R.D. BY: MARWAN ABOUAMMOH. R.D. Rhegmatogenous Tractional Exudative 1/10000 In aphakics: 1-3%...
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Transcript of R.D. BY: MARWAN ABOUAMMOH. R.D. Rhegmatogenous Tractional Exudative 1/10000 In aphakics: 1-3%...
R.D.
BY:
MARWAN ABOUAMMOH
R.D.
Rhegmatogenous Tractional Exudative
1/10000 In aphakics: 1-3% Rhegmatogenous R.D. has 5% chance of
forming PVR
R.R.D. Vitreous liquifaction R. break Eye’s movement PVD, V-R traction
PVD Loss of hyaluronic acid 15% of acute PVD have a retinal tear 13-19% have vit. He PVD+hge= 70% with tears PVD+no hge= 2-4% with tears Weiss ring
Acute PVD: Examine preiphery Vit hge = rest, patching ou, examine later U/S
R.D. RISK FACTORS
1. Lattice & other peripheral degen.:1. 8% of pop.2. A cause of RD in 20-30%3. In RD with L.D.:
1. 30-45% atrophic holes2. 55-70% tear at the edge of L.D.
1. Dentate process, oral bay, pars plana island peripheral, cystoid degen., Paving stone degen.,
2. High myopia:>6D
3. Cataract surgery:More with PVD, ICCE>ECCE, Increased risk with P.C.otomy (1.3%), and vit.
Loss50% of R.D.’s in 1st yr.
4. Glaucoma > In pigment dispersion syndrome COAG > in R.D. patients(7% vs. 1%) Miotics & R.D.
5. R.D. in the fellow eye or FHx of R.D.
6. Trauma: retinal dialysis, giant tear
Symptoms:
Exam: don’t forget indentation
40-50% of all R.R.D. have > 1 break usually located 90 degrees from primary break.
Types of breaks: Horse-shoe tear Operculated hole Atrophic hole Dialysis
RRD ERD TRD
VITREOUS PIGMENT ± BLOOD
NO PIGMENT ± INFLAMMATORY CELLS
NO PIGMENT
FLUID FAIRLY STATIC DEPENDENT SHIFTING FLUID
LITTLE FLUID, NON SHIFTING
SHAPE CONVEX CORRUGATED
CONVEX SMOOTH
CONCAVE
RETINAL FEATURES
BREAKS ± DEGENERATION
NORMAL OR FEATURES OF UNDERLYING DISEASE
PRERETINAL FIBROSIS
CHRONIC R.D.
Retinal thinning
Demarcation line
Intraretinal cysts
PVR
CAUSES OF TRD
PRD
ROP
SCR
VMT
INCONTINENTIA PIGMENTI
RETINAL DYSPLASIA
PVR A B C
1-12 TYPE
ERD: Idiopathic
Coats disease Central serous chorioretinopathy Uveal effusion syndrome
Inflammatory Vogt-Koyanagi-Harada syndrome Syphilis Scleritis Sympathetic ophthalmia Other vasculitic entities (eg, rheumatoid arthritis, Wegener granulomatosis) Other uveitic conditions (eg, toxoplasmosis, cytomegalovirus [CMV] retinitis) Dengue fever Orbital pseudotumor Lymphomatoid granulomatosis
Congenital Nanophthalmos Colobomas of the optic nerve Familial exudative vitreoretinopathy
Neoplastic Choroidal melanoma Choroidal metastases Choroidal nevus Choroidal hemangioma Retinoblastoma Primary intraocular lymphoma
Iatrogenic Excessive panphotocoagulation Scleral buckling
Vascular factors Eclampsia Exudative age-related macular degeneration Chronic renal failure Hypertension