Ординатура / Офтальмология / Английские материалы / Ocular Differential Diagnosis 7th edition_Roy_2002

9. Trauma

10. Unknown

Duinkerke-Eerola, et al. Atrophic maculopathy associated with hereditary ataxia. Am J Ophthalmol 1980;90:846.

Isenberg SJ. The eye in infancy. Chicago: Year Book Medical, 1989.

Nomura R, et al. Unilateral cone dysfunction with bull's eye maculopathy. Ophthalmology 2001;108:49â??53.Bibliographic Links

Macular Wisps and Foveolar Splinter

These are noted in focal illumination with Goldmann contact lenses but are invisible ophthalmoscopically.

1. Direct and indirect ocular concussion

2. Following absorption of small prefoveal hemorrhage

3. Foveomacular retinitis

4. Juvenile macular degeneration

5. Old, healed chorioretinitis

6. Retinitis pigmentosa

7. Spontaneous senile posterior vitreous detachment

8. Whiplash injury

Daily L. Foveolar splinter and macular wisps. Arch Ophthalmol 1970;83:406â??411.Bibliographic Links

Daily L. Further observations on foveolar splinter and macular wisps. Arch Ophthalmol 1973;90:102â??103.Bibliographic Links

Macular Hypoplasia (Incomplete Macular Development Manifested by Decreased Vision)

1. *Albinism P.455

2. *Associated with autosomal-dominant aniridia

3. Associated with microcornea and corectopia

4. Associated with myelinated nerve fibers

5. Forsiusâ??Eriksson syndrome (Aland disease)

6. *Goldenharâ??Gorlin syndrome (oculoauriculovertebral dysplasia)

7. Krause syndrome (encephaloophthalmic dysplasia)

8. Ring chromosome

9. Syndrome of foveal hypoplasia and presenile cataract (O'Donnellâ??Pappas syndrome)â??autosomal dominant

10. Tuomaalaâ??Haapanen syndrome

11. Waardenburg syndrome (interoculoiridodermatoauditive dysplasia)

Ghose S, Mehta U. Microcornea with corectopia and macular hypoplasia in a family. Jpn J Ophthalmol 1984;28:126â??130.Bibliographic Links

Margolis S, et al. Retinal and optic nerve findings in Goldenhar-Gorlin syndrome. Ophthalmology 1984;91:1327â??1333.Bibliographic Links

Roy FH. Ocular syndromes and systemic diseases, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2002.

Szymanski KA, et al. Genetic studies of ocular albinism in a large Virginia kindred. Ann Ophthalmol 1984;16:183â??185.Bibliographic Links

Premacular Subhyaloid Hemorrhage

1. Branch retinal vein occlusion

2. Blood dyscrasia

3. Diabetic retinopathy

4. Retinal macroaneurysm

5. Terson syndrome

6. Valsalva retinopathy

Ulbig MW, et al. Long-term results after drainage of premacular subhyaloid hemorrhage into the vitreous with a pulsed Nd: YAG laser.

Retinal Vascular Tortuosity

1. Acute malnutrition

2. Aortic coarctation

3. Bazzana syndrome (angiospastic ophthalmoauricular syndrome)

4. Choked disc (see p. 593)

5. Chronic respiratory insufficiency, such as in cystic fibrosis and familial dysautonomia (Rileyâ??Day syndrome)

6. *Coats disease (retinal telangiectasia)

7. Congenital

8. Cri-du-chat syndrome (cat-cry syndrome) 9. Cryoglobulinemia

10. Down syndrome (trisomy 21)

11. Eales disease (periphlebitis)

12. Engelmann syndrome (diaphyseal dysplasia)

13. Fabry disease (diffuse angiokeratosis)

14. *Glaucoma, open angle

15. Granulocytic sarcoma of orbit

16. Hereditary hemorrhagic telangiectasis (Osler disease)â??tortuosity and varicosity P.456

17. Hypertension

18. Kenny syndrome (dwarfism, thickened long bone cortex, transient hypocalcemia) 19. *Leukemia

20. Lymphogranuloma venereum (Nicolasâ??Favre disease)

21. Maroteauxâ??Lamy syndrome (mucopolysaccharidoses type VI)

22. Macroglobulinemia

23. Mosse syndrome (polycythemiaâ??hepatic cirrhosis syndrome)

24. Myopia

25. Normal variation with fullness

26. Polycythemia with vessel fullness

27. Retinopathy of prematurity

28. Racemose hemangioma of retina, angiomatosis retinae without obvious tumor formation, or von Hippelâ??Lindau syndrome (retinocerebral angiomatosis)

29. Reimann syndrome (hyperviscosity syndrome)

30. *Sickle cell disease

31. Visceral larva migrans (nematode ophthalmia syndrome)

Davis JL, et al. Granulocytic sarcoma of the orbit. Ophthalmology 1985;92:1758â??1762.Bibliographic Links

Roy FH. Ocular syndromes and systemic diseases, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2002.

Wells CG, Kalina RE. Progressive inherited retinal arteriolar tortuosity with spontaneous retinal hemorrhages. Ophthalmology 1985;92:1015â??1024.Bibliographic Links

Venous Beading

1. *Diabetes mellitus

2. Loaiasis (Loa loa)

retinal pallor and a cherry-red spot in macula are noted.

1. Embolismâ??cardiac or pulmonary sources

A.Air emboli following trauma or surgery

B.Amniotic fluid embolization

C.Cardiac myxoma

D.Corticosteroid emboli

E.Espildoraâ??Luque syndrome (ophthalmic Sylvian syndrome)

F.Fat emboli following long-bone fractures

G.Iatrogenic trauma induced by angiography

H.*In older patientsâ??due to atheroma of carotid artery

I.In young personsâ??due to postrheumatic vegetations (rheumatic fever), cardiac catheterization, or valvotomy

J.Leudoemboliâ??vasculitis, Purtscher retinopathy, septic endocarditis

K.Moyamoya disease (multiple progressive intracranial arterial occlusion)

L.Nicolau syndrome (emboli of medication inadvertently introduced into artery)

M.Synthetic material used in cardiac and vascular procedures

N.Talc emboliâ??long-term intravenous drug abusers

O.Tumorsâ??atrial myxoma, mitral valve papillary fibroelastoma

P.With cerebral infarction after periocular subcutaneous cosmetic silicone injection

2. *Atherosclerosis of common carotid artery (ophthalmodynamometry employed for diagnosis)

3. Ischemia

A.Carotid occlusion or dissection

B.Essential hypotension

C.Following orbital floor fractures or repair

D.Following surgery for retinal detachment

E.Generalized shock

F.Heart failure (rare)

G.Kahler disease (multiple myeloma)

H.Kneeâ??chest position

I.Massive hemorrhage, such as that occurring in hematemesis, gastrointestinal bleeding, or surgical procedures

J.Migraine

K.Mosse syndrome (polycythemiaâ??hepatic cirrhosis syndrome)

L.Orbital hemorrhage following retrobulbar injection

M.After surgery for scoliosis

N.Too rapid lowering of blood pressure in hypertensive subjects

4. Inflammation

P.458

A.Abdominal typhus (typhoid fever)

B.African eye-worm disease (loiasis)

C.Arteriole vasculitis, such as periarteritis nodosa (Kussmaul disease)

D.Bacterial endocarditis

E.Behçet disease (dermatostomatoophthalmic syndrome)

F.Diphtheria

G.Familial factor V Leiden polymorphism and positive rheumatoid factor

H.Giant cell arteritis

I.Herpes zoster

J.Metastatic bacterial endophthalmitis

K.Mucormycosis (phycomycosis)

L.Pancreatitis

M.Recurrent toxoplasmic retinochoroiditis

N.Rocky Mountain spotted fever (spotted fever)

O.Rubeola (measles)

P.Subacute bacterial endocarditis

Q.Systemic lupus erythematosus

R.Takayasu disease (pulseless disease)

S.*Temporal arteritis

T.Toxoplasma retinochoroiditis

U.Varicella (chickenpox)

5. Blood disease

A.After platelet transfusion

B.Following ocular trauma with secondary glaucoma in youths with sickle-trait hemoglobinopathy

C.Polycythemia vera (Vaquezâ??Osler syndrome)

D.Sickle cell disease

6. Syphilis (acquired lues)

7. Associated factors

8. Diathermy of persistent hyaloid

A.Drusen of optic nerve (see p. 559â??560)

B.Giant cell arteritis

C.Papilledema (see p. 593â??601)

D.Subdural cerebral hemorrhage

E.Arteriosclerosis of central retinal artery

F.Chronic simple glaucoma

9. After dye, yellow photocoagulation

10. Complication of retrobulbar block

11. Degos syndrome (malignant atrophic papulosis)

12. Disseminated lupus erythematosus

13. Fabryâ??Anderson syndrome (glycosphingolipid lipidosis)

14. Goldenharâ??Gorlin syndrome (oculoauriculovertebral dysplasia)

15. Homocystinuria syndrome

16. Hyperhomocystinemia

17. Lyme disease

18. Neoplastic angioendotheliomatosis

P.462

Localized Arterial Narrowing

1. Retinal atrophy following:

A.Degeneration

B.Inflammation

C.Trauma

D.Treatment with diathermy, light, or cryopexy

2. Any vascular retinopathy

Nover A. The ocular fundus: methods of examination and typical findings, 4th ed. Philadelphia: Lea & Febiger, 1981.

Perkins ES, Dobree JH. The differential diagnosis of fundus conditions. St. Louis: CV Mosby, 1972.

Generalized Arterial Narrowing

1. Local causes

A.Apparent narrowing

1. High hypermetropiaâ??common, small disc, narrow vessels, sometimes pseudopapilledema (see p. 601)

2. Congenital microphthalmosâ??rare, hypermetropia, often cataract (see p. 252â??253)

3. Aphakiaâ??cataract operation, dislocated lens (see p. 405) 4. Hollenhorst syndrome (chorioretinal infarction syndrome) 5. Wagner syndrome (hyaloideoretinal degeneration)

B.Trauma

1. Avulsion of optic nerveâ??rare, secondary optic atrophy

2. Fracture involving bony optic canalâ??rare, secondary optic atrophy 3. Following retroocular injectionâ??rare secondary optic atrophy

4. Orbital hemorrhage following retroocular injection or orbital operationâ??rare, secondary optic atrophy

5. Carotid ligation for carotidâ??cavernous fistula, rare, secondary optic atrophy 6. Following angiographyâ??rare, secondary optic atrophy

7. Siderosis bulbiâ??metallic intraocular foreign body

C.Infection and edema

1. Orbital cellulitisâ??exophthalmos, restricted ocular movements

2. Following thyrotropic exophthalmosâ??ocular muscle paresis, lid retraction

D.Degenerations, such as progressive cone-rod degeneration

E.Primary tapetoretinal degenerations, such as retinitis pigmentosa; Hallgren syndrome (retinitis pigmentosa-deafness-ataxia syndrome)

2. Systemic disease

A.Arteriosclerosis

1. In involutionary sclerosisâ??population older than 50 years of age, generalized arteriolar narrowing, diminished light reflexes

2. In arteriosclerotic disease

a.Arteriosclerotic central artery occlusionâ??common arteriovenous crossing signs, focal arteriolar constriction

b.*Embolus from atheromatous plaque, common, sudden onset, visible white embolus

P.463

B.Hypertensive conditions

1. *Essential hypertensionâ??retinal hemorrhages, cotton-wool spots, arteriovenous crossing signs

2. *Malignant hypertensionâ??retinal hemorrhages, cotton-wool spots, edema of disc 3. Toxemia of pregnancyâ??rare, sometimes hemorrhages, cotton-wool spots, edema

of disc, serous detachment

4. Coarctation of aortaâ??rare, hypertensive changes vary greatly in degree 5. Pheochromocytomaâ??rare, hypertensive changes vary greatly in degree

6. Adrenal tumor, hyperaldosteronism (adrenal medulla tumor syndrome)â??rare, hypertensive changes vary greatly in degree

7. Cushing tumor (adrenocortical hyperfunction)â??rare, hypertensive changes vary greatly in degree

8. Motor-neuron disease of cervicothoracic cord hypertension; may occur after prolonged artificial pulmonary ventilation

C.Other forms of vascular disease

1. Retinal ischemiaâ??hypotension following severe or recurrent bleeding, unilateral blindness in patients

2. *Temporal arteritis (cranial arteritis, giant-cell arteritis)â??common, 50 years or older; mean age at onset, 55 years; sudden blindness at onset

3. Polyarteritis nodosa (Kussmaul disease)â??multiple signs involving choroid, retina, cornea, episclera, and ocular muscles

4. Proliferative diabetic retinopathyâ??arterial narrowing occurs in 17% of patients with proliferative diabetic retinopathy, mainly in cicatricial stage