Clinical Features of

Retinal Disease

______

David A. Quillen, MD

Penn State College of Medicine

Barbara A. Blodi, MD

University of Wisconsin-Madison

Handout modified from: Quillen DA, Blodi, BA, and Bennett TJ. Clinical Features of Retinal Disease. Quillen DA and Blodi BA, eds. Clinical . Chicago: AMA Press, 2002. CHAPTER 3 Clinical Features of Retinal Disease 71

TABLE 1 Clinical Features of Retinal Disease

Bull’s Eye Cherry Red Spot Choroiretinal Folds

Macular Diseases Age-Related Macular Age-Related Degeneration

Macular Hole (chronic) Hypotony Maculopathy

Pattern Dystrophy Idiopathic Chorioretinal Folds

Posterior Microphthalmos

Retinal Vascular Diseases Central Retinal Artery Occlusion

Hereditary Disorders Tay-Sachs Disease

Cone Dystrophy Niemann-Pick Disease

Retinitis Pigmentosa Cherry Red Spot Myoclonus

Fenestrated Sheen Macular Dystrophy

Concentric Annular Macular Dystrophy

Drug Toxicities Chloroquine/ Gentamicin Toxicity Hydroxychloroquine

Fomivirsen

Inflammatory Diseases Acute Macular Posterior Neuroretinopathy

UAIM

Tumors

Trauma Commotio Retinae

Peripheral Retinal Diseases

Vitreous

Other

Optic Disc Drusen

Retrobulbar Tumor

continued 72 CHAPTER 3 Clinical Features of Retinal Disease

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Choroidal Cotton Wool Spot Cystoid Neovascularization

Macular Diseases Age-Related Macular Age-Related Macular Degeneration Degeneration Post-Intraocular Surgery CME Pattern Dystrophy Vitreoretinal Traction Syndrome Polypoidal Choroidal Hypotony Maculopathy Vasculopathy Idiopathic Retinal Vascular Diseases Diabetic Branch Retinal Vein Occlusion Retinal Vascular Occlusions Central Retinal Vein Occlusion Leukemic Retinopathy Radiation Retinopathy Anemia Bone Marrow Transplantation Hereditary Disorders Best’s Disease Pigmentosa Stargardt Disease X-Linked Juvenile Gyrate Atrophy Drug Toxicities Interferon Toxicity Latanoprost-related CME Nicotinic Acid Maculopathy Epinephrine Reaction Inflammatory Diseases POHS HIV Retinopathy Birdshot Chorioretinopathy Multifocal Choroiditis CMV Retinopathy Intermediate Serpiginous Choroiditis Systemic Lupus Idiopathic Vitritis Erythematosus Behçet’s Disease Giant Cell Arteritis Polyarteritis Nodosa Cat Scratch Disease Tumors Choroidal Nevus Choroidal Melanoma Choroidal Osteoma Trauma Choroidal Rupture Purtscher’s Retinopathy Blunt Trauma Peripheral Retinal Diseases Chronic Vitreous Other Laser Photocoagulation Drusen CHAPTER 3 Clinical Features of Retinal Disease 73

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Drusen Flecked Retina Foveal Yellow Spot Syndromes

Macular Diseases Age-Related Macular Macular Hole, Stage I Degeneration Central Serous Chorioretinopathy

Choroidal Neovascularization

Cystoid Macular Edema

Pattern Dystrophy

Solar Retinopathy

Age-Related Macular Degeneration (Drusen)

Retinal Vascular Diseases Diabetic Retinopathy

Toxemia of Pregnancy

Branch Retinal Vein Occlusion

Central Retinal Vein Occlusion

Hereditary Disorders North Carolina Stargardt Disease Macular Dystrophy Fundus Albipunctatus

Dominant Drusen Flecked Retina of Kandori

Retinitis Punctata Albescens

Alport’s Syndrome

Drug Toxicities Crystalline

Inflammatory Diseases

Tumors Choroidal Nevus

Trauma

Peripheral Retinal Diseases Uveal Effusion Syndrome

Vitreous

Other Type II Glomerulonephritis

continued 74 CHAPTER 3 Clinical Features of Retinal Disease

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Intraretinal Lipid Exudates Macular Atrophy Hemorrhages

Macular Diseases Age-Related Macular Age-Related Macular Degeneration Degeneration Chronic Central Serous Angioid Streaks Chorioretinopathy Central Serous Chorioretinopathy Myopic Degeneration Chronic CME Macular Phototoxicity Pattern Dystrophy Retinal Vascular Diseases Diabetic Retinopathy Diabetic Retinopathy Hypertensive Retinopathy Hypertensive Retinopathy Branch Retinal Vein Branch Retinal Vein Occlusion Occlusion Central Retinal Vein Central Retinal Vein Occlusion Occlusion Leukemic Retinopathy Juxtafoveal Retinal Telangiectasis Radiation Retinopathy Radiation Retinopathy Anemia Retinal Arterial Macroaneurysm Ocular Ischemic Coat’s Disease Syndrome Retinal Arterial Macroaneurysm Sickle Cell Retinopathy Bone Marrow Transplantation High-altitude Sickness CHAPTER 3 Clinical Features of Retinal Disease 75

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Intraretinal Lipid Exudates Macular Atrophy Hemorrhages

Hereditary Disorders Retinitis Pigmentosa Stargardt Disease Best’s Disease North Carolina Macular Dystrophy Sorsby’s Macular Dystrophy Gyrate Atrophy Cone Dystrophy Rod-Cone Degeneration Drug Toxicities Intraocular Gentamicin Chloroquine/ Hydroxychloroquine Inflammatory Diseases HIV Retinopathy POHS CMV Retinitis Toxoplasmosis Sarcoidosis Multifocal Choroiditis Behçet’s Disease Serpiginous Choroiditis Tumors Choroidal Melanoma Retinal Capillary Hemangioma Trauma Blunt Trauma Chronic Retinal Detachment Commotio Retinae Shaken Baby Syndrome Choroidal Rupture Valsalva Retinopathy Terson’s Syndrome Purtscher’s Retinopathy Peripheral Retinal Diseases Vitreoretinal Traction Retinal Detachment Syndrome Retinal Tear/Detachment Vitreous Posterior Vitreous Detachment Other Laser Photocoagulation

continued 76 CHAPTER 3 Clinical Features of Retinal Disease

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Optic Disc Edema with Peripheral Pigment Epithelial Macular Star Pigmentation Detachment

Macular Diseases Central Serous Age-Related Macular Chorioretinopathy Degeneration Central Serous Chorioretinopathy Polypoidal Choroidal Vasculopathy

Retinal Vascular Diseases Hypertensive Retinopathy

Hereditary Disorders Retinitis Pigmentosa Stargardt Disease Pigmented Paravenous Retinochoroidal

Drug Toxicities Chloroquine Toxicity Siderosis

Inflammatory Diseases Cat Scratch Disease DUSN Toxoplasmosis Viral Retinitis Lyme Disease Syphilis Tuberculosis Polyarteritis Nodosa

Tumors Optic Disc Capillary BDUMP Hemangiomas

Trauma Commotio Retinae Choroidal Rupture

Peripheral Retinal Diseases Choroidal Effusion (late) Chronic Retinal Detachment Reticular Pigmentary Degeneration Lattice Degeneration

Vitreous Other Papilledema Scatter Laser Photocoagulation CHAPTER 3 Clinical Features of Retinal Disease 77

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Pigmented Lesions Preretinal Hemorrhage Retinal Crystals

Macular Diseases

Retinal Vascular Diseases Juxtafoveal Retinal Diabetic Retinopathy Juxtafoveal Retinal Telangiectasis Telangiectasis Sickle Cell Retinopathy Branch Retinal Vein Sickle Cell Retinopathy (Black Sunburst) Occlusion Sickle Cell Retinopathy Leukemic Retinopathy Retinal Arterial Macroaneurysm

Hereditary Disorders X-Linked Juvenile Bietti’s Crystalline Retinal Retinoschisis Dystrophy Cystinosis Hyperoxaluria

Drug Toxicities Tamoxifen Toxicity Canthaxanthine Toxicity Talc Retinopathy

Inflammatory Diseases Toxoplasmosis (inactive scar)

Tumors Choroidal Nevus Choroidal Melanoma CHRPE Bear Tracks Melanocytoma

Trauma Terson’s Syndrome Valsalva Retinopathy Shaken Baby Syndrome

Peripheral Retinal Diseases Retinal Tear

Vitreous Posterior Vitreous Detachment

Other

continued 78 CHAPTER 3 Clinical Features of Retinal Disease

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Retinal Retinitis Rubeosis Neovascularization

Macular Diseases

Retinal Vascular Diseases Diabetic Retinopathy Diabetic Retinopathy Branch Retinal Vein Central Retinal Artery Occlusion Occlusion Radiation Retinopathy Central Retinal Vein Occlusion Sickle Cell Retinopathy Retinopathy of Prematurity Coat’s Disease Leukemic Retinopathy Radiation Retinopathy FEVR Retinopathy of Prematurity Eale’s Disease

Hereditary Disorders Norrie’s Disease Incontinentia Pigmenti

Drug Toxicities Talc Retinopathy

Inflammatory Diseases Eale’s Disease Toxoplasmosis Pars Planitis CMV Retinitis Sarcoidosis HSV Retinitis Acute Retinal Necrosis PORN Cat Scratch Disease Toxocariasis Syphilis Fungal Behçet’s Disease

Tumors Retinoblastoma Choroidal Melanoma

Trauma

Peripheral Retinal Diseases Chronic Retinal Detachment Chronic Retinal Detachment

Vitreous CNS Lymphoma

Other CHAPTER 3 Clinical Features of Retinal Disease 79

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Subretinal Fluid Vasculitis Vitelliform Lesions

Macular Diseases Age-Related Macular Age-Related Macular Degeneration Degeneration Central Serous Pattern Dystrophies Chorioretinopathy

Retinal Vascular Diseases Coat’s Disease Eale’s Disease Toxemia of Pregnancy Ocular Ischemic Syndrome

Hereditary Disorders Best’s Disease

Drug Toxicities

Inflammatory Diseases Vogt-Koyanagi-Harada Behçet’s Disease Syndrome Posterior Scleritis Sarcoidosis Systemic Lupus Erythematosus Pars Planitis/ Multiple Sclerosis Toxoplasmosis Syphilis Tuberculosis Viral Retinitis/ARN Toxocariasis Birdshot Chorioretinopathy Lyme Disease Leukemic/Lymphoma Frosted Branch Angiitis

Tumors Choroidal Melanoma Choroidal Hemangioma Choroidal Metastasis

Trauma

Peripheral Retinal Diseases

Vitreous Idiopathic Vitritis CNS Lymphoma

Other Optic Pit

continued 80 CHAPTER 3 Clinical Features of Retinal Disease

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Vitreous Hemorrhage White-Centered White Dot Syndromes Hemorrhages

Macular Diseases Age-Related Macular Drusen Degeneration Retinal Vascular Diseases Diabetic Retinopathy Diabetic Retinopathy Branch Retinal Vein Occlusion Sickle Cell Retinopathy Leukemic Retinopathy Leukemic Retinopathy Hypertensive Retinopathy Retinal Arterial Anemia Macroaneurysm Eale’s Disease Coat’s Disease Peripapillary Arterial Loops Retinopathy of Prematurity Hereditary Disorders X-Linked Juvenile Stargardt Disease Retinoschisis Fundus Albipunctatus Retinitis Punctata Albescens Flecked Retina of Kandori Drug Toxicities CHAPTER 3 Clinical Features of Retinal Disease 81

TABLE 1 Clinical Features of Retinal Disease (cont’d)

Vitreous Hemorrhage White-Centered White Dot Syndromes Hemorrhages

Inflammatory Diseases Sarcoidosis HIV Retinopathy APMPPE Pars Planitis Candida MEWDS DUSN Toxoplasmosis Multifocal Choroiditis Serpiginous Choroiditis Birdshot Chorioretinitis Sarcoidosis Histoplasmosis Pneumocystis Choroidopathy Behçet’s Disease Toxoplasmosis Sympathetic Ophthalmia Syphilis Tumors Trauma Terson’s Syndrome Shaken Baby Syndrome Shaken Baby Syndrome Childbirth Optic Disc Evulsion Peripheral Retinal Diseases Retinal Tear/Detachment Vitreous Posterior Vitreous Detachment Lymphoma Other Subacute Bacterial Laser Photocoagulation Endocarditis Intracranial Hemorrhage Carbon Monoxide Poisoning/Anoxia

continued