Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retinal Vascular Diseases
Stage 3 sickle cell peripheral proliferative retinopathy with a "seafan" neovascularization and fibrovascular proliferation. Fluorescein angiogram demonstrating arteriolar-venular anastomoses at the junction of perfused and nonperfused retina and dye leakage.

  • May present as nonproliferative or proliferative retinopathy.
  • Among other systemic hemoglobinopathies, sickle cell disease constitutes the more common cause of peripheral proliferative retinopathy.
  • Clinical features:
    • Symptoms:
      • Asymptomatic in the early stage of the disease
      • Decreased vision secondary to vitreous hemorrhage, macular edema or capillary nonperfusion involving the macula
    • Signs:
      • Nonproliferative Retinopahty; the following characteristics can be observed: comma-shaped vaso-occlusions of conjunctival vasculature, iris atrophy, "salmon patch" retinal hemorrhage, "black sunburst" spots, and various abnormalities of the retinal vasculature, macula, choroid, optic disc, and vitreoretinal interface
      • Proliferative Retinopathy has been classified into 5 stages by Goldberg;
        • Stage 1: Peripheral arteriolar occlusion or capillary nonperfusion
        • Stage 2: Vascular remodeling at the boundary between perfused and nonperfused peripheral retina
        • Stage 3: "Seafan" peripheral retinal neovascularization
        • Stage 4: Vitreous hemorrhage
        • Stage 5: Vitreous band, complicated with rhegmatogenous and tractional retinal detachment
  • Management:
    • Treatment of systemic condition.
    • Indication for ocular treatment: bilateral, progressive proliferative disease, rapid neovascularization and spontaneous hemorrhages.
    • Ocular treatment may include; laser photocoagulation, pars plana vitrectomy, and scleral buckling.


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