27 Retina

Structures

• retina: most important structures. Other structures support its function

• blue layer: choroid, vasculature

Pathology

Retinitis Pigmentosa

• AD, AR, or X-linked.,

• association with abetalipoproteinemia

• no real inflammation, just loss of photoreceptors.,

Retinitis

• floaters: dark spots in visual field

.,

Diabetic Retinopathy

• proliferative vs. nonproliferative

Nonproliferative

• most common type

• microaneurysm: small outpatchings of blood vessels on retina

• cotton wool spot: not unique to diabetes

• damage to macula from macular swelling, leads to accumulation of yellow exudates.,

• most common form

Proliferative

.,

• vitrectomy: removal of part of vitrous humor, done when bleeding from new blood vessels or debris accumulation

Retinal Detachment

• upper left: retina folded on itself like wrinkled paper.,

• vitreous humor surrounded by vitreous membrane

• pts complain of floaters, flashes of lights before retina detachment

Amaurosis Fugax

• transient monocular vision loss via emboli that lasts a few seconds.,

Retinal Vein Occlusion

• arteriosclerosis association with hypertension

• arterioles and veins run in AV sheath. Thickened arterioles compress veins

• streaky hemorrhages.,

Retinal Artery Occlusion

.,

• artery occlusion: ischemia

• Tay Sachs: sphingolipid accumulate around macula

• patient can have painless vision loss

Papilledema

Macula Degeneration

• commonly associated with aging

• macular important for central vision

Dry

• retina, retinal pigment epithelium, bruch's membrane, choroid:

• yellow dots.,

Wet

.,

• hemorrhage