21. Peripheral fundus

• fill with fluid during indentation
• can just ask px to look in a diff direction

• ubiquitous from young age and benign
• development of cystoid cavities
• grainy appearance

• raised bands of tissue running across the peripheral retina
• ocassional small hole at base

• enclosed oral bay
• mistaken for retinal hole

• white lesions on a dentate process
• similar to drusen
• veryyyy peripheral

• common with ageing, caucasian, benign
• equatorial migration of pigment up to sensory retina

common

• seen in young px
• loss of RPE/choriocapillaris and thinning of overlying sensory retina
• can see down to the sclear
• hyperpigmentation at edges

• multiple focal chorioretinal atrophies that aggregate and coalesce
• increased pigmentation dispersed throughout the lesion
• ageing
• wont affect VA too peripheral

• similar to pavingstone's but larger and creamier
• no loss of tissue: RPE has become depigmented
• becomes larger with age
• hyperpigmentation at margins

• unusual vitreoretinal relationship where the NFL has become disorganised
• seen in myopes and plp with dark fundi

• hazy white sheen with indistinct margin
• demarcated borders- high risk of retinal tear along this border
• scalloped margin

• retinal tear
• high myopia
• lattice degen
• vitreous degen

• homogenous flat brown areas darker than fundi
• posterior pole
• if seen in caucasians- sickle cell disease

• smooth ovoid elevation
• grape/finger like structure

• idiopathic
• RD
• uveitis
• Multiple myeloma

• choroid: grey green (through RPE filter)
• retina: black

• >equator
• solitary, margins are depigmented looks like its floating on the retina, benign

toxo scar: except upon inspection, well circumscribed edges

• has multiple polyps that develop into melanomas
• fatal by 35 years

• pigmented ovoid RPE lesions with a depigmented tail
• multiple lesions

• CHRPE: unilateral discoid and solitary
• Toxo: unilateral

soiltary, benign, elderly

• diabetes: bilateral
• carotid artery disease: unilateral
• MS: phlebitis and female
• trauma: following event

proliferative diabetic retinopathy

hyperpigmented border due to hyperplasia, pulling of RPE

• near equator
• grey structures overlying retina
• area of increase vitreoretinal traction

• record
• dont need to do anything about these
• maybe a site for retinal tear

• atrophic peripheral retina in lattic pattern and may develop tears/breaks/holes
• found in 20-40% eyes with RRD
• bilateral
• evident in 20s
• increased prevalence myopes

• lattice runs parallel to ora
• may/may not have hyperpigmentation/hyaluronisation of vessels
• area of retina has thinned

• lacuna- pocket of liquefaction overlying lattice lesion
• vitreous along edges of lattice lesion adheres to retina
• ischaemia and thinning will disturb RPE-> RPE hyperplasia and pigmentary changes
• holes/retinal atrophy
• REFERRRR

• atrophic holes: adjacent or within
• fluid between sensory retina and RPE

• sharply demarcated bands of tightly packed ‘snowflakes’ which give the peripheral retina a white frost-like appearance
• cigar shaped
• higher risk of RT or RB

• 6-12m referral
• immediate

vitreous liquefication: collagen free liquid filled spaces

• exudation of liquid from vitreous gel as collagens, other molecules clump/aggregate
• vitrous collapse

PP glial tissue that reminas attached to posterior vitreous cortex after a detachment

• IOP
• Matrix/proteoglycans between PR and RPE
• interdigitation of PR and RPE
• RPE pumping ions and fluid across the retina-> choroid

• seen after PVD
• seen behind the lens hanging from the superior vitreous base
• DDX: prepapillary vascular loop

PVD at site of vessels ruptures it

• IMPORTANT FOR PVD!
• pigment granules immediately behind the crystalline lens from RPE migrating anteriorly

• loss of sensory retinal due to nutritonal deprivation and inadequate supply from choriocapillaris
• RD risk low

• things in VF
• more common in myope, diabetes, post cataract

RD URGENT

when vitreous contract and pulls away from retina, rips piece of it out

• detachment risk
• not much since youve ripped retina out

• dangerous
• persistent tracion on flap which opens subretinal space to let liquified vitreous in

• yes!
• high rish of RD
• refer for laser

• separation of sensory retina at the ora
• semicircular shaped, red/brown break
• 1. spontaneous: IT, native indians
• 2. traumatic: SN, blunt trauma

• puckering of macula due to peripheral retinal tear
• RPE cells (schafers) drop down onto retina to cause proliferation

laser photocoagulation

is RB is large

• becomes atrophic and contracts
• minus undulations

if subretinal fluid remains stationary for >3m: hyperplasia of RPE at margin and demarcation will develop