Posterior Segment Update Featured Speaker: Dr. Kyle Cheatham, FAAO, DIP ABO DISCLOSURE STATEMENT We have no direct financial or proprietary interest in any companies, products or services mentioned in this presentation.
Q A Which of the Retinal vessels following represents the TIGHTEST Macula vitreous attachment to the sensory retina? Optic nerve head Ora serrata
Q A Which of the Retinal vessels following represents the TIGHTEST Macula vitreous attachment to the sensory retina? Optic nerve head Ora serrata
VITREOUS ATTACHMENTS ORA SERRATA BACK OF LENS OPTIC NERVE MACULA RETINA VESSELS MACULAR HOLE ERM VMT VMA
Vitreous Review
NEOVASCULARIZATION PRERETINAL PROLIFERATIVE SUBRETINAL CNMV ( NET )
NEOVASCULARIZATION PRERETINAL PROLIFERATIVE SUBRETINAL CNMV ( NET ) DIABETES ROP VEIN OCCLUSION OIS SICKLE CELL ANEMIA
65 year old DM
Q A This patient is at risk Vitreous hemorrhage for all of the following EXCEPT? Preretinal hemorrhage Tractional retinal detachment Choroidal Neovascular Membrane
Q A This patient is at risk Vitreous hemorrhage for all of the following EXCEPT? Preretinal hemorrhage Tractional retinal detachment Choroidal Neovascular Membrane
NEOVASCULARIZATION PRERETINAL PROLIFERATIVE SUBRETINAL CNMV ( NET ) DIABETES ROP VEIN OCCLUSION OIS SICKLE CELL ANEMIA
NEOVASCULARIZATION PRERETINAL PROLIFERATIVE DIABETES TRACTIONAL RD ROP VEIN OCCLUSION OIS SICKLE CELL ANEMIA THREATS! PRERETINAL HEM VITREOUS HEM
Q A Which of the Diabetes following does NOT cause proliferative Vein occlusions retinopathy? Retinopathy of prematurity ARMD
Q A Which of the Diabetes following does NOT cause proliferative Vein occlusions retinopathy? Retinopathy of prematurity ARMD
DIABETIC RETINOPATHY NONPROLIFERATIVE (NPDR) PROLIFERATIVE (PDR) MACULAR DISEASE PRERETINAL VITREOUS HEMORRHAGES TRACTIONAL RETINAL DETACHMENTS MACULAR EDEMA MACULAR ISCHEMIA NEOVASCULAR CLAUCOMA
NEOVASCULARIZATION PRERETINAL PROLIFERATIVE SUBRETINAL CNMV ( NET ) DIABETES ROP VEIN OCCLUSION OIS SICKLE CELL ANEMIA
75 year old / DM and HTN
Q A What is the MOST Cholesterol plaque common cause of this condition? Heart valve plaque Thrombus Sickle Cell Anemia
Q A What is the MOST Cholesterol plaque common cause of this condition? Heart valve plaque Thrombus Sickle Cell Anemia
Q A Which of the ARMD following does NOT result in choroidal Lacquer cracks neovascular membrane Histoplasmosis formation? Toxoplasmosis
Q A Which of the ARMD following does NOT result in choroidal Lacquer cracks neovascular membrane Histoplasmosis formation? Toxoplasmosis
NEOVASCULARIZATION PRERETINAL PROLIFERATIVE SUBRETINAL CNMV ( NET ) CHOROIDAL RUPTURE HISTOPLASMOSIS BEST S DISEASE ANGIOID STREAKS LACQUER CRACKS AMD
NEOVASCULARIZATION SUBRETINAL CNMV ( NET ) SUB-RPE HEMORRHAGE CHOROIDAL RUPTURE SUB-RPE DETACHMENT SENSORY RETINAL HEMORRHAGE SENSORY RETINAL DETACHMENT THREATS! HISTOPLASMOSIS BEST S DISEASE ANGIOID STREAKS LACQUER CRACKS AMD
Wet AMD
Q A What type of net is visible in this patient? Pigment epithelial detachment (PED) Sub-RPE detachment Sensory retinal hemorrhage Sub-RPE hemorrhage
Q A What type of net is visible in this patient? Pigment epithelial detachment (PED) Sub-RPE detachment Sensory retinal hemorrhage Sub-RPE hemorrhage
What type of CNVM ( net )?
Types of Detachments
MACULAR DEGENERATION NON-EXUDATIVE (DRY) EXUDATIVE (WET) SICK RPE SUB-RPE HEMORRHAGE SUB-RPE DETACHMENT GEOGRAPHIC ATROPHY DRUSENOID PED SENSORY RETINAL HEMORRHAGE SENSORY RETINAL DETACHMENT
75 year old AA / HTN / High cholesterol / Smoker
Q A Which of the Hard drusen following is a risk factor for progression High cholesterol to exudative AMD in this patient? Focal hyperpigmentation African American race
Q A Which of the Hard drusen following is a risk factor for progression High cholesterol to exudative AMD in this patient? Focal hyperpigmentation African American race
MACULAR DEGENERATION NON-EXUDATIVE (DRY) BIG 4 EXUDATIVE (WET) SICK RPE SUB-RPE HEMORRHAGE SUB-RPE DETACHMENT GEOGRAPHIC ATROPHY DRUSENOID PED SENSORY RETINAL HEMORRHAGE SENSORY RETINAL DETACHMENT
30 year-old with 20/30 BCVA OD
Q A What is the MOST BRAO likely diagnosis? Sickle Cell Anemia Histoplasmosis Toxoplasmosis
Q A What is the MOST BRAO likely diagnosis? Sickle Cell Anemia Histoplasmosis Toxoplasmosis
Histoplasmosis Most common in the Ohio-Mississippi River Valley.
Histoplasmosis Most common in the Ohio-Mississippi River Valley. Caused by a fungus that grows in soil and material contaminated with bird or bat droppings.
Histoplasmosis Most common in the Ohio-Mississippi River Valley. Caused by a fungus that grows in soil and material contaminated with bird or bat droppings. Asymptomatic unless maculopathy develops; the earliest symptom is metamorphopsia.
Histoplasmosis Most common in the Ohio-Mississippi River Valley. Caused by a fungus that grows in soil and material contaminated with bird or bat droppings. Asymptomatic unless maculopathy develops; the earliest symptom is metamorphopsia. Starts in the CHOROID and can spill-over into the retina, but never the vitreous!
Histoplasmosis Most common in the Ohio-Mississippi River Valley. Caused by a fungus that grows in soil and material contaminated with bird or bat droppings. Asymptomatic unless maculopathy develops; the earliest symptom is metamorphopsia. Starts in the CHOROID and can spill-over into the retina, but never the vitreous! CNVM is a late manifestation; if it occurs, it is most likely to happen between the ages of 20 and 45.
NEOVASCULARIZATION SUBRETINAL CNMV ( NET ) SUB-RPE HEMORRHAGE CHOROIDAL RUPTURE SUB-RPE DETACHMENT SENSORY RETINAL HEMORRHAGE SENSORY RETINAL DETACHMENT THREATS! HISTOPLASMOSIS BEST S DISEASE ANGIOID STREAKS LACQUER CRACKS AMD
35 year old / BCVA: 20/200 OD, 20/400 OS
Q A What is the MOST Best s disease likely diagnosis? Myopic degeneration Histoplasmosis Angioid Streaks
Q A What is the MOST Best s disease likely diagnosis? Myopic degeneration Histoplasmosis Angioid Streaks
Angioid Streaks 50% idiopathic / Main known cause is pseudoxanthoma elasticum.
Angioid Streaks 50% idiopathic / Main known cause is pseudoxanthoma elasticum. May be asymptomatic or have profound vision loss from choroidal neovascularization (CNVM). 70% of patients will eventually have some form of vision loss.
Angioid Streaks 50% idiopathic / Main known cause is pseudoxanthoma elasticum. May be asymptomatic or have profound vision loss from choroidal neovascularization (CNVM). 70% of patients will eventually have some form of vision loss. Classic spoke-like (from the optic disc) red/orange or brown lines within the elastic core of Bruch s membrane.
VES Sport 4x Telescope DISCLOSURE STATEMENT We have no direct financial or proprietary interest in any companies, products or services mentioned in this presentation.
35 year old / BCVA: 20/200 OD, 20/400 OS
27 year old / BCVA: 20/30 OD, 20/25 OS
Best s Disease The age of onset varies but the condition classically presents in early childhood (5-10 years old) from AD inheritance. The majority of cases are detected with little or no patient symptoms (75% better than 20/40) 5 stages stage 5 occurs around age 50 and is characterized by presence of CNVM.
kmkupdate.com
Posterior Segment Update Featured Speaker: Dr. Kyle Cheatham, FAAO, DIP ABO DISCLOSURE STATEMENT We have no direct financial or proprietary interest in any companies, products or services mentioned in this presentation.