What is the photo?
Age-related macular degeneration
Degeneration of macula (central area of retina). Causes distortion (metamorphopsia) and eventual loss of central vision (scotomas)
Dry (nonexudative) - more than 80%. Deposition of yellowish extracellular material in and beneath Bruch membrane and retinal pigment epithelium ("drusen") with gradual loss in vision. Prevent progression with multivitamin and antioxidant supplements
Wet (exudative) - rapid loss of vision due to bleeding secondary to choroidal neovascularization. Treat with anti-VEGF injections like ranibizumab or laser
What is this?
Retinal damage due to chronic hyperglycemia. Two types.
1) Nonproliferative - damaged capillaries leak blood leading to lipids and fluid seeping into retina. This leads to hemorrhages and macular edema. Treatment is blood sugar control and macular laser
2) Proliferative - chronic hypoxia results in new blood vessel formation with resultant traction on retina. Treatment is peripheral retinal photocoagulation, anti-VEGF like bevacizumab
Identify the images
Retinal vein occlusions
Blockage of central or branch retinal vein due to compression from nearby arterial athero. Retinal hemorrhage and venous engorgement, edema in affected areas.
What is this?
Separation of neurosensory layer of retina (photoreceptor layer with rods and cones) from outermost pigmented epithelium (normally shields excess light, supports retina) leading to degeneration of photoreceptors and vision loss.
May be secondary to retinal breaks, diabetic traction, inflammatory effusions. Visualized on fundoscopy by the splaying and paucity of retinal vessels.
Breaks more common in patients with high myopia and are often preceeded by posterior vitreous detachment (flashes and floaters) and eventual monocular loss of vision like a curtain drawn down. Surgical emergency.
What is the pathology?
Central retinal artery occlusion
Acute, painless monocular vision loss. Retina cloudy with attenuated vessels and a cherry red spot at fovea
You know the drill
Inherited retinal degeneration. Painless, progressive vision loss beginning with night blindness (rods affected first). Bone spicule-shaped deposits around macula.
another eye pic
Retinal edema and necrosis leading to scar. Often viral (CMV, HSV, HZV). Associated with immunosuppression.