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Retinal Detachment Hypertensive Retinopathy Retinitis Pigmentosa

Retinal Detachment Hypertensive Retinopathy Retinitis Pigmentosa. Dr. SGP. Retinal Detachment. Separation of neurosensory retina from the RPE Types Rhegmatogenous Tractional Exudative. Rhegmatogenous. Retinal break/hole/tear SRF seepage. Predisposing factors 40-60 yrs M:F 3:2 Myopia

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Retinal Detachment Hypertensive Retinopathy Retinitis Pigmentosa

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  1. Retinal Detachment Hypertensive RetinopathyRetinitis Pigmentosa Dr. SGP

  2. Retinal Detachment • Separation of neurosensory retina from the RPE Types • Rhegmatogenous • Tractional • Exudative

  3. Rhegmatogenous • Retinal break/hole/tear • SRF seepage

  4. Predisposing factors • 40-60 yrs • M:F 3:2 • Myopia • Aphakia • Retinal degenerations • Trauma • PVD

  5. Prodormal symptoms • Floaters • Photopsia Detached retina • Sudden painless DOV

  6. Signs • IOP may be low • Marcus Gunn pupil/ RAPD • Altered red reflex • Fundus • Visual fields • B scan

  7. Freshly detached • Grey reflex, raised anteriorly • Folds…oscillate • Large bullous • Total RD: funnel shaped • Retinal breaks: round/horse shoe/slit

  8. Old detachments • Retinal thining • Subretinal demarcation line • Secondary intraretinal cysts

  9. Complications • PVR • Complicated cataract • Uveitis • Phthisis bulbi

  10. Treatment • Sealing of retinal breaks with photocoagulation, cryo, diathermy • SRF drainage • Maintain chorioretinal apposition • Scleral buckle • Silicone oil • Pnematic retinopexy SF6 ,C3F8

  11. TRD • Retina pulled away • Contraction of fibrous tissue in the vitreous Causes • Post traumatic • PDR • ROP • Sickle cell retinopathy

  12. Clinical features • Vitreoretinal bands • Concave • Breaks may be absent • Retinal mobility severely reduced

  13. Treatment • PPV • SRF drainage • Flatten the retina with silicone oil or PFCL • Endolaser • Internal tamponade

  14. Exudative RD • Retina pushed away by fluid/growth Causes Ocular: • Inflammations • Vascular • Neoplasms • Sudden hypotony Systemic: • Toxaemia of pregnancy • Blood dyscrasias • Renal HTN

  15. Clinical features • Absence of photopsia • No holes, tears • No undulations • Smooth and convex • Shifting fluid

  16. Retinitis Pigmentosa • Degenerative disease • Affects primarily the rods • Affects BE • Starts in childhood, blind by middle age • Commences near the equator of the eye • Macula affected in late stage

  17. Inheritance: • Recessive: common • Dominant: mildest • X linked: rare, severe

  18. Clinical features: • Nyctalopia • Fields: ring scotoma, tubular vision • Central vision lost by 50-60 years

  19. Fundus: • Bony corpuscles • Arterial attenuation • Optic atrophy: waxy pallor • Late stages: posterior cortical cataract • Subnormal ERG and EOG

  20. Associated ocular anomalies • Glaucoma • Keratoconus Associated syndromes • Laurence-Moon-Biedl syndrome • Usher syndrome

  21. Hypertensive Retinopathy • Simple hypertension without sclerosis • Hypertension with involutionary sclerosis • Diffuse hyperplastic sclerosis • Malignant hypertension

  22. Keith Wagner Barker Classification • Grade 1 – Mild to moderate narrowing or sclerosis of smaller arterioles • Grade 2 – Moderate to marked narrowing of retinal arterioles, exaggeration of light reflex, changes at A-V crossings • Grade 3 – Grade 2 + retinal oedema,cotton wool spots, flame-shaped hemorrhages • Grade 4 – Grade3 + papilloedema

  23. you’re welcome

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