Central venous occlusion

Transcription

1 Central venous occlusion Central venous occlusion (right eye) There are dark haemorrhages at the macula and all over the retina.

2 Choroidal haemangioma A choroidal haemangioma has salmon pink colour. There is a risk of retinal detachment.

3 Choroidal melanoma Choroidal melanoma. See next image.

4 Choroidal melanoma Choroidal melanoma 3 years later (see previous image). The tumour has become larger. The colour may be very dark, chocolate brown, amelanotic, or variable (as in this patient).

5 Choroidal naevus A choroidal naevus in upper temporal macula. A small area of atrophy of the pigment epitelium is visible near the naevus.

6 Diabetic retinopathy during pregancy Diabetic retinopathy often progresses during pregnancy. This patient has several retinal microinfarctions. Follow-up is mandatory. The microinfarctions disappeared a few months after delivery.

7 Diabetic retinopathy with neovascularisation A 29-year-old woman with type 1 diabetes. There are small haemorrhages in the macula, and a small neovascularisation on the upper temporal side of the macula. There are several haemorrhages in the temporal retina - this demonstrates the importance of sufficient visualisation of the temporal retina during retinal photography screening.

8 Diabetic retinopathy: neovascularisation and a microinfarction There is a solitary microinfarction in the upper temporal region, and considerable neovascularisation above the arcade. Proliferative diabetic retinopathy.

9 Drusens in a patient with nonexudative macular degeneration Large, soft drusens and minimal pigment accumulations in a 71-year-old woman with nonexudative (dry) macular degeneration.

10 Exudative macular degeneration in a 70-year-old woman Exudative form of age-related macular degeneration in a 70-year-old woman: macular oedema, lipid exudates, and haemorrhages.

11 Foreign body on the cornea with rust ring A foreign body on the cornea, causing a red eye. There is a rust ring around the foreign body.

12 Gardner's syndrome Gardner's syndrome: hyperplasia of the pigment epithelium. There are several dark retinal spots in both eyes. The condition is of genetic origin, and it is encountered in patients who have familial adenomatous polyposis of the colon.

13 Haemorrhage due to macular degeneration The visual acquity of this 85-year-old man was suddenly decreased. There is a large haemorrhage under the pigment epithelium, caused by choroid neovascularisation associated with macular degeneration. See also the next image.

14 Hypertensive retinopathy Large, deep haemorrhages, retinal microinfarctions, and hard (lipid) exudates in the left eye. Superior temporal venous occlusion above and at the macula. High blood pressure causes compression at the crossings of veins and arteries, causing obstruction of venous flow.

15 Large choroidal melanoma surrounding the optic disk A large choroidal melanoma almost totally surrounds the optic disk. The colour of the tumour is metallic green.

16 Lower temporal branch venous occlusion Lower temporal venous occlusion (left eye). Haemorrhages on both sides of the lower arcade. There are only small haemorrhages at the macula, and no macular oedema. The central visual acquity is unaffected.

17 Macular haemorrhage in a patient with servere myopia Severe myopia (myopia magna, myopia maligna) predisposes the patient to macular haemorrhages ('Fuchs spots') at an early age. The retina and subretinal tissues have become thinner when the eye has become longer. There is a grey oedema in the central macula, and a haemorrhage around it. Note the peripapillar atrophy and narrow vessels. The choroidal vessels are more visible than usual.

18 Macular scar formation 2 years after a large haemorrhage The same eye as in the previous image. Two years after the haemorrhage there is a large scar formation in central retina.

19 Optic nerve drusen Optic nerve drusen: the optic disk borders look hazy and they are irregular because of drusen accumulations. The optic disk is not oedematous. The condition may be congenital, or caused by papilloedema that has already subsided.

20 Panphotocoagulation Panphotocoagulation has stopped the growth of neovascularisation, but the widespread vascular occlusion has resulted in retinal atrophy and cystic macular degeneration. The central visual acquity is 0.1

21 Papilloedema caused by high intracranial pressure Papilloedema: the central pit has disappeared, the optic disk is oedematous and it has hazy borders. The condition is bilateral, and the visual acquity is normal. The patient has increased intracranial pressure.

22 Papilloedema caused by papillitis The optic disk is oedematous and it has hazy borders. The condition is unilateral, and the visual acquity is decreased in the affected eye. The condition is caused by papillitis.

23 Proliferative diabetic retinopathy A 52-year-old woman with type 2 diabetes. Neovascularisation both above and below the optic disk. Microaneurysms and haemorrhages in the macula, and lipid exudates on the temporal side of the macula. Panphotocoagulation is indicated.

24 Retinitis pigmentosa Retinitis pigmentosa starts from the periphery of the retina, causing night blindness, glare and tunnel vision. Osteoblast-looking pigmentation and narrow vessels are visible in the retina. The macula may remain unaffected for a long time. Retinitis pigmentosa occurs in many forms, with varying hereditability, severity, and speed of progression. Retinitis pigmentosa is a important cause for visual impairment in working-age people. No treatment is available.

25 Retinoblastoma Retinoblastoma is the most common intraocular tumour in children. The colour is typically white.

26 Severe nonproliferative diabetic retinopathy A 60-year-old male with type 2 diabetes has severe nonproliferative retinopathy: different types of haemorrhages and microinfarctions. The central retina is unaffected. The patient needs careful follow-up.

27 Successful panphotocoagulation Successful panphotocoagulation: the growth of neovascularisation has been halted.

28 Toxoplasma retinochoroiditis in a child Maternal toxoplasmosis has spread into the foetus, causing a central macular inflammatory scar. The central visual acquity is poor and the child has strabismus.

29 Typical findings of diabetic retinopathy A young woman with type 1 diabetes. Several typical findings of diabvetic retinopathy: engorged veins, microaneurysms, different types of haemorrhages, microinfarctions, IRMA (intraretinal microvascular abnormalities), and neovascularisation (a typical vessel formation is visible on the temporal side of the macula).