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vascular disorders of retina 2

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									VASCULAR DISORDERS OF
       RETINA
   Prof Brig Asad Jamal Dar
                     FRCS(Ed)
   Commandant/Dean AFIO
RETINAL VESSELS…..
…………….ART/VEINS……..RETINA
BASIC CONCEPT
Direct Ophthalmoscopy
Optic Fundus
        CLINICAL IMPORTANCE
•   LOSS OF VISION
•   SUDDEN
•   PAINLESS
•   RED EYE ……..NIL
•   PBQ………RELEVANCE IN EXAM
          WHAT DOES IT MEANS

• CRVO/BRVO
• CRAO
• HYPERTENSIVE RETINOPATHY
• ROP
• SICKLE CELL
• VASCULAR ANOMALIES


• DIABETIC RETINOPATHY
CRVO
CRVO
BRVO
CRAO
CRAO(ARTERITIC)
            Clinical Examination
HISTORY
  AGE,GEN.HEALTH,
  DIABTES,HYPERTENSION,HYPERLIPIDEMIAS
  GLAUCOMA
GEN PHYSICAL EXAMINATION
  BP,PULSE
SYSTEMIC EXAMINATION
  CVS.CNS
         DIABETIC RETINOPATHY
TYPE                  LESIONS
• NO RETINOPATHY      • NO CLINICAL LESION SEEN
• MILD NPDR           • MICROANURYSM ONLY
• MODERATE NPDR       • MICRO+EXUDATES+HGES

• SEVERE NPDR         • +++IRMAS,VENOUS
                        BEADING
• PROLIFERATIVE DR    • NEOVESSELS
• ADVANCED DIABETIC   • TRACTIONAL RD
  EYE DISEASE
             PATHOGENESIS
•   MICROANGIOPATHY(MICROCIRCULATION)
•   EXACT MECHANISM………?
•   CONTENT OF BLOOD
•   CAPILLARY WALL
•   CAPILLARY CLOSURE
•   ISCHEMIA
•   VASCULAR ENDOTHELIAL GROWTH FAC(VEGF)
Diabetic Retinopathy
Pre proliferative DR
BACKGROUND DR
DIABETIC RETINOPATHY
STAGES OF DIABETIC RETINOPATHY
FUNDUS FLUORESEIN
  ANGIOGRAPHY
DIABETIC MACULOPATHY
Tractional retinal detachment
ADVANCED DIABETIC EYE DISEASE
              MANAGEMENT
• DIAGNOSIS
  – CLINICAL EXAM
  – FUNDOSCOPY
  – FFA/OCT
• ROLE OF PHOTOCOAGULATION
• ANTI VEGF
• SURGERY
   HYPERTENSIVE RETINOPATHY
• PATHOPHSIOLOGY
  – ACUTE
    • SEGMENTAL NARROWING ARTEIOLES
    • COTTON WOOL SPOTS
  – CHRONIC
    • VESSEL WALL CHANGES
    • EXUDATION
     VASCULAR RETINOPATHIES
• LASERS
• TYPES
• INDICATIONS

								
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