Ret On Web

Toxoplasma Retinochoroiditis - Most common cause for infectious posterior uveitis. - Mainly caused by 3 strains of toxoplasma gondi. In which type II is severe and high chances of recurrences - can be congenital or acquired. - Clinical features :        1. Congenital- well defined punched out  hyperpigmented chorioretinal atrophy most commonly involving the macula and posterior pole. There can be underlying scleral show  Why macula is most commonly involved?  As in early deveopment of eye posterior pole is first developed Toxoplasma cysts gets encystedin smaller arterioles which are present near the macula. While resolution there can be associated vitreous adhesion and later ERM can develop.         2. Acquired -  Typical: Yellowish white necrotizing retinitis adjacent to the old scar with associated vitritis. If vitritis is more then retinitis lesion appears as headlight in fog appearence which is ch...

LVPEI has started clinical pearls Just A minute where can learn lot of practical tips in opthalmology. recap of these can be seen in youube video.  https://www.youtube.com/playlist?list=PLrEVEDGXFU9MdW7p8FwkzlanZBBvbz2nJ

Basic Interpretation of OCT angiography Introduction: OCTA is a non-invasive, non-dye imaging system that has ability to recognize both structural and blood flow information within retina. Concept of OCTA is that it employs motion contrast imaging resolution volumetric blood flow information which helps in  generating angiographic images . Use of SSADA( Split spectrum amplitude decorrelation angiography) algorithm helps to compare decorrelation signal between segmental OCT B scan taken at precisely same cross section in order to construct a map of blood flow. As retina has capillaries in various layers allows retinal segmentation into specific layers. 4 slabs which has been arbitrarily divided : 1.      Superficial retinal capillary plexus: capillary network in ganglion cell layer. Between ILM to inner plexiform layer 2.      Deep retinal capillary plexus: capillary network between inner plexiform and outerplexifor...

Algorithm for management of Uveitis: Any patient with uveitis attend to your clinic , first you examine and decide whether its anterior uveitis, intermediate or posterior uveitis.  Always first rule out infectious uveitis before further investigation of the paients Some pearls to know is whether its infectious uveitis. Some pearls which help to diagnose infectious uveitis: 1 . Toxoplasmosis :  Vitritis with yellowish full thickness necrotizing retinitis most commonly adjacent to the old scar.  This picture is clasical of toxopalsmosis and then u can start them of antitoxoplasma agents Sometimes, atypical presentation like new retinitis lesion without old scar or multiple retinitis lesion can be seen especially in immunocompromised patients.  2. ARN:  most commonly seen in immunocompetant person with classical triad of vitritis, retinitis which are more commonly peripheral and vasculitis. if not treated aggresively they w...