Neuroconduction of Retina

  • 3 neurons:

    • Photoreceptor
    • Bipolar
    • Ganglion cell
  • Supporting tissue:

    • Müller cell
  • Rod (scotopic vision)

  • Cone (photopic vision)

  • Connecting cell between photoreceptor and ganglion

  • Conduct to brain


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

Signs

  • Intracellular edema

    • Retinal artery occlusion: ischemia leads to edema of bipolar cell, ganglion and RNFL
  • Extracellular edema

    • Capillary endothelium injury, and then exudation
  • Cystoid macular edema

    • Henle’s fibers are radially located; This pooling forms a flower-petal pattern.

Intracellular Edema

Extracellular Edema


Exudates

  • Leakage of capillary absorb deposition of lipid in outer plexiform layer

  • Since be called “soft exudation”

    • Precapillary arteriole occlusion axoplasmic transport blocked organelles stack