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OPHTHALMOLOGY-IM 2, :recycle:
Central scotoma+ changes in color…
OPHTHALMOLOGY-IM 2
RETINITIS IN AIDS PATIENTS
HSV AND VZV RETINITIS
- acute retinal necrosis syndrome
- : keratitis, uveitis and conjunctivitis with eye pain,
- Funduscopy;central necrosis of the retina
- orneal blindness in the United States.
CMV RETINITIS 
- Most common serious complication of HIV pts
- full-thickness retinal inflammation
-----> edema and scarring
LS
- blurred vision, floaters and photopsia (sensation of flashing lights) , đau it ( ko anh huong kết mac hay giac mac)
CLS:
- Fundoscopy: yellow-white, fluffy, hemorrhagic lesions along the vasculature.
- CMV +
BC:
- blindness
- retinal detachment
Rx:
- oral antivirals (eg, valganciclovir)
HIV RETINOPATHY
- ko có triệu chứng LS
- tư giải quyết
- ko gây mờ mắt
CLS: hình ành nôi bong NHƯng KO xuất huyết
-
DIABETIC RETINOPATHY
3 typt:
- ko cò tắng sinh mạch máu: dilation of veins,microaneurysms,dot and blot hemorrhage,macular edema---> dot and blot hemorrhages
- tăng sinh nhẹ cotton wool spots
- tăng sinh + bênh ac tình:newly formed vessels.
-
HYPERTENSIVE RETINOPATHY
- hemorrhages, exudates and/or papilledem
- focal spasm of arterioles
- sclerosis and narrowing
- :red_cross: Acute vision loss not typical
----->Funduscopy: copper or silver wiring ( dải bạc)
CENTRAL RETINAL VEIN OCCLUSION (CRVO)- tắc TM trung tâm võng mạc
- đột ngột/1 bên mờ + KO dau / thức dậy vào buổi sáng
- thrombosis
- Risk: atherosclerotic risk/coagulopathy, hyperviscosity, chronic glaucoma
dx: fluorescein angiography
( phì dĩa thị giác/ dãn TM xoắn, xuất huyết, nổi bông- cotton wool spots----> blood thunder
1 ko macular edema-->> TD sát
2 macular edema->i ntravitreal injection of vascular endothelial growth factor inhibitors.
OPTIC NEURITIS
- nữ
- 2 mắt
- mất thi trường kiểu central scotoma.
- Swollen disc on exam
- thay đổi màu sắc
(Marked changes in color perception)
-
VITREOUS HEMORRHAGE - xuât huyết sau dich kính
- mất tầm nhìn ĐỘT NGỘT+ vât thể trôi nổi ( sudden + floaters
- diabetic retinopathy
- sói đáy mắt rất khó phát hiên và chỉ thầ y floating debris and dark red glow may be seen
-
CATARACT
-Risk factors: advancing age, diabetes, smoking, chronic sunlight exposure, and glucocorticoid use.
- Usually bilateral
- :check:Loss of night time vision is very
characteristic
CLS
- early cataract formation: normal red reflex and retinal visualization
- cataract progresses,red reflex is lost and retinal detail may not be visible
-
-
-
:recycle:
- Central scotoma+ changes in color perception
----> optic neuritiis or multiple scleroisis
-