Retina-Vascular

Retinal Macroaneurysm (RAM) SYMPTOMS Quiescent retinal macroaneurysm: Typically asymptomatic Exudative retinal macroaneurysm: Gradual central and/or peripheral vision loss Hemorrhagic retinal macroaneurysm: Sudden central and/or peripheral vision loss SIGNS Retinal macroaneurysms are 100-250 microns in diameter and typically seen in the superior temporal aspect of the posterior pole at an arteriovenous crossing There are 3 types…

Lipemia Retinalis SYMPTOMS Typically asymptomatic SIGNS Salmon/pink colored retinal arteries and arterioles, veins and venules, and capillaries.The entire fundus can also have a salmon/pink color as well WORK-UP Pupils, EOMs, Full eye exam with dilated retinal exam, OCT analysis of the macula, OCT-Angiography, Fluorescein Angiography, Fundus photos TREATMENT Refer to PCP/ER STAT in order to…

Ocular Ischemic Syndrome (OIS) SYMPTOMS Decrease in vision is the most common symptom as it occurs in 91% of patients with OIS (vision loss is gradual 67% of the time and about 66% of patients with OIS end up seeing 20/60 or worse) Eye pain (typically a dull ache over brow) due to ischemia occurs…

Branch Retinal Vein Occlusion (BRVO) SYMPTOMS Central vision varies as it can be anywhere from 20/20 to 20/200 Peripheral vision is typically abnormal in the area correlating to the BRVO Patient may also report Mild to severe vision loss in the presence of neovascular glaucoma, an intravitreal hemorrhage, a subhyaloid hemorrhage, and a preretinal hemorrhage,…

Central Retinal Vein Occlusion (CRVO) SYMPTOMS Non-ischemic CRVO: Sudden painless vision loss (typically 20/200 or better) Ischemic CRVO: Sudden painless vision loss (typically counting fingers or worse) Patients with a non-ischemic CRVO tend to have Normal peripheral vision while patients with an ischemic CRVO tend to have Abnormal peripheral vision Patient may also report Mild…

Branch Retinal Artery Occlusion (BRAO) SYMPTOMS Sudden painless vision loss (typically 20/40 or better) and visual field loss (correlates to area of branch retinal artery occlusion) Severity of vision loss and visual field loss depends on the extent and location of the branch retinal artery occlusion Patient may also report Mild to severe vision loss…

Central Retinal Artery Occlusion (CRAO) SYMPTOMS Sudden painless vision loss (typically counting fingers to light perception) May report a history of amaurosis fugax SIGNS Typically unilateral Acute occlusion: Immediate APD, Superficial retina opacification, Cherry red spot at the fovea, Boxcarring, Cotton wool spots, Few intraretinal hemorrhages (Dot/Blot/Flame), Paracentral acute middle maculopathy (PAMM), Optic nerve edema,…

Radiation Retinopathy SYMPTOMS Central vision loss and Peripheral vision loss At 3 years post-radiation treatment, about 50% of patients saw 20/200 or worse with little to no chance of visual improvement even with treatment SIGNS Signs typically develop 6 months to 3 years post-radiation treatment Non-proliferative signs: Microaneurysms, Dot/blot hemorrhages, Flame hemorrhages, Cotton wool spots,…

HIV Retinopathy SYMPTOMS Typically asymptomatic but there can be Central vision loss and Peripheral vision loss in the presence of opportunistic infections such as toxoplasmosis SIGNS Typically bilateral Microaneurysms, Dot/blot hemorrhages, Flame hemorrhages, Roth spots, Cotton wool spots, Signs of opportunistic infections such as toxoplasmosis WORK-UP Pupils, EOMs, Full eye exam with dilated retinal exam,…

Sickle Cell Retinopathy SYMPTOMS Non-proliferative: Typically asymptomatic but may report Central vision loss and Metamorphopsia in the presence of cystoid macular edema, Central vision loss in the presence of macular ischemia and thinning, Central vision loss and Peripheral vision loss in the presence of optic neuropathy and retinal artery occlusions Proliferative: Central vision loss and…