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Chapter-12.8 Systemic Diseases with Retinal Manifestations

BOOK TITLE: Postgraduate Ophthalmology (2 Volumes)

Author
1. Gopal Lingam
ISBN
9789350252703
DOI
10.5005/jp/books/11051_53
Edition
1/e
Publishing Year
2012
Pages
15
Author Affiliations
1. Sankara Nethralaya, Chennai, India, Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India, Sankara Nethralaya Chennai, Tamil Nadu, India, Medical Research Foundation, Sankara Nethralaya Chennai, Tamil Nadu, India, Shankara Nethralaya, Chennai, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India, Medical Research Foundation, Sankara Nethralaya, Chennai, India, National University Hospital System, Singapore, Sankara Nethralaya, Chennai, Tamil Nadu, India, National University Health System, Singapore; Sankara Nethralaya, Chennai, Tamil Nadu, India, National University Health System 1E, Kent Ridge Road, Tower Block Level 7, Singapore; Sankara Nethralaya A Unit of Medical Research Foundation, Nungambakkam, Chennai, Tamil Nadu, India, University Health System, Singapore, Shri Mahavir Vitreoretinal Service, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
Chapter keywords
diabetic retinopathy (DR), general ophthalmologist, retinal surgeon, capillary basement membrane, loss of pericytes, microaneurysms, blood-retinal barrier breakdown, vascular occlusion, neovascularization, vascular diseases, nonproliferative diabetic retinopathy, dilated retinal veins, intraretinal microvascular abnormalities (IRMA), soft exudates, hard exudates, retina, preretinal traction, shallow retinal detachment, optical coherence tomography, fundus photography, fundus fluorescein angiography (FFA), automatic detection of diabetic retinopathy, optical coherence tomography (OCT), laser photocoagulation, burns in the retina, transpupillary delivery, laser energy, vitreoretinal surgeons, anti-VEGF drugs, va, scularity, intraoperative hemorrhage, core vitrectomy, relief of tangential traction, removal of free blood, hemostasis, diabetic retinopathy study, early treatment diabetic retinopathy study (ETDRS), diabetic retinopathy vitrectomy study (DRVS), hypertension, mo

Abstract

Diabetic retinopathy (DR) remains the most common retinal condition that a general ophthalmologist as well as retinal surgeon is likely to come across in daily practice. Pathology in diabetic retinopathy includes capillary basement membrane, loss of pericytes, microaneurysms, blood-retinal barrier breakdown, vascular occlusion, and neovascularization. Microaneurysms are seen in other vascular diseases but are characteristic of nonproliferative diabetic retinopathy. Dilated retinal veins, intraretinal microvascular abnormalities (IRMA), soft exudates, hard exudates, and so on are described. The retina can be pulled by the preretinal traction. Shallow retinal detachment is best picked up on optical coherence tomography rather than clinically. Investigations include fundus photography, fundus fluorescein angiography (FFA), automatic detection of diabetic retinopathy, optical coherence tomography (OCT), and so on. Laser photocoagulation involves deliberate production of burns in the retina using transpupillary delivery of laser energy. Most vitreoretinal surgeons use anti-VEGF drugs preoperatively in eyes with significant vascularity, so that risk of intraoperative hemorrhage can be minimized. Surgical procedure include following a core vitrectomy, relief of tangential traction, removal of free blood, and hemostasis. Summary of major clinical trials related to management of diabetic retinopathy explains diabetic retinopathy study, early treatment diabetic retinopathy study (ETDRS), diabetic retinopathy vitrectomy study (DRVS), and so on. Hypertension is identified as a major cause of morbidity and mortality across the world. Malignant hypertension describes sudden increase in blood pressure. Sickle cell disease is the term used when both chromosomes are affected. Clinical features include conjunctival vascular changes, iris changes, intraretinal hemorrhage and sequelae, retinal vessel changes, and proliferative vasculopathy.

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