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Retinal Imaging Conference

Retinal Imaging Conference. Ahmet Ozkok MD University of Louisville School of Medicine Department of Ophthalmology & Visual Sciences 6/5/14. Subjective. CC: Decreased vision OD HPI: 71 y ear-old fe male referred to Retina clinic for decreased vision in the

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Retinal Imaging Conference

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  1. Retinal Imaging Conference Ahmet Ozkok MD University of Louisville School of Medicine Department of Ophthalmology & Visual Sciences 6/5/14

  2. Subjective • CC: Decreasedvision OD • HPI: 71 year-old female referred to Retina clinic for decreasedvision in the righteye. She complains of difficulty drivingandfloaters of lastfew years durationandgettingworsegradually. • POH: CE+IOL OU 2004 • PMHx: NIDDM (10 years), artritis, hypothroidism, GERD • Meds: Omeprozole, hydrocodone, metformin, levothyroxine, meloxicam • Allergies: Codeine

  3. Exam OD OS BCVA 20/80 20/30 -2.00 , +1.00 X 180 -0.50 Pupils: 3 → 2 3 → 2 no APD IOP: 11 mm Hg 12 mm Hg EOM: Full OU CVF: Full OU Ant Segment: PCIOL OU

  4. Slit lamp photo OS OD

  5. Exam DFE: OD: ON: C/D= 0.2 Blurry view 2/2 AH Vessels: atherosclerotic changes A/V 1/2 Macula: Blurry OS: ON: C/D=0.1 Macula: blurry view Veins: Atheroscloric changes A/V 1/2

  6. OD

  7. ASSESSMENT • 71 year old female with epiretinal membrane and asteroid hyalosis • Plan: PPV+ERMp OD

  8. ASSESSMENT POW# 3 BCVA 20/60+

  9. Take Home Message Fa and oct

  10. Asteroid Hyalosis • Characterized by diffuse spherical white opacities stuck to vitreous • Unilateral (75-90% ) • Etiology ? • Calcium-associated phospholipids • Presence is obvious upon ocular exam but patients are usually asymtomatic • May interfere with retina exam (FA, OCT, AF) • Rarely cause visual disturbance and needs Sx

  11. Asteroid HyalosisRisk Factors • Age AJO 2001;132:70-75

  12. Asteroid HyalosisRisk Factors (under debate) • Gender (m>f) • DM • Hypercholesterolemia • HT • Hypercalcemia • Hyperphosphatemia • Hyperopia • Gout • Alcoholconsumption • RP

  13. Cataract SurgeonBe Careful! • IOL calculation • Falsely short axial lenght measurement with automated biometry • Association between asteroid hyalosis and late postoperative dystrophic calcification of silicone lenses.

  14. References • Ikeda Y, Hisatomi T, Murakami Y, Miyazaki M, Kohno R, Takahashi H, Hata Y, Ishibashi T: Retinitis pigmentosa associated with asteroid hyalosis. Retina 2010, 30(8):1278-1281. • 2. Kador PF, Wyman M: Asteroid hyalosis: pathogenesis and prospects for prevention. Eye 2008, 22(10):1278-1285. • 3. Fawzi AA, Vo B, Kriwanek R, Ramkumar HL, Cha C, Carts A, Heckenlively JR, Foos RY, Glasgow BJ: Asteroid hyalosis in an autopsy population: The University of California at Los Angeles (UCLA) experience. Archives of ophthalmology 2005, 123(4):486-490. • 4. Browning DJ, Fraser CM: Optical coherence tomography to detect macular edema in the presence of asteroid hyalosis. American journal of ophthalmology 2004, 137(5):959-961. • 5. Foot L, Werner L, Gills JP, Shoemaker DW, Phillips PS, Mamalis N, Olson RJ, Apple DJ: Surface calcification of silicone plate intraocular lenses in patients with asteroid hyalosis. American journal of ophthalmology 2004, 137(6):979-987. • 6. Mitchell P, Wang MY, Wang JJ: Asteroid hyalosis in an older population: the Blue Mountains Eye Study. Ophthalmic epidemiology 2003, 10(5):331-335. • 7. Komatsu H, Kamura Y, Ishi K, Kashima Y: Fine structure and morphogenesis of asteroid hyalosis. Medical electron microscopy : official journal of the Clinical Electron Microscopy Society of Japan 2003, 36(2):112-119. • 8. Moss SE, Klein R, Klein BE: Asteroid hyalosis in a population: the Beaver Dam eye study. American journal of ophthalmology 2001, 132(1):70-75. • 9. Winkler J, Lunsdorf H: Ultrastructure and composition of asteroid bodies. Investigative ophthalmology & visual science 2001, 42(5):902-907.

  15. Thank you

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