PANCE Blueprint EENT (7%)

Vascular disorders (PEARLS)

NCCPA™ PANCE Eyes, Ears, Nose, and Throat Content Blueprint eye disorders ⇒ vascular disorders

Retinal vascular occlusion Caused by systemic disorders, including diabetes, hypertension, preeclampsia-eclampsia, blood dyscrasias, and HIV disease -may affect the retina

  • Diabetic retinopathy falls into two main classes: nonproliferative (early) and proliferative (late, advanced)
  • Prolonged hyperglycemia causes basement membrane thickening, decreased pericytes (hyperproliferation), microaneurysms, and neovascularization
  • Leading cause of blindness in adults

Nonproliferative type (an early form of the disease)

Proliferative type (most severe, abnormal blood vessel growth)

  • Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease
  • At this stage, circulation problems deprive the retina of oxygen. As a result new, fragile blood vessels can begin to grow in the retina and into the vitreous. The new blood vessels may leak blood into the vitreous, clouding vision
  • Fundoscopic exam (abnormal growth of vessels) neovascularization
  • Complications: Preretinal and vitreous hemorrhages, retinal tears, retinal detachments, neovascular glaucoma, and blindness

TX:  control of blood glucose and BP

  • Ocular treatments: retinal laser photocoagulation, intravitreal injection of antivascular endothelial growth factor drugs (eg, ranibizumab, bevacizumab), intraocular corticosteroids, vitrectomy, or a combination
  • If diabetic get yearly dilated ophthalmoscopic examination
Hyphema (ReelDx + Lecture) (Prev Lesson)
(Next Lesson) Retinal vascular occlusion (Lecture)
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