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RETINAL DETACHMENT Demir Başar (Professor) DB07

RETINAL DETACHMENT Demir Başar (Professor) DB07. ANATOMICAL CONSIDERATIONS. NEURONS Photoreceptors Bipolars Ganglion cells. Rods &Cones Nuclei Plexiform Nuclei Plexiform Ganglion cells Nerve fibers. Rods and Cones External limiting External nuclear

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RETINAL DETACHMENT Demir Başar (Professor) DB07

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  1. RETINAL DETACHMENT Demir Başar (Professor) DB07

  2. ANATOMICAL CONSIDERATIONS

  3. NEURONS Photoreceptors Bipolars Ganglion cells Rods &Cones Nuclei Plexiform Nuclei Plexiform Ganglion cells Nerve fibers

  4. Rods and Cones External limiting External nuclear External plexiform Internal nuclear Internal plexiform Ganglion cells Nerve fibers Internal limiting

  5. Pigment Epithelium Rods and Cones External limiting External nuclear External plexiform Internal nuclear Internal plexiform Ganglion cells Nerve fibers Internal limiting

  6. TWO MAIN LAYERS Pigment epithelium Neural retina

  7. There are no tissue adhesives between pigment epithelium and neural retina (i.e. fibronectins) WHATthen , KEEPS THE RETINA IN PLACE ?

  8. Equator Patellary fossa IOP Light Optic nerve Hyaloid membrane Equator Lens Vitreus Gel

  9. VARIOUS FORCES PLAY PART... Sclera Choroid Epithelial pump (suction power) Pigment epithelium Neural retina Retina Vitreus IOP and WATER STREAM from vitreus to choroid push the neural retina towards the pigment epithelium

  10. WHY DETACHMENT OCCURS? PREDISPOSING FACTORS 1-VITREUS DEGENERATİON 2-PERIPHERAL RETINAL DEGENERATION 3-VITREO-RETINAL ADHESIONS (fibrosis)

  11. VITREUS DEGENERATION

  12. Muscoe volitantes Light Shadow Syneresis

  13. flo2.JPG

  14. Syneresis Posterior hyaloid water Vitreus gel

  15. Newtons first law of motion (Law of Inertia) Objects tend to keep on doing what they are doing. An object at rest tend to stay at rest , and an object in motion tend to stay in motion with the same speed and in the same direction

  16. Vitreus collapse and vitreus shock (Photopsia) Posterior hyaloid rupture (Newtons 1rst law of motion) Drained lagoon Water moves behind Vitreous gel collapsed Detached post.hyaloid

  17. Vitreous traction Vitreoretinal adhesion

  18. LATTICE DEGENERATION

  19. Retinal tractional tear

  20. Pigment epithelium Neural retina Water Tear

  21. VITREUS DEGENERATION + PERIPHERAL RETINAL DEGENERATION + FIBROTIC TRACTION RETINAL TEAR RETINAL DETACHMENT

  22. SIGNS and SYMPTOMS SUBJECTIVE I- Before the onset of retinal detachment (NOT CONSTANT) 1-Entopsia A-muscoe volitantes (flying objects) B-photopsia (seeing lights that do not exist) II-After the retina is really detached 2-loss of part of the visual field 3-deterioration of visual acuity(when macula is involved)

  23. OBJECTIVE 1-Grey and elevated area(s) in ophthalmoscopy against red fundus reflex 2-One or more retinal tear(s) in various shapes and locations 3-Blurred vitreus in some cases, showing the existence of intravitreal hemorhage (due to retinal rupture)

  24. DIAGNOSTIC TOOL OPHTHALMOSCOPY

  25. TREATMENT SURGERY 1-SCLERAL 2-TRANSVITRERAL

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