Retina

Professor of Ophthalmology Dr. Amani Badawi

Table of Contents

• Retinal Edema and Exudates

  • Intracellular Edema

  • Extracellular Edema

  • Exudates

  • Retinal Hemorrhage

    • Preretinal Hemorrhage
    • Subretinal Hemorrhage
    • Deep Hemorrhage
    • Superficial Hemorrhage

  • Neovascularization

  • Blood Vessel Change

Classification of Retinal Diseases

• Vascular diseases

• Macular diseases

• Retinal detachment

• Retinal degeneration

• Retinal tumor

• Ocular manifestation of general diseases

  • Retinal Vascular Disease

    • Retinal artery occlusion

    • Retinal venous occlusion

    • Diabetic retinopathy

    • Vasculitis

    • Coats disease

    • Central Retinal Artery Occlusion (CRAO)

      • Clinical Manifestation
      • Comparison of Eye Fundus
      • FFA of CRAO
      • Treatment
      • Prognosis

    • Central Retinal Vein Occlusion (CRVO)

  • Macular Degeneration

  • Retinal Detachment

  • Retinitis Pigmentosa

  • Retinoblastoma

• CRAO case

• RD case

• DR case

Anatomy and Physiology of Retina

• Human Retina
• Macula Lutea
• Histology of Retina
• Neuroconduction of Retina
• Vasculature of Retina
• Retina Barrier

Human Retina

• Fovea
• Optic nerve

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Normal Right Eye

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Macula Lutea Y

• Located 3mm temporally to the optic papilla, right on the visual axis.

• A concave central retinal depression is called Fovea Centralis.

• Macula lutea contains only cones; 1 cone synapses to 1 bipolar cell, which synapses to 1 ganglion cell, leading to the most sensitive vision. In peripheral retina, 600 rods connect to 1 ganglion.

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Histology of Retina Y

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Neuroconduction of retina

3 neurons: Photoreceptor Bipolar Ganglion cell

Supporting tissue: Müller cell

Vasculature of retina

• inner layer→ central retinal vascular system

• outer layer→ choroid（ciliary vascular system）

• macula lutea→ choriocapillaries

Retina barrier

Inner barrier（blood–retina barrier） dense connection of retinal capillary endothelium

Outer barrier（choroid-retina barrier） zonula occludens between the RPE

RPE- Bruch’s membrane- choriocapillaries complex

Symptoms

• Visual impairment - Related to lesion site

• Metamorphopsia

• Flickering - Vitreous traction to the retina

• Macropsia

• Micropsia - Retina edema→ fewer cones stimulated →micropsia

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