Podcast
Questions and Answers
What characterizes CMV retinitis as noted in the clinical presentation?
What characterizes CMV retinitis as noted in the clinical presentation?
Which factor has significantly reduced the incidence of CMV retinitis in HIV patients?
Which factor has significantly reduced the incidence of CMV retinitis in HIV patients?
What is a common therapeutic approach for managing cytomegalovirus retinitis?
What is a common therapeutic approach for managing cytomegalovirus retinitis?
Which of the following is primarily a prevention strategy for reducing trauma-related eye injuries?
Which of the following is primarily a prevention strategy for reducing trauma-related eye injuries?
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Which of these conditions increases susceptibility to CMV retinitis?
Which of these conditions increases susceptibility to CMV retinitis?
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What is a common symptom of optic neuritis?
What is a common symptom of optic neuritis?
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Which treatment option is commonly used for optic neuritis?
Which treatment option is commonly used for optic neuritis?
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What characterizes pathological myopia?
What characterizes pathological myopia?
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Which feature is commonly associated with maculopathy in diabetic retinopathy?
Which feature is commonly associated with maculopathy in diabetic retinopathy?
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What are lacquer cracks in pathological myopia?
What are lacquer cracks in pathological myopia?
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What percentage of individuals with type 1 diabetes may develop diabetic retinopathy after 30 years?
What percentage of individuals with type 1 diabetes may develop diabetic retinopathy after 30 years?
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Which of the following is NOT a part of the management for diabetic retinopathy?
Which of the following is NOT a part of the management for diabetic retinopathy?
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What is the geographic prevalence rate of optic neuritis in the USA?
What is the geographic prevalence rate of optic neuritis in the USA?
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What is the primary treatment option for non-infective posterior uveitis?
What is the primary treatment option for non-infective posterior uveitis?
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Which parasite is responsible for Toxoplasma retinochoroiditis?
Which parasite is responsible for Toxoplasma retinochoroiditis?
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What characteristic feature distinguishes Punctate Inner Choroidopathy (PIC)?
What characteristic feature distinguishes Punctate Inner Choroidopathy (PIC)?
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Under what circumstances is treatment required for Toxoplasma retinochoroiditis?
Under what circumstances is treatment required for Toxoplasma retinochoroiditis?
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Which treatment options are combined for Toxoplasma retinochoroiditis?
Which treatment options are combined for Toxoplasma retinochoroiditis?
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Which demographic is primarily affected by Punctate Inner Choroidopathy?
Which demographic is primarily affected by Punctate Inner Choroidopathy?
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Where are lesions typically located in patients with Serpiginous Chorioretinitis?
Where are lesions typically located in patients with Serpiginous Chorioretinitis?
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What is a common symptom of Toxoplasmosis presented in the eye?
What is a common symptom of Toxoplasmosis presented in the eye?
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Study Notes
Impairment in the Working Age Person
- Impairment in the working age person is discussed
- Various eye conditions are described, including their causes, symptoms and treatments
Diabetic Retinopathy
- Non-proliferative diabetic retinopathy: Characterized by microaneurysms, intraretinal hemorrhages, hard exudates, cotton wool spots and macular edema
- Proliferative diabetic retinopathy: Includes microaneurysms, retinal hemorrhages, hard exudates, cotton wool spots and macular edema, and neovascularization (new blood vessel growth).
- Severity of Diabetic retinopathy is graded, with stages having different features, such as leakage, masked hemorrhages and exudates
Grading of Diabetic Retinopathy Stages
- Stage one: Mild non-proliferative diabetic retinopathy with small microaneurysms.
- Stage two: Moderate non-proliferative diabetic retinopathy showing microaneurysms, bleeding, and deposits.
- Stage three: Severe non-proliferative diabetic retinopathy with increased microaneurysms, bleeding, and blood vessel abnormalities.
- Stage four: Proliferative diabetic retinopathy featuring new, abnormal blood vessels (neovascularization) which can lead to scar tissue and retinal detachment.
Prevalence of Diabetic Retinopathy in Type 1
- First 5 years: No retinopathy
- 5-10 years: 27% have diabetic retinopathy
- 10+ years: 71% with diabetic retinopathy
- After 30 years: Incidence rises to 90% with 30% having PDR (Proliferative Diabetic retinopathy)
Prevalence of Diabetic Retinopathy in Type 2
- Maculopathy can be presenting feature
- Diabetes may be undiagnosed for years
- Severe damage to retinal capillaries
Management of Diabetic Retinopathy
- Blood sugar control is crucial
- Anti-VEGF treatments
- Laser photocoagulation
- Vitrectomy is also a procedure
Pathological Myopia
- Choroidal neovascular membranes (CNVMs): Occur in some cases of myopia (nearsightedness)
- Myopia: Eye is longer/increased curvature compared with normal, causing difficulty focusing.
Management of Pathological Myopia
- Non Surgical Management: Eyeglasses, contact lenses
- Pharmacological treatments. Steroids
- Laser treatments for Intravitreal neovascularization.
- Surgical interventions
Acute Optic Neuritis
- Inflammation of the optic nerve, often causing pain and vision loss.
- Often unilateral (one eye)
- Symptoms include gradual blurring of vision, pain, and partial/full vision loss
- USA: 46 per 100,000; England and Wales: 93 per 100,000
- Treatment includes oral prednisolone and intravenous methylprednisolone
Treatment of Acute Optic Neuritis
- Oral prednisolone, oral placebo, intravenous methylprednisolone, followed by oral.
- Red desaturation is used to assess progression
Posterior Uveitis
- Inflammation of the uveal tract (iris, ciliary body, choroid)
- Incidence: 15-40 per 100,000
- Causes include infective (e.g., toxoplasmosis) as well as non-infective conditions.
- Treatments include anti-infective agents, immunosuppressive agents
Management of Posterior Uveitis
- Improved visual prognosis
- Quality of life improves
- Long-term medication often required
Toxoplasmosis Retinochoroiditis
- Infection causing inflammation in the retina and choroid (middle layer of eye).
- Characterized by presence of white, smooth and elevated retinochoroidal lesions
- Causative agent is Toxoplasma gondii
- Usually occurs in individuals with compromised immune systems.
- Transmission occurs via cat feces.
- Treatment includes clindamycin and corticosteroids or pyrimethamine, sulfonamides, folinic acid, and steroids
Punctate Inner Choroidopathy
- Bilateral inflammatory condition in young adults (often women)
- Symptoms include blurred vision, photopsia (light flashes) and scotoma (blind spots)
- Findings include multiple yellow-white lesions in the inner choroid and retina
- Treatments options include laser photocoagulation, photodynamic therapy, steroids, but role of steroids is contentious
Serpiginous Chorioretinitis
- Bilateral progressive inflammatory eye disease affecting the inner choroid, retina, and retinal pigment epithelium (RPE).
- Location is peripapillary area
- Lesions spread centrifugally, often appearing as a jigsaw-like pattern.
- Lesions are often circumscribed and gray-white in appearance.
Cytomegalovirus (CMV) Retinitis
- CMV retinitis occurs more commonly when the patient has a weakened immune system due to existing illnesses or treatments.
- Incidence of the condition has increased in the past decade
- Symptoms include retinal necrosis and intraretinal hemorrhage. Can appear as a "tomato ketchup and mayonnaise" retinopathy
- Treatment and Management includes intravenous therapy, and intravitreal implants
- Patients often have reduced T-cell function
Impact of HIV CMV Retinitis
- HIV patients experience progressive T-cell function loss, increasing susceptibility to CMV retinitis.
- HAART (Highly Active Antiretroviral Therapy) has significantly reduced CMV retinitis incidence
Trauma as a Cause of Bilateral Blindness
- Trauma can cause bilateral blindness, due to issues like road accidents, electrocution, or self-inflicted injuries, or chemical injuries.
Prevention and Reduction of Trauma
- Health and safety education at home and work
- Eye care professionals have role in promoting safety awareness
Table 3.3 Fundal Changes in the Inflammatory Retinopathies
- Table summarising different inflammatory retinopathies and features such as anterior uveitis, vitreous cells/vitritis, chorioretinal scars in various conditions like Punctate inner choroidopathy, acquired toxoplasmosis etc
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Description
Explore the various stages and conditions of diabetic retinopathy, including non-proliferative and proliferative types. Learn about the implications of these conditions on working-age individuals, their symptoms, causes, and treatments. This quiz provides insights into the grading of diabetic retinopathy stages.
