Retina

Retina

Hammouda Ghoraba Professor of ophthalmology Tanta University

Retina : -

What is the retina ?

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Anatomy : surface & minute

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Embryology

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Blood supply

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The retina is :

A part of the brain

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The retina is :

The visual receptor

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The eye : Is the retina surrounded by : A layer for nutrition = uveal tract A layer for protections = corneo scleral Adnexia for proper function

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RD : Types : - 1ry = rhegmatogenous = simple = idiopathic - Tractional - Exaudative H. Ghoraba

TRD e.g. 1- PDR 2- Cyclitic membranes 3- ROP 4- Others Fibrous band pulling the retina Ttt. : vitrectomy if ……… H. Ghoraba

Exaudative RD : The retina is pushed by : 1- Malignant mass

e.g. m.m. 2nd

2- Fluid exudation

e.g. Harada

- Subretinal haemorrhage

e.g. ARMD

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Ultrasonography

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Transilluminuten

Ttt = ttt of the cause H. Ghoraba

Rhegmatogenous RD :

Def. : Collection of subretinal fluid through a retinal break separating the neurosens ory retina from the retinal P.E. H. Ghoraba

What keeps the retina attached to P.E. !!

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Rhegm. RD : 3 forces : Apposition forces Adsorptive forces Absorptive forces

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RRD : Apposition forces : Anatomy of retina suites the inner surface of the globe

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RRD : Adsorptive forces : Adhesive materials between the photoreceptors and the PE

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RRD :

Absorptive forces : Pump function of the PE

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RRD :

What detaches the retina : - Retinal break - Traction on the break - Moving fluid H. Ghoraba

Rhegm. RD :

Retinal break : - Vitreogenic - Retinogenic

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Rhegm. RD :

Vitreogenic break : - The vitreous is a part of the retina ??? - Structure - PVD H. Ghoraba

Rhegm. RD :

Retinogenic break : Atrophy of retinal tissue

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Rhegm. RD :

Moving fluid Source : fluidly vitreous Part of aqueous Moving: eye movements (shaking) Bed rest

RD

Bil. Cover H. Ghoraba

Rhegm. RD :

Traction on the break By - vit. fibrils

e.g. operculum

- Traction band - Tangential traction

Tr. rhegm. RD membrane

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Rhegm. RD :

Apposition Adsorption Absorption

Break Against

Traction Mobile fluid

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PVD - Normal sequences - > 40 years - Centre to periphery - Early in

hoarseshoe direction

- Severe myopia - Trauma - Inflammations - After surgery - Others H. Ghoraba

Rhegm. RD : Incidence Patient

: > 40

why ?

Sex

: ♂ >

why ?

Refraction : Myopia 2/3 of RD are myopic 3% of myopes have RD

why ??

Bilateral in > 10% of cases H. Ghoraba

Rhegm. RD :

Cl. P. : C/O : photopsia = traction on the retina. light is the retinal language

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Rhegm. RD : C/O

Musca volitions : Sources : - collapsed vitreous fibrils - haemorrhage - P.E. migration

90% of musca don’t have breaks. what is the cause ??

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Rhegm. RD :

C/O : veiling and field defect V.A. when ??

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Rhegm. RD : May be asymptomatic for long time When ??

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Rhegm. RD :

Sings : = Fundus examination with dilated pupil Fundus : -

Grey RR why ?

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Retina is wavy & mobile

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VV: wavy

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Break

Tension : Soft : absorption of fluid through the break . Field : Defect

according to ……

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Rhegm. RD : If not treated -

Total R.D

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PVR

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Cataract

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Iridocylitis

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2nd gl.

proliferative vitreoretinopathy

Atrophia bulbi H. Ghoraba

Rhegm. RD. Ttt. = Surgery Goals : - Find the break - Close the break . Relief the traction on the break . H. Ghoraba

Rhegm. RD. Close the break : induction of inflammation Localized choridinal adhesions

Sealing the break ( no fluid can pass through )

By : Freezing = Cryo Light

= Photocaogulation

Heat

= Diathermy H. Ghoraba

Rhegm. RD :

Look to the follow eye why ?

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Rhegm. RD :

Relief the traction : Scleral buckling

Vitrectomy H. Ghoraba

Rhegm. RD :

- Tear without RD = laser photocaogulation

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Retinoschisis :

Retinal splitting of neurosensory layer - Senile - X-linked Not common Ttt

only if - endangers the macula Or

- rhegmatogenous component H. Ghoraba

.. Thank You • [email protected]