retinal vascular diseases · vitreous hemorrhage located in under retina, mostly the source is...
TRANSCRIPT
![Page 1: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/1.jpg)
RETINAL VASCULAR DISEASES
Prof. Dr. Şengül Özdek www.sengulozdek.com
![Page 2: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/2.jpg)
Retinal Vein Occlusions
Retinal Artery Occlusions
Diabetic Retinopathy
Retinal Vasculitis (Behçet, Eales etc)
Retinal telangiectasis (Coats diesase)
ROP
Age Related Macular Degeneration
![Page 3: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/3.jpg)
Histology of retina
Internal limiting membrane
Nerve fiber layer
Ganglion cell layer
Inner plexiform layer
Inner nuclear layer
Outer plexiform layer
Outer nulear layer
External limiting membrane
photoreceptor
RPE
Bruch’s membrane
![Page 4: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/4.jpg)
Retinal Vasculature
inner layer→ central retinal vascular
system
outer layer→ choroid (ciliary vascular
system)
macula lutea→ choriocapillaries!
![Page 5: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/5.jpg)
Retinal Barriers
Inner barrier (blood–retina barrier): retinal
capillary endothelium
Outer barrier (choroid-retina barrier): zonula
occludens between the RPE, RPE- Bruch’s
membrane- choriocapillaries complex
![Page 6: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/6.jpg)
Symptoms
Visual impairment
Metamorphopsia
Macropsia / Micropsia
![Page 7: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/7.jpg)
Signs
Edema
Hemorrhage
Exudation
Neovascularization
![Page 8: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/8.jpg)
Signs
Intracellular edema
Extracellular edema
Cystoid macular edema
Retinal artery occlusion:
ischemia leads to edema
of bipolar cell, ganglion and RNFL
Capillary endothelium injury and
exudation
Henle’s fibers are radically located;
This pooling forms a flower-petal pattern.
![Page 9: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/9.jpg)
Retinal Edema
Intracellular edema
CRAO
Extracellular edema
CRVO
![Page 10: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/10.jpg)
Exudates Hard exudate
Soft exudate
Leakage of capillary →absorb →
deposition of lipid in outer plexiform layer
“Cotton-wool spot”
Precapillary arteriole occlusion→
axoplasmic transport blocked→organelles stack
![Page 11: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/11.jpg)
Cotton-wool spot
Hard exudate (Diabetic retinopathy)
![Page 12: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/12.jpg)
Hemorrhage
Subretinal hemorrhage
Retinal hemorrhage
Preretinal hemorrhage
Vitreous hemorrhage
Located in under retina,
mostly the source is choroid
Located in nerve fiber layer
Line, strip, flame-like, bright
red
Crescent-shaped hematocele
with transverse section
Profuse preretinal
hemorrhage into the vitreous
or hemorrhage of retinal
neospastic vasculature
![Page 13: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/13.jpg)
![Page 14: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/14.jpg)
![Page 15: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/15.jpg)
![Page 16: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/16.jpg)
Neovascularization
Retinal ischemia
VEGF
neovascularization
![Page 17: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/17.jpg)
Blood vessel change
Atherosclerosis, stenosis, occlusion
Tortuous vein, dilated vein, bead-like
change
![Page 18: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/18.jpg)
Microaneurysm
A-v cross sign
Vessel white sheath
![Page 19: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/19.jpg)
CENTRAL RETINAL ARTERY
OCCLUSION
![Page 20: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/20.jpg)
Causes
Atherosclerosis-related thrombus
Emboli:
Carotid: arheroma plaques
Cardiac: (calcific valvular or mural thrombosis in atrial fibrillation)
Aortic
Inflammatory: Giant cell arteritis, SLE
Trauma,
Thrombophilic disorders:
![Page 21: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/21.jpg)
Signs-Symptoms
Sudden painless visual loss
Mostly Counting Fingers level
Examination: RAPD!
(Direct pupil reflex
Fundus!
![Page 22: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/22.jpg)
![Page 23: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/23.jpg)
![Page 24: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/24.jpg)
FFA
![Page 25: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/25.jpg)
![Page 26: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/26.jpg)
![Page 27: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/27.jpg)
Treatment
Vasodilator: antispasm or pushing thrombus to the smaller branch
Reducing IOP: Massage
anterior chamber paracentesis
CAI, Mannitol 20%
O2 inhalation: mixture of 95% oxygen &5% carbon dioxide
Fibrolytics: for patients suspect of thrombosiis: urokinase, tPA
![Page 28: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/28.jpg)
Prognosis
Poor
Treatment?
Only within first few hours
![Page 29: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/29.jpg)
CENTRAL/BRANCH RETINAL VEIN OCCLUSIONS
![Page 30: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/30.jpg)
![Page 31: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/31.jpg)
Risk Factors
CRVO Systemic Hypertension Cardiovascular Disease Diabetes Mellitus POAG
BRVO Systemic Hypertension Cardiovascular Disease Glaucoma Increased Body Mass Index at 20 yrs old Hypercoaguable States
![Page 32: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/32.jpg)
Nonischemic vs Ischemic
![Page 33: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/33.jpg)
![Page 34: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/34.jpg)
CRVO Nonischemic
CRVO ischemic
![Page 35: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/35.jpg)
Treatment
Antitrombotic agents?
Intravascular thrombolysis?
IV steroids
Triamcinolone
Dexamethasone implants
IV Anti-VEGFs
Bevacizumab
Ranibizumab
![Page 36: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/36.jpg)
Ischemic CRVO
Neovascularization: Iris&angle
Neovascular Glaucoma
Panretinal Laser Photocoagulation: PRP
![Page 37: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/37.jpg)
BRANCH RETINAL VEIN OCCLUSION (BRVO)
![Page 38: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/38.jpg)
Treatment
Grid Laser
Laser PC to ischemic areas if NVE (+)
IV steroids
Triamcinolone
Dexamethasone implants
IV Anti-VEGFs
Bevacizumab
Ranibizumab
![Page 39: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/39.jpg)
![Page 40: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/40.jpg)
Prognosis
CRVO Approximately 30% ischemic (10 DD on FA)
NVG 40% to 60% of these eyes vs 5% Nonischemic
<10% developed retinal neovascularization
CVOS – 83% of undetermined developed ischemia or NVI
BRVO 1/3 to 1/2 recover VA of 20/40 or better w/o therapy
50% Ischemic (5 DD) of which 40% develop neovascularization; 60% of these develop VH
NVI Rare; 1%
![Page 41: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/41.jpg)
BRVO-Collaterals
![Page 42: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/42.jpg)
COATS DISEASE
![Page 43: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/43.jpg)
Unilateral gradual loss of vision
Predominantly in young males (1st decade)
Peak age of onset: 6-8 years
RD, NVG, Cataract, Leukocoria,
DD: Retinoblastoma
![Page 44: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/44.jpg)
Retinal Findings
Aneurismal and telangiectatic vessels
Breakdown of blood retinal barrier
Leakage of blood, serum, cholesterol to retina
Exudative RD….Loss of retinal red reflex
Loss of retinal capillary
Ischemia…. NV….NVG…
![Page 45: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/45.jpg)
Loss of retinal red reflex
![Page 46: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/46.jpg)
![Page 47: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/47.jpg)
![Page 48: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/48.jpg)
![Page 49: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/49.jpg)
![Page 50: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/50.jpg)
![Page 51: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/51.jpg)
NOTICE!
DIFFERANTIATE FROM RETINOBLASTOMA!
Other DD:
ROP, FEVR
![Page 52: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/52.jpg)
Treatment
Laser PC
Cryotherapy
IV-Anti-VEGF
RD: Surgery: VRS
Enucleation
![Page 53: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/53.jpg)
PREMATURE RETINOPATHY
![Page 54: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/54.jpg)
Patogenez
Normal retinal vaskülerizasyon:
Nazal : 36 hf
Temporal: 40.hf.
İntrauterin retinal vaskülerizasyon:
rölatif hipoksik ortam
Prematürite: avasküler retina...
O2 ted.....VEGF down regülasyonu
Vaskülerizasyon duraklar.... Avasküler alandan
VEGF.... VEGF up regülasyonu… ROP
![Page 55: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/55.jpg)
![Page 56: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/56.jpg)
Uluslararası ROP sınıflandırması (ICROP)
Parametreler
1. Zon (1,2,3)
2. Evre (1-5)
3. Yaygınlık (saat kadranı)
4. “Artı hastalık” varlığı
![Page 57: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/57.jpg)
ICROP
![Page 58: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/58.jpg)
Hastalığın yaygınlığı
![Page 59: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/59.jpg)
Evre 1: Demarkasyon hattı
![Page 60: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/60.jpg)
Evre 2
![Page 61: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/61.jpg)
Evre 2-3
![Page 62: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/62.jpg)
Evre III ROP Hafif-Orta-Şiddetli
![Page 63: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/63.jpg)
Evre 4
4a 4b 4b
![Page 64: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/64.jpg)
Evre 5
![Page 65: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/65.jpg)
Artı (plus) hastalık
Arka kutupta retinal vasküler dilatasyon ve tortuosite artışı
Aktif progresyon belirtisi
Çok hızlı ilerleme!....
![Page 66: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/66.jpg)
Zon 1, Artı hastalık (APROP)
![Page 67: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/67.jpg)
Tedavi endikasyonu (ICROP-revisited-2005)
zon I ROP: artı hastalık
(evre, yaygınlık önemsiz)
zon I ROP: evre 3 / artı hastalık (-)
zon II: evre 2 veya 3 / artı hastalık
International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123:991–999
![Page 68: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/68.jpg)
AP-ROP: Aggressive Posterior ROP (AP-ROP): ÇDDAP daha sık
Posterior yerleşim (Zone 1)
(+) hastalık
Evre önemsiz ve sınır genellikle belirsiz
72 saatte tedavi!...
![Page 69: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/69.jpg)
Tedavi öncesi ve sonrası
lazer
Anti- VEGF
![Page 70: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/70.jpg)
TARAMA
![Page 71: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/71.jpg)
Tarama AAP-AAO (2006 ROP Politikası)
<32hf ve <1500gr: Rutin tarama
1500-2000gr
>32 hf
Klinik gidiş stabil değilse
Kardiopulmoner destek ihtiyacı (+)
![Page 72: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/72.jpg)
Retina muayenesi
İlk muayene: Optimal zaman
**PP 4. hf veya PM 31. hf (hangisi daha geç ise)
Eşik veya eşik öncesi yüksek risk: 35-37hf
![Page 73: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/73.jpg)
TEDAVİ
![Page 74: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/74.jpg)
Krio - Lazer
![Page 75: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/75.jpg)
![Page 76: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/76.jpg)
![Page 77: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/77.jpg)
Zon 1 prematürite retinopatisinde tedavi sonuçları ve prognoz
Lazer tedavisi: Anatomik başarı >%90
Cerrahi tedavi: Anatomik başarı <%50
Tök L, Urgancıoğlu B, Özdek Ş, ve ark. Zon 1 prematürite retinopatisinde tedavi sonuçları ve prognoz. MN Oftalmoloji, 2008; 15(2): 101-105.
![Page 78: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/78.jpg)
Evre 4: Subtotal Retina dekolmanı a) extrafoveal b) foveayı da içine alan RD
TEDAVİ: CERRAHİ
![Page 79: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/79.jpg)
Çevresel Skleral Çökertme
![Page 80: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/80.jpg)
Vitrektomi
![Page 81: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/81.jpg)
Lens koruyucu vitrektomi
![Page 82: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/82.jpg)
Evre 5: Total retina dekolmanı: Lökokori
![Page 83: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/83.jpg)
Yeni tedaviler
Anti VEGF ajanlar (intravitreal)
Bevacizumab (Avastin/Altuzan)
Ranibizumab? (Lucentis)
![Page 84: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/84.jpg)
AGE RELATED MACULAR DEGENERATION
![Page 85: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/85.jpg)
ARMD
DRY WET
NEOVASCULAR or EXUDATIVE ARMD
EARLY VS ADVANCED DISEASE
![Page 86: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/86.jpg)
Risk Factors
Age >55y
Genetic predisposition: Family history
Cigarettes smoking
HT
![Page 87: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/87.jpg)
Signs&Symptoms
Metamorphopsia
Central scotoma
Visual loss
FUNDUS: Drusen, RPE atrophy
![Page 88: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/88.jpg)
Drusen Histopathology
• Small well-defined spots
• Usually innocuous
• Larger, ill-defined spots
• May enlarge and coalesce
Soft Hard
• Increased risk of AMD
![Page 89: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/89.jpg)
Diagnostic tests
Fundus Fluorescein Angiography (FFA)
Optic Coherence Tomography (OCT)
![Page 90: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/90.jpg)
FFA
![Page 91: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/91.jpg)
OCT
![Page 92: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/92.jpg)
OCT in wet ARMD
![Page 93: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/93.jpg)
OCT in Dry ARMD
![Page 94: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/94.jpg)
Advanced atrophic ARMD
![Page 95: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/95.jpg)
Management of Dry ARMD
Regular follow-up
Early visit if metamorphopsia develops
Anti-oxidant Vitamin-Fish oil intake to decrease the risk for neovascular ARMD
![Page 96: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/96.jpg)
Progression to wet type
![Page 97: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/97.jpg)
Neovascular ARMD
Rapidly progressive visual loss
Progressing central scotoma if untreated
Treatment:
IV-Anti-VEGF injections
PDT: rarely
Laser Photocoagulation?
![Page 98: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/98.jpg)
![Page 99: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/99.jpg)
![Page 100: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/100.jpg)
![Page 101: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/101.jpg)
Treatment
IV Pharmacotherapy
IV Anti-VEGF:
Ranibizumab
Bevacizumab
Aflibercept (VEGF trap eye)
PDT: Rarely
Laser Photocoagulation??
![Page 102: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/102.jpg)
IV Injection
![Page 103: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/103.jpg)
Response to Anti-VEGF
%25-30: VEGF Responder: ilk 3 doz
yeterli
%65: VEGF Bağımlı
%5-10: VEGF Cevapsız
![Page 104: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/104.jpg)
VA:0.3…………………VA:1.0
![Page 105: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/105.jpg)
Treatment
VA: CF 1m
VA: 0.3
PDT+4xIVL
![Page 106: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/106.jpg)
Nonresponders-Hemorrhagic response
![Page 107: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/107.jpg)
![Page 108: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/108.jpg)
DIABETIC RETINOPATHY
![Page 109: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/109.jpg)
DR-DMÖ
![Page 110: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/110.jpg)
![Page 111: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/111.jpg)
PDR-NV
![Page 112: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/112.jpg)
![Page 113: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/113.jpg)
![Page 114: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/114.jpg)
![Page 115: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/115.jpg)
![Page 116: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/116.jpg)
![Page 117: RETINAL VASCULAR DISEASES · Vitreous hemorrhage Located in under retina, mostly the source is choroid Located in nerve fiber layer Line, strip, flame-like, bright red ... Prognosis](https://reader030.vdocuments.mx/reader030/viewer/2022040409/5ec11446300dff050d3a4451/html5/thumbnails/117.jpg)
Panretinal Laser Photocoagulation treatment