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AMD

AMD. DEHGHANI.A. Soft drusen Classic CNV Occult CNV Fibrovascular pigment epithelium detachment Retinal angiomatous proliferation Polypoidal choroidal vasculopathy. SOFT DRUSEN.

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AMD

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  1. AMD DEHGHANI.A

  2. Soft drusen • Classic CNV • Occult CNV • Fibrovascular pigment epithelium detachment • Retinal angiomatous proliferation • Polypoidal choroidal vasculopathy

  3. SOFT DRUSEN • Localized multiple elevation of the hyper-reflective band of the retinal pigment epithelium-bruch's membrane-choriocapillaris complex • With no shadowing backwards to choroid • Neither any sub-retinal nor intra-retinal fluid accumulation • The different retinal layers remain normally organized

  4. GEOGRAPHIC ATROPHY • A decrease in thickness of the neurosensory retina • A disappearance of the hyporeflective band corresponding to the photoreceptors • An increased hyper-reflectivity of the retinal pigment epithelium-Bruch's membrane-choriocapillaris extending back towards the underlying choroid

  5. CLASSIC CNV • direct exudative symptoms • indirect exudative symptoms

  6. Direct Exudative Symptoms: • a hyper-reflective,fusiform area of thickening, above and adjacent to the RPE • The shadowing underneath the RPE towards the choroid

  7. Indirect Exudative Symptoms: • increase of thickness of the sensory retina due to intra-retina fluid accumulation • flattening of the foveal depression • Detachment and elevation of the neurosensory retina • RPE detachment (serous or hemorrhagic)

  8. OCCULT CNV • A hyper-reflective thickened band confounded with the RPE usually irregular and sometimes fusiform (cigar-like) with shadowing towards the choroid • RPE detachment • Sub-retinal and/or intra-retinal accumulation of serous fluid with or without intraretinal cystoid edema

  9. FIBROVASCULAR PIGMENT EPITHELIUM DETACHMENT • A thicker hyper-reflectivity notch appended on the choroidal side of the elevated retinal pigment epithelium might represent CNV

  10. RETINAL ANGIOMATOUS PROLIFERATION • Deep retinal neovascularization • The retinal neovascularization eventually communicates with the subretinal and choroidal space • Choroidal neovascularization is present in late-stage RAP

  11. A distinct form of occult CNV associated with proliferation of intraretinal capillaries in the paramacular area

  12. POLYPOIDAL CHOROIDAL VASCULOPATHY • A unique form of occult choroidal neovascular membrane

  13. 1. A branching network of inner choroidal vessels 2. Terminal, aneurysmal dilations of the vessels 3. Subtle nodular choroidal protrusions 4. Serosanguineous retinal pigment epithelial detachments 5. Exudative retinopathy 6. Vitreal hemorrhage 7. Chronic and recurrent course

  14. Prognosis Generally good, provided the macula is not involved

  15. Conclusion: • Helping in categorization • Picking up the associated secondary changes • Monitoring response to the therapies

  16. پایان

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