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Ординатура / Офтальмология / Английские материалы / Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001

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Exophytic retinoblastoma

 

 

Multiglobulated white mass with

May be difficult to visualize

overlying retinal detachment

through deep detachment

 

 

CT diagnosis of retinoblastoma

Calcification

Optic nerve involvement

Orbital and CNS extension

Pinealoblastoma

Treatment Options of Retinoblastoma

1.Small tumours

Laser photocoagulation

Transpupillary thermotherapy

Cryotherapy

2.Medium tumours

Brachytherapy

Chemotherapy

External beam radiotherapy

3.Large tumours

Chemotherapy followed by local treatment

Enucleation

4.Extraocular extension

External beam radiotherapy

5.Metastatic disease

Chemotherapy

Poor Prognostic Factors in Retinoblastoma

1.Optic nerve involvement

2.Choroidal invasion

3.Large tumour

4.Anterior location

5.Poor cellular differentiation

6.Older children

Histology of retinoblastoma

 

 

Well-differentiated with many

Poorly differentiated

Flexner-Wintersteiner rosettes

 

 

 

Differential diagnosis of leukocoria

Congenital cataract

Persistent hyperplastic

Inflammatory cyclitic

 

primary vitreous

membrane

 

 

 

 

 

 

Unilateral or bilateral

Unilateral

Unilateral or bilateral

 

 

 

Coats disease

Posterior pole toxocara

Advanced retinopathy

 

granuloma

of prematurity

 

 

 

Unilateral

Unilateral

Always bilateral but

may be asymmetrical

 

 

INTRODUCTION TO RETINAL

DETACHMENT (RD)

1.Definitions and classifications

Retinal breaks

Retinal detachment

2.Anatomy

Anatomical landmarks

Variants of ora serrata

Vitreous base

3.Examination techniques

Indirect ophthalmology

Scleral indentation

Fundus drawing

Slitlamp biomicroscopy

Definition and classification

Break - full-thickness defect in sensory retina

Hole - caused by chronic retinal atrophy

Tear - caused by dynamic vitreoretinal traction

Morphology of tears

a. Complete U-tear

d. Operculated

b. Linear

e. Dialysis

c. Incomplete L-shaped

 

Retinal detachment (RD)

Separation of sensory retina from RPE by subretinal fluid (SRF)

 

 

Rhegmatogenous - caused by a

Non-rhegmatogenous - tractional or

retinal break

exudative

 

 

Normal anatomical landmarks

Short ciliary arteries

Nasal ora serrata

Vortex ampullae

Long ciliary artery

Vortex vein

Temporal ora serrata

Short ciliary nerves

Macula

Long ciliary nerve

Microcystoid degeneration

Short ciliary nerves

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