Takayasu arteritis
Cloudy retinal swellingBreak up of blood column in
arteryFundus findings
1.Microaneurysms2.Neovascular glaucoma3.Ischemic optic neuropathy4.Classic “wreath like” peripapillary arteriovenous anastamoses……….
Behcets syndrome
Chronic , relapsing vasculitisNamed after Turkish dermatologistCharacterised by1.Recurrent aphthous ulcer2.Genital ulceration3.Arthalgia4.Recurrent uveitis and retinal vasculitis5.Skin lesions6.Positive pathergy test
Behcets disease
The picture shows 1.Soft exudates2.Intraretinal hemorrhaghes1.Retinal infiltrates
2.Periphlebitis3.Occlusive disease4.Retinal vasculitis5.Optic disc vasculitis6.Chorioretinal scar
SarcoidosisMultisystem granulomatous diseaseMost affected organs lungs skin eyeFrequency of ocular involvement 30 – 50 %
Pan uveitis is commonNodules are seen in conjuctiva, uvea and choroid
sarcoidosis1.Snow ball vitreous opacities in sarcoid uveitis2.Periphlebitis3.Choroidal infiltrates4.Choroidal granuloma5.Retinal vasculitis , new vessels in optic disc6.Punched out chorioretinal lesions
sarcoidosis1.Candle wax drippings2.Retinal sarcoid granuloma3.Granuloma in optic disc
Giant cell arteritisAlso called as temporal arteritisInflammatory disease of large vsselsMean age of presentation 70 yrsRapidly progressing vision loss
GCAOphthalmic , posterior choroidal arteries are commonly involved
Anterior Ischemic Optic neuropathyCommones t cause of vision loss
Choroidal infarcts can occur
Vogt koyanagi harada syndromeUveo dermatological syndromeSystemic disease involving melanocyte containing
organsCharacterised by1.Bilateral uveitis2.Cutaneous3.Neurological4.Auditory abnormalities
VKH syndrome1.Sunset glow fundus2.Multiple retinal detachment3.Dalen Fuchs nodules in choroid4.Subretinal fibrosis
Neurodegenrerative disease with specific fundus findings
1.Freidrichs ataxia2.Spinocerebellar ataxia3.Inherited mitochondrial diseasesMetabolic diseases1.Niemann Picks disease2.Tay Sachs
Friedrichs ataxiaInherited diseaseProgressive neurological illness involving cortico spinal tract, posterior columnRetinitis pigmentosaDeafnessdilated cardiomyopathyPes cavusAutosomal recessive
Mitochondrial disease1.Kearns Sayre disease2.MELAS3.Mitochondrial myopathiesLebers hereditary optic neuropathyNeuropathy, ataxia retinitis PigmentosaLeighs syndrome
Cherry red spot in fundus1.Tay sachs disease2.Niemann Picks 3.CRVO4.CRAO5.Sandhoffs disease6.Sialidosis7.Gauchers
Optic neuritisMost common etiology
Multiple sclerosis
Loss of colour vision is the earliest manifestation
Papilledema
1.Meningitis, Encephalitis2.Venous sinus thromb osis3.Tumours4.Idiopathic Intracranial hypertension
Others……..
Purtshners retinopathySickle cell retinopathyRoth spotsLeopard spot fundus
Purtschners retinopathy
Caused in1.Acute pancreatitis2.Lymphoma3.Thrombotic thrombocytopenic purpura
Due to, Microvascular damage with occlusion And Ischemia of retinal vessels
Multiple white retinal patches
Roth spots
1.Infective endocarditis2.Severe anaemia3.Leukemia
Leopard spot fundus
leukemia
Sickle cell retinopathy
Tractional retinal detachment
Phacomatoses1.Von hippel lindau syndrome2.Tuberous sclerosis3.Neurofibroma
Tuberous sclerosisAdenoma sebaceumEpilepsyGiant cell astrocytoma
Fundus
Retinal hamartoma are common
Von Hippel LindauRetinal hemangioblastoma can occur
Chromosome 3