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Retinal Detachment Hypertensive Retinopathy Retinitis Pigmentosa

Learn about retinal detachment, hypertensive retinopathy, retinitis pigmentosa, their causes, clinical features, and treatment options including photocoagulation, cryo, scleral buckling, and more. Understand the complications and associated syndromes. Keith-Wagner Barker Classification explained.

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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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