anatomy of retina about it and explanation.pptx

anatomy of retina about it and explanation

1. Anatomy of Retina Presenter: Mr. Sourav Das Moderator: Mr. Surajit Batabyal L V Prasad Eye Institute KVC Campus, Vijayawada

2. Learning objectives Basic Anatomy of Retina Layer of Retina Blood supply of Retina

3. Demographic Details Age : 50 years Gender : Female Profession : House wife Location : Vijayawada, Andhra Pradesh First visit : 23.08.2024

4. Chief Complaint : Gradually decrease of vision in distance and near in Left eye since 6 months. No other complaints History of present illness : No history of head and ocular injury  History of using spectacles since 3 months, PGP same. No prior procedures History of past illness : History of DM since 7 years under control on oral medication  

5. Visual acuity & Refraction OD OS Unaided VA 20/20, N12 @ 33 cm RI 20/50, N24 @ 33cm RI Aided VA 20/20, N6 @ 33cm RI 20/50, N8 @ 33cm RI Pin hole VA 20/20 20/50 PGP Add = +3.0D Add = +3.00D Objective Refraction +1.00 D +1.25 D Subjective refraction 0.00, Add= +2.25D 0.00, Add= +2.25D BCVA 20/20 (N06) 20/50 ( N08)

6. Slit lamp Examination             Right eye Left eye Eyelids Flat Flat Conjunctiva Normal Normal Sclera Normal Normal Cornea Clear Clear Anterior Chamber Normal in Contents and Depth PACD = 1CT Normal in Contents and Depth PACD = 1CT Iris Normal Color and Pattern Normal Color and Pattern  Pupil Round, Regular, Reacting Round, Regular, Reacting, No RAPD IOP (GAT) @ 10:37 am 12 mmHg 08 mmHg

7. Fundus Examination             Right eye Left eye Media Clear Clear PVD Absent Absent Optic Disc Size Medium size Disc Medium size Disc Cup/Disc Ratio 0.3 0.3 Optic Disc Normal Normal Blood Vessels Arteries:-Normal Veins:-Normal A/V Ratio:- 2:3 Arteries:-Normal Veins:-Normal A/V Ratio:- 2:3 Macula FR Dull, Whitish cuff around fovea. FR Dull, Whitish cuff around fovea. Fundus Retina ON Retina ON

8. Investigation:- OCT RETINA+ OCT ANGIOGRAPHY Both Eyes Plan of management BE NS II BE Fundus:-Disc WNL,.FR Dull ,whitish Cuff Around Fovea, Retina On OCT:-Intraretinal cavitations with EZ Disruption IMP:-BE Mactel PLAN :- BE GVP Explained RTC 3 months Diagnosis :- Both Eyes:- Senile Cataract Both Eyes:- Juxta Foveal Telangiectasia- JXT

9. Learning object :-1 Anatomy of Retina:- Retina, the innermost part of the eye ball. It is a thin and transparent membrane of they eye Its thickness at the posterior pole is approximately 0.56 mm At the equator 0.18-0.2 mm At the ora serrata 0.1 mm It is the highly developed tissue of the eye.

10. Gross Anatomy of Retina:- Ophthalmoscope examination it can divided three distinct region:- 1. Optic disc 2. Macula lutea 3. Peripheral retina

11. Optic disc :- It is a pale pink ,circular area of about 1.5 mm diameter. Increase in the size of the cup and difference in the size of cup of two eyes should be watched suspiciously to rule out glaucoma Macula lutea :- Macula lutea is a comparatively dark area 5.5 mm in diameter, it situated at the posterior pole of the eye, temporal to the optic disc. It consist :- Fovea Foveola Para foveal area Peri foveal area Umbo

12. Fovea :- Fovea is the central depressed part of macula. Diameter of Fovea 1.85 mm and 0.25 in thickness. Foveola :- Foveola forms the central floor of the fovea. Diameter 0.35 mm. Para foveal Area :- The Para foveal area is a belt that measures 0.5 mm in width and surrounds the foveal margin. Peri foveal area:- The peri fovea surrounds the parafovea as a belt that measure 1.5 mm with. Umbo :- Tiny depression is the center of the Foveola.

13. Peripheral retina:- It can be divided into 4 regions :- Near periphery Mild periphery Far periphery ora serrata 1.Near periphery:- Refers to circumscribed region of about 1.5 mm around the macula. 2.Mild periphery:- Occupies 3 mm wide zone around the near periphery. 3.Far periphery:- It extends from optic disc 9-10 mm on the temporal side and 16 mm on the nasal side in the horizontal meridian 4. Ora serrata:- It is the serrated peripheral margin where the retina ends and Ciliary body starts. At the ora, the sensory retina is firmly attached both to the vitreous and pigmented epithelium. 2.1 mm wide temporally and 0.7 -0.8 mm wide nasally . Its distance from the limbus is 6.0 mm nasally and 7.0 mm temporally It is located 6-8 mm away from the equator and 25 mm from the optic nerve on the nasal side.

14. Learning object :-2 Microscopic structure of the Retina from outwards to inwards :- Retinal pigments epithelium Layers of Rods and cons . External limiting membrane. Outer nuclear layer. Outer plexiform layer. Inner nuclear layer. Inner plexiform layer. Ganglion cell layer. Nerve fibre layer. Internal limiting membrane.

15. 1.Retinal pigments epithelium:- Outer most layer of retina. Consists of a single layer of hexagonal shaped cells containing pigmented. RPE is adherent to the underlying branch membrane (basal lamina of the choroid) and loosely attach to the layer of rods and cons. The space between RPE and Sensory retina is called subretinal space. 2. Layer of Rods and Cons:- Rods contains a photo sensitive substance visual purple and peripheral vision (scotopic vision) Cons responsible for central vision and photopic vision and colour vision. Total number of Rods 120 million. Total number of cones 6.5 million. 3. External limiting Membrane:- Actually it is formed by the junction between the cell membrane of photo receptors and Muller's cells. 4.Outer nuclear layer:- It formed by nuclei of rods and cones.

16. 5.Outer plexi form layer:- This layer contains the synapses between the rod spherule and cone pediclees with the dendrites of the bipolar cells. 6. Inner nuclear layer:- It is thin as compared to the outer nuclear layer ,this layer consists of five cells;- Bipolar cells Horizontal cells Amacrine cells Muller’s cells Capillaries of the central retinal vessels 7.Inner Plexiform layer:- It consist of synapses between the axon of bipolar cells dendrites of ganglion cells and processes of integrative amacrine cells. This layer is absent at the Foveola.

17. 8.Ganglion cell layer:- The cell bodies and nuclei of the ganglion cells lie in this layer. It is absent the foveola. 9. Nerve fibre layer:- This layer also contains;- 1. centrifugal nerve fibres. 2. Processes of Muller's cells 3. Neuroglial cells 4.Retinal vessels 10. Internal limiting membrane:- It consists of True basement membrane that forms the interface between retina and vitreous. Collagen fibrils. Hyaluronic acid of the vitreous. Plasma Membrane of the Muller cells and the Glial cells of the Retina.

18. Learning object :-3 Blood supply of retina:- Inner six layer –Central retinal artery Outer four layer –Choriocapillaries Fovea-Choriocapillaries Macular region- superior and inferior temporal branch of central retinal artery. 17