retinal desease

Anatomy and physiology of retina

 Fundus of eye
• 10 layers,4 quadrants
• Fovea, macular
• Optic disc
 Anotomy of retina
Retina
A thin ,semitranparent,multilayered sheet of neural
tissue that lines the inner aspect of the posterior tw
o-thirds of the wall of the globe.ending at a point,th
e ora serrata.there are two parts:
1 Senory retina
2 Retinal pigment epithelium
But at the optic disk and the ora serrata,the retina
and retinal pigment epithelium are bound together
 Sensory retina

Horizontal cell
Neuron vascular
Bipolar cell
 anatomy of sensory retina

• Rods and cones

• External limiting membrance
• Outer nuclear layer
• Outer plexiform layer
• Inner nuclear layer
• Inner plexiform layer
• Ganglion cell layer
• Capillary
• Nerve fiber layer
• Internal limiting membrane
 Physiology of retina
• the light inject into the ocular,the Rods and
cones in the photoreceptor layer transfo-rmi
ng light stimulus into nerve impulse,that is c
onducted by the nerve fiber layer,through th
e optic nerve and ultimately to the occipital v
isual cortex.
• the macular is responsible for the best visu
al acuity and for color vision ,and most cell a
re cones.
Cones in macular
Normal fundus
 Vessels of retina( two sources)
• Choriocapillaris supply out one third of reti
na:rods ,cones ,outer plexiform and retina
pigment epithelium
• The branch of Central retinal artery supply
inner 2/3 of retina
• Central retinal vein
 Pathiology of retina
1,Vascular change
2,nerve degeneration
3,retinal pigment epithelium change
vascular change and nerve tissue d
egeneration
• 1 retinal edema
• 2 hemorrhage
• 3 exudation and microculation
• 4 vascular itself change
• 5 neuvascular
 1 retinal edema
• Cellular retinal edema
• Extracellular edema
Cellular retinal edema
extracellular Retinal edema
Central serous chorioretin-opathy(F
A)
Another patient
Macular edema(extracellular) optic
coherent tomography
 2 hemorrhage
1,Retinal hemorrhage
spot hemorrhage in cell layer
splinter hemorrhage in nerve fiber layer
2,Preretinal hemorrhage
half moon like hemorrhage
3,Vitreous hemorrhage
 3 Exudation
• Hard exudation : tissue ischemy, apopt-osi
s or necrosis ,lipd get together
• Soft exudation/cotton-wool spot
hard1
hard2
soft1
soft2
 Vascular itself change
Artery
1 Occlusion
2 microaneurysm
3 inflamation
4 hemorrhage and so on
Vein
1 occlusion
2 beeding
3 bleeding and so on
neuvascular
neuvascular
 Retinal pigment epitheliun change

1,Pigmental change
2,RPE proliferation
degeneration
Proliferation of Pigment Epithelium
Central retinal artery occlusion
 cause

• 1 vascular lasting depression

• 2 thrombus formation
• 3 embolism (embolus block )
• 4 hypertension, injury,blood coagulational f
ailure operation and so on
 Clinical apperance
• Painless ,suddenly,completely acuity visio
n loss
• derect light reflection loss,inderect light ref
lection is sensetive
• Retina ischemy edema with macular cherr
y-like red
 Sex and age
• Main are older than 50 ages
• The young also happen
• No sex diffrentiation
 treatment
• No effective management
• the follow ways can be tried :
1 High depression oxygen
2 decrease tonometery(depress eye-ball,s
urgery or other ways)
3 anticoagulant, fiberinolitycs