Transcript 35-PIH - MM Joshi Eye Institute

FUNDOSCOPY IN PIH
RETINA
Mirror to the cardiovascular system of the body
FUNDOSCOPY
Visualization of hypertensive changes
PIH
Retinal changes run parallel with the severity
of hypertension hence that of pre-eclampsia.
PROCEDURE
ONE DROP
EVERY 10 MINUTES
THREE TIMES
FUNDOSCOPY
AFTER ONE HOUR
BEFORE FOUR HOURS
SYSTEMIC HYPERTENSION
VASOSPASM
VASOSCLEROSIS
RETINOPATHY
NORMAL FUNDUS
Uniform Caliber
Smooth sinuous
course
Brach at obtuse
angle
VASOSPASM
NARROWING
STRAIGHTENING
ACUTE ANGLED
BRANCHING
A-V RATIO 1:3
VASOSCLEROSIS
SALU’S SIGN
Deflection in the course of the vein at
the Arterio-venous crossing
VASOSCLEROSIS
GUNN’S SIGN
Concealment of the vein
beneath the artery
at the Arterio-venous crossing
RETINOPATHY
SOFT EXUDATES
RETINAL HEMORRHAGES
RETINAL EDEMA
HARD EXUDATES
RETINAL DETACHMENT
RETINOPATHY
SOFT EXUDATES
Occulsion of precapillry arteriole
Capillary nonperfusion
Localised axoplasmic stasis
Compact yellowish white fluffy lesions
Cotton wool spots
RETINOPATHY
FLAME SHAPED
HAEMORRGHAGES
Fibrinoid necrosis in the vessel wall
Located in the Nerve fibre layer of retina
Bright red flamed shaped hemorrhage
RETINOPATHY
MACULAR STAR
HARD EXUDATES
Increased capillary Permeability
Retinal edema
Precipitation of lipids
Discrete dense yellow lesions
Macular star
RETINAL DETACHMENT
LOCALISED RETINAL DETACHMENT
Accumulation of Serous fluid
between
Retinal pigment epithelium
and
Neurosensory retina
RETINAL DETACHMENT
TOTAL BULLOUS DETACHMENT
OPTIC DISC EDEMA
MALIGNANT HYPERTENSIVE RETINOPATHY
KEITH-WAGENER-BARKER
1939
FEATURES
Narrowing of the retinal arteries
A-V CHANGES
SALU’S SIGN AND GUNN’S SIGN
K-W-R
GRADING
I
II
SURVIVAL
EXCELLENT
GOOD
RETINOPATHY
SOFT EXUDATES
FLAME HAEMORRHAGES
HARD EXUDATES
III
POOR
IV
VERY POOR
RETINAL EDEMA/RETINALDetachment
DISC EDEMA
AMERICAN
OPHTHALMOLOGICAL SOCEITY
K-W-R
GRADING
I
AOA
GRADING
FEATURES
O
Normal fundus
I
II
Focal Narrowing
Diffuse generalised narrowing
II
III
III
RETINOPATHY
IV
IV
DISC EDEMA
SOFT EXUDATES/FLAME HAEMORRHAGES
RETINAL EDEMA/RETINAL DETACHMENT
IMPLICATION
FEATURES
PREGNANCY
NORMAL FUNDUS
CONTINUE
FOCAL NARROWING
DIFFUSE NARROWING
RETINOPATHY
SOFT EXUDATES
FLAME HAEMORRHAGES
HARD EXUDATES
RETINAL EDEMA/RD
DISC EDEMA
TERMINATE
FUNDOSCOPY IN PIH
CONTINUE
TERMINATE
PROGNOSIS