CM ENT 20- disorders of the macula
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29 terms
Terms | Definitions |
|---|---|
 age-related macular degeneration | -most common cause of irreversible visual loss in the aging eye -loss of central vision -risk factors: advanced age, family history, smoking, CV disease, diet, obesity |
| smoking | this is the number one preventable cause of macular degeneration |
| drusen | look for these on the macula when evaluating for ARMD. they look like large irregular spots/shapes in the macular area |
| dry ARMD | -atrophy of photoreceptors and choriocapillaris -gradual visual loss |
| wet ARMD | -neovascularization between retina and choroid -macular edema, hemorrhage, disciform scar -more sudden visual loss; can go blind in a very short period of time |
| intermediate stage | stage of ARMD: -no symptoms or slight difficulty with reading, driving, etc. due to atrophy not yet involving the center of the macula -peripheral vision usually remains intact |
| advanced stage | stage of ARMD: -straight lines may appear crooked -central blind spot -peripheral vision usually remains intact |
| vitamin A, zinc | can take these dietary supplements to help with ARMD |
| senile macular hole | -small break in the macula, located in the center of the retina -typically in patients older than 60 -more common in women -patients usually have an abrupt loss of central vision -usually develops in stages -full-thickness macular hole appears as a round, brick-colored lesion in the center of the macula, usually on-third to two-thirds of a disc diameter |
| diabetic retinopathy | -retinal complications of diabetes -leading cause of blindness in working-age americans |
| hypertension control | -as important as glucose control in lowering risk of diabetic retinopathy -ACE inhibitor or beta blocker decreases microvascular complications |
| cholesterol | lowering this may lead to decreased hard exudates and improved vision |
| diabetic retinopathy pathogenesis | increased glucose + VEGF + increased capillary permeability/abnormal vasoproliferation |
| microaneurysms | common vascular problem seen in diabetic retinopathy |
| nonproliferative diabetic retinopathy | early clinical signs: -microaneurysms -hard exudates -intraretinal hemorrhages -patients may be asymptomatic |
| proliferative diabetic retinopathy | clinical signs -neovascularization -vitreous hemorrhage and traction -NPDR features, including macular edema |
| macular edema | a common clinical feature in nonproliferative diabetic retinopathy and preproliferative diabetic retinopathy |
| vitreous hemorrhage | symptoms: -floaters -severe visual loss -requires immediate ophthalmologic consultation! |
| neovascular glaucoma | neovascularization of the iris leads to a clogged up trabecular meshwork which can lead to this disease |
| diabetes | it is recommended that patients with this disease should have an eye exam at least once per year |
| retinal vein occlusion | -one of the msot common causes of blindness after diabetic retinopathy -acute loss of vision -subdivided as nonischemic and ischemic -can be central (CRVO) or branched (BRVO) |
| central retinal vein occlusion | -nonischemic: subtle, intermittent vixion loss, painless, mild to moderate vision loss -ischemic: acute vision loss, pain may be present, marked vision loss |
| branched retinal vein occlusion | -often noted with an onset of blurred vision or visual field defect -may be asymptomatic if the occlusion is small -usually unilateral -9% of cases are bilateral |
| retinal artery occlusion | -common complaint is an acute persistent painless vision loss -central has central, dense vision loss -branched has peripheral vision loss -history of hypertension or diabetes -a cherry red spot in the macula is common |
| central retinal artery occlusion | -embolus from the heart is the most common cause -coagulopathies from sickle cell anemia or antiphospholipid antibodies are common etiologies in patients younger than 30 years -atherosclerotic disease is the leading cause -migranes rare cause but are more common in younger patients |
| branched retinal artery occlusion | -boxcar segmentation of the blood column is observed -amaurosis fugax preceding persistent loss of vision can be a sign -typically involves the temporal retinal vessels -doesn't usually require ocular therapeutics unless perifoveolar vessels are threatened |
| hypertensive retinopathy | -hypertension may be unknown to patient -more common in african americans than caucasians -nearly always visually asymptomatic -findings include cotton wool spots and flame shaped hemorrhages -arteriosclerosis is often found concurrently |
| sickling retinopathy | -grouped according to the presence or absence of neovascularization -non-neovascular ocular manifestations include conjunctival vascular occlusions -neovascular ocular manifestations include the growth of abnormal vascular fronds which predispose to vitreous hemorrhage and retinal detachment |
| retinitis pigmentosa | -hereditary retinal dystrophy -mottling of the retinal pigment epithelium with black bone-spicule pigmentation -other features include waxy pallor of the optic nerve head, attenuation of the retinal vessels, cellophane maculopathy, cystic macular edema, and posterior subcapsular cataract -night blindness usually precedes tunnel vision by years or even decades -can't do much about this disease |
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