Clinical/Imaging Findings
Drusen, Geographic Atrophy
Dry Macular Degeneration (Dry AMD)
SRH (Subretinal Hemorrhage), SRF (Subretinal Fluid), PED (Pigment Epithelial Detachment), Drusen
Wet AMD or Neovascular AMD
Floaters
Observation unless bothersome enough to the patient to warrant surgery (PPV)
Posterior Vitreous Detachment (PVD)
Observation
Caused by a retinal tear or hole
Rhegmatogenous Retinal Detachment
Small moving shadows seen on OCT
Vitreous Opacities - could be hemorrhage, could be floaters
Glistening, crinkled sheen to the retinal surface
ERM (Epiretinal Membrane)
Retinoschisis
Usually observation, sometimes demarcation barrier laser (can rarely lead to RD)
Retinal Tear
Laser
Scar Tissue contracts and causes the retina to separate from the RPE
Tractional Retinal Detachment
Small hole in the central macula
Macular Hole
Dot Blot Hemorrhages, Lipid, Vitreous Hemorrhage, Microaneurysms, NVE (Neovascular growth Elsewhere)
Active PDR (Proliferative Diabetic Retinopathy)
Macular Hole
Vitrectomy with membrane peel vs observation
*Bonus Question: When would we observe instead of surgical intervention?*
VMT (Vitreomacular Traction)
Observe vs surgery
*Bonus Question: When would we observe vs surgery?*
No breaks/tears in the retina, often caused by leaking blood vessels or a tumor
Exudative or Serous Retinal Detachment
Honeycomb pattern in fovea
CME (Cystoid Macular Edema)
Scattered flame shaped hemorrhages in all four quadrants, often w/CME and SRF on OCT
CRVO
CME (Cystoid Macular Edema)
NSAID topical therapy, topical steroids, Sub-Tenons Kenalog Injection (STK), intravitreal steroid injection, systemic treatment of an inflammatory disorder
CRVO (Central Retinal Vein Occlusions) & BRVO (Branch Retinal Vein Occlusions)
Anti-VEGF injections, steroid injections, sometimes laser Treatment
Parasitic organism that infects many animals, although cats are the defective host and shed the organism in their feces.
Toxoplasma Gondii
Hypopyon, Cells and Flare in the AC, Conjunctival Injection, Corneal Edema
Endophthalmitis
Cherry red spot in the central macula with surrounding retinal paleness
CRAO
CRAO (Central Retinal Artery Occlusion)
Undergo urgent evaluation for possible stroke, including neuroimaging and a systemic workup. Possible Hyperbaric Chamber. Observation.
Choroidal Melanoma
Radiation therapy with plaque, proton beam therapy, or gamma knife. Enucleation.
One of the most common inherited retinal dystrophies. Several genes have been implicated, the most common being the ABCA4 gene.
Stargardt Disease