高血压英文ppt精品课件systemic diseases and eye

Systemic diseases and Eye diseases The 4th Affilitated Hospital of China Medical University Eye Hospital of China Medical University 1.To understand that difficult ocular diseases may correlate to systemic diseases. 2.To understand ocular manifestations of common systemic diseases. Object Internal diseases retinopathy leukemia tuberculosis Thyroid related eye diseases Vitamin deficiency diabetes hypertension AS eye Retinal Arteriosclerosis Senile degenerative sclerosis and arteriolar sclerosis Reflecting systemic arteriosclerosis to certain extent Arteriosclerotic retinopathy Fundus: A vessel course B caliber、 color、 arteriolar light reflex； C arterio-venous nicking； D retinal hemorrhage, exudates Grading of chronic hypertensive retinopathy retinal hemorrhage,edema, hard exudates,cotton-wool spot, disc swelling retinal hemorrhage, edema,hard exudates, cotton-wool spot silverwire arteriole 、 hemorrhage、 hard exudates arterial narrowing、 wider arteriolar light reflex Significance: different prognosis 70% 1% Grade 1 Grade 2 Grade 4 Acute hypertensive retinopathy Acute hypertensive retinopathy Pregnancy-induced Hypertension syndrome Malignant hypertension Chromaffin cell tumor nephritis Diabetic retinopathy (DR) DR is a serious complication of diabetes and a frequent cause of blindness 50% of diabetic patients suffer from DR Classification and grading of DR Nonproliferative DR I. Red hemorrhage (microaneurysm、 small bleeding spot) II. Yellow exudates (hard exudate、 small bleeding spot ) III. White cotton-wool spot (cotton-wool spot 、 hard exudate) Proliferative DR IV. Neovascularization and/or vitreous hemorrhage V. Neovascularization , fibrotic proliferation VI. Neovascularization, tractional retinal detachment Nonproliferative diabetic retinopathy Grade Grade Grade Nonproliferative DR Grading Proliferative Diabetic retinopathy Proliferative DR Grade Grade Grade Diagnosis 1.history of diabetes: more than 5 yrs； 2.visual acuity decreased or not； 3.ocular signs： microaneurysm, hemorrhage, exudates, neovascularization, fibrotic proliferation, tractional retinal detachment 4.FFA： leakage， telangiectasia； 5.clincal staging :non-proliferative， proliferative Treatment Drug, Laser, surgery 1.Blood glucose control 2.Blood pressure control 3.Thrombosis prevention 4.Improving capillary permeability 5.Improving axial transport, repairing neural fibers 6.Vitreous hemorrhage treatment 7.Laser Tyroid related immune orbitopathy TAO Graves ophthalmopathy Immune disease TRIO Eye: upper lid lag and retraction proptosis diplopia、 restricted extraocular movement conjunctival injection optic neuropathy urgent proptosis : Acute orbital hypertension TRIO Treatment: Correction of thyroid status Corticosteroid Immunosupression Botox A injection Radiation of pituitary gland Supportive therapy orbital decompression Brian trauma Optic nerve duct fracture（ pupil reflex） epidural hemotoma（ hippocampal hernia-oculomotor palsy、 pupil reflex） Subdural hemotoma（ intracranial pressure increases、 papillary edema） Skull-base fracture（ bilateral eyelid,conjunctival ,subdermal bruise） Brain trauma（ visual field、 nerve palsy） Purtscher retinopathy Retinopathy of prematurity Long time oxygen inspire, premature child Fibrovascular proliferation of avascular retina Retinal hemorrhage, vitreous hemorrhage Tractional retinal detachment Secondary glaucoma Eyeball growth retardation、 atrophy Syphilis Required： I stage-eyelid、 conjunctival chancre II stage-acute iridocylitis syphilitic roseola chorioretinitis stromal keratitis III stage-Argyll Robertson pupil（ 90%） optic atrophy （ 20%） oculomotor palsy congenital Stromal keratitis chorioretinitis（ peppersalt fudus） optic atrophy Syphilis Neurological disorders myasthenia gravis : autoimmune disease（ striated muscle ） Ach insufficiency neuromuscular conducting disorder clinical manifestation： sudden or slow onset symptoms alleviation in the morning or after rest aggravated when continuous and repeated excerise 0.5-1 mg neostigmine im 20-40yrs， female Neurological disorders Brain tumor: tumor mass： papillary edema (high intracranial pressure) tumor compression ： visual field defect Pupillary edema