Medical retina

Author(s):  
Bheema Patil ◽  
Pankaj Puri

The chapter begins by discussing key clinical skills, namely fundus fluorescein angiography, abnormal fluorescein angiography, indocyanine green angiography, and electrophysiology. The following areas of clinical knowledge are then discussed: diabetic retinopathy, hypertensive retinopathy, retinal vein occlusion, retinal artery occlusions, age-related macular degeneration, intravitreal anti-VEGF injections, central serous chorioretinopathy, retinal vascular anomalies, retinal dystrophies, and choroidal dystrophies. The chapter concludes with eight case-based discussions, on gradual visual loss, central visual loss, visual loss in a hypertensive patient, sudden, painless visual loss, diabetic retinopathy, difficult night vision, visual loss in child, and macular lesion.

Author(s):  
Venki Sundaram ◽  
Michel Michaelides

This chapter starts off with a discussion of fundus fluorescein angiography and the causes of abnormal fluorescein angiography. It then discusses indocyanine green angiography, including the main indications for this technique. It goes on to cover fundus autofluorescence imaging and electrophysiology. It also includes clinical knowledge areas of diabetic retinopathy, hypertensive retinopathy, retinal vein occlusion, retinal artery occlusions, age-related macular degeneration, central serous chorioretinopathy, retinal vascular anomalies, inherited retinal disorders, macular dystrophies, and choroidal dystrophies. It also discusses a number of important clinical trial studies and contains a section on the use of intravitreal injections of agents against vascular endothelial growth factor (known as VEGF).


2013 ◽  
Vol 72 (3) ◽  
Author(s):  
K.S. Naidoo ◽  
D Sweeney ◽  
J Jaggernath ◽  
B. Holden

A cross-sectional, population-based, epidemiological study of blindness and visual impairment was conducted to evaluate the prevalence of vision loss and various sight-threatening conditions in the Lower Tugela health district of the KwaZulu-Natal province, South Africa. This study was conducted on a randomly selected sample of 3444 individuals from the district. This number represented 84% of those who were visited and 80.1% of the total sample selected. The participants ranged in age from 5 to 93 years (mean of 29.2 years and a median of 20.0 years). The proportion of men to women differed between participants aged <30 years and those aged >30 years. In both age groups, women represented the majority of participants (66.5%), but the number of women to men in the older age group was approximately twice that found in the group aged less than 30 years. The difference in age between the men and women in the study was not statistically significant (p >0.5). The study revealed that 6.4% of the population studied were visually impaired. The distribution of uncorrected visual acuity was better for women than for men for both OD and OS (p = 0.000 for OD and OS). The main causes of visual impairment were refractive error (44.5%), cataract (31.2%), glaucoma (6.0%), hypertensive retinopathy (4.1%) and diabetic retinopathy (4.1%). Unilateral blindness (OD) was present in 0.78% (95% Confidence interval (CI): 0.42%-1.14%) of participants and unilateral blindness (OS) was present in 1.1% (95% CI: 0.70%-1.50%). Thirty-one participants (0.9%) were bilaterally blind with the main causes being cataracts (54.8%) and refractive error (12.9%). Glaucoma and hypertensive retinopathy were responsible for 6.4% of ..bilateral blindness. Diabetic retinopathy, other retinal conditions (coloboma) and corneal scarring were each responsible for 3.2% of bilateral blindness. Albinism, coloboma and age-related macular degeneration accounted for 9.7% of bilateral blindness. The data provides much needed information to support the planning of eye care programs in KwaZulu-Natal.  (S Afr Optom 2013 72(3) 110-118)


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054225
Author(s):  
Nishanthan Ramachandran ◽  
Ole Schmiedel ◽  
Ehsan Vaghefi ◽  
Sophie Hill ◽  
Graham Wilson ◽  
...  

ObjectivesTo evaluate the prevalence of incidental non-diabetic ocular comorbidities detected at first screen in a large diabetic retinopathy (DR) screening programme.DesignCross-sectional cohort study.SettingSingle large metropolitan diabetic eye screening programme in Auckland, New Zealand.ParticipantsTwenty-two thousand seven hundred and seventy-one participants who attended screening from September 2008 to August 2018.ResultsHypertensive retinopathy (HTR) was observed in 14.2% (3236/22 771) participants. Drusen were present in 14.0% participants under the age of 55 years, increasing to 20.5% in those 55 years and older. The prevalence of neovascular age-related macular degeneration (AMD) was 0.5% in participants aged<55 years, 2.4% in participants aged 55–75 years and 16% in participants aged>75 years. Retinal vein occlusion and retinal arterial embolus were prevalent in 0.7% and 0.02%, respectively, in participants aged<55 years, increasing to 2.2% and 0.4%, respectively, in those >75 years. Cataracts were common being present in 37.1% of participants over the age of 75 years. Only 386 individuals (1.7%) were labelled as glaucoma suspects. Geographic atrophy, epiretinal membrane, choroidal nevi and posterior capsular opacification had an increased prevalence in older individuals.ConclusionsOur data suggest that AMD, HTR and cataracts are routinely detected during DR screening. The incorporation of the detection of these ocular comorbidities during DR screening provide opportunities for patients to modify risk factors (smoking cessation and diet for AMD, blood pressure for HTR) and allow access to cataract surgery.


Author(s):  
Jonathan M. Gibson

When screening the diabetic population for diabetic retinopathy (DR), many other retinal conditions can be identified, which may represent harmless variations of normality or serious ophthalmic pathology. The most important conditions that may be detected are retinal vein and artery occlusion, hypertensive retinopathy, arterial emboli, and retinal changes due to blood disorders, for example, anaemia. These conditions need local protocols for management, which are best obtained by input and advice from the relevant medical teams. Overall, familiarity with fundal appearance and pattern recognition are important in order to recognize common abnormalities, for example, drusen, chorioretinitis, asteroides hyalosis, choroidal naevi, and age-related macular degeneration.


Author(s):  
Tanya M. Monaghan ◽  
James D. Thomas

This chapter concerns ophthalmology, and covers red eye, diabetic retinopathy, hypertensive retinopathy, optic disc swelling, glaucoma, optic atrophy, cataracts, central retinal vein occlusion, retinal detachment, age-related macular degeneration, and cytomegalovirus retinitis.


Biomolecules ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 593
Author(s):  
Khaled Elmasry ◽  
Samar Habib ◽  
Mohamed Moustafa ◽  
Mohamed Al-Shabrawey

Bone morphogenetic proteins (BMPs) play an important role in bone formation and repair. Recent studies underscored their essential role in the normal development of several organs and vascular homeostasis in health and diseases. Elevated levels of BMPs have been linked to the development of cardiovascular complications of diabetes mellitus. However, their particular role in the pathogenesis of microvascular dysfunction associated with diabetic retinopathy (DR) is still under-investigated. Accumulated evidence from our and others’ studies suggests the involvement of BMP signaling in retinal inflammation, hyperpermeability and pathological neovascularization in DR and age-related macular degeneration (AMD). Therefore, targeting BMP signaling in diabetes is proposed as a potential therapeutic strategy to halt the development of microvascular dysfunction in retinal diseases, particularly in DR. The goal of this review article is to discuss the biological functions of BMPs, their underlying mechanisms and their potential role in the pathogenesis of DR in particular.


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