Oclusión de Vasos Retinianos

Anatomía

• La arteria carótida interna ingresa al AL Amyloidosis cráneo a través del agujero carotídeo y se ramifica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la arteria oftálmica, que luego se divide en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
  • La arteria central de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy; irriga los LOS Neisseria ⅔ internos de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy
  • Las arterias ciliares posteriores (rama de la arteria retiniana); irrigan el ⅓ externo de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy

• La vena central de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy
  • Drena directamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vena oftálmica superior o en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el seno cavernoso

Etiología

Oclusión de la arteria central de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy/oclusión de la rama de la arteria retiniana

• Embolia (causa más común de oclusión de la arteria central de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy ipsilateral)
  • Cardiogénica (abajo de los LOS Neisseria 40 años) o aterosclerótica (arriba de los LOS Neisseria 40 años y más comúnmente de origen carotídeo)
    • Los LOS Neisseria factores de riesgo incluyen:
      • Hipertensión
      • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus
      • Fibrilación auricular
      • Problemas valvulares cardíacos/foramen oval permeable (conduce a la ruptura de coágulos)
  • Embolia de colesterol; por lo general ocurre después de la cateterización de los LOS Neisseria vasos
  • Embolia séptica, como consecuencia de endocarditis Endocarditis Endocarditis is an inflammatory disease involving the inner lining (endometrium) of the heart, most commonly affecting the cardiac valves. Both infectious and noninfectious etiologies lead to vegetations on the valve leaflets. Patients may present with nonspecific symptoms such as fever and fatigue. Endocarditis infecciosa
• Afecciones inflamatorias como la arteritis temporal y otras formas de vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus

Oclusión de la vena retiniana central/oclusión de la rama de la vena retiniana

Las causas exactas no se conocen, aunque existe una asociación con las siguientes condiciones:

• Condiciones ateroscleróticas
  • Hipertensión
  • Hipercolesterolemia
  • Hábito tabáquico
  • Diabetes mellitus
  • Obesidad
• Estado de hipercoagulabilidad
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types falciforme
  • Síndrome antifosfolipídico
  • Mieloma múltiple
• Condiciones inflamatorias crónicas (e.g., lupus eritematoso sistémico (LES))
• Farmacológica (e.g., píldoras anticonceptivas orales)
• La oclusión de la vena central de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy se clasifica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2 tipos según la etiología: isquémica (retinopatía hemorrágica) y no isquémica (retinopatía por estasis venosa)

Presentación Clínica y Diagnóstico

Presentación clínica

Oclusión de la arteria central de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy

• Pérdida súbita, indolora y completa de la visión monocular
• Los LOS Neisseria pacientes pueden recordar episodios transitorios similares (e.g., amaurosis fugax Amaurosis fugax Transient complete or partial monocular blindness due to retinal ischemia. This may be caused by emboli from the carotid artery (usually in association with carotid stenosis) and other locations that enter the central retinal artery. Carotid Artery Stenosis)
• El examen de fondo de ojo revela:
  • Palidez o blanqueamiento de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy con atenuación de las arteriolas
  • Mancha “rojo cereza” en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la mácula ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la fóvea central)

Oclusión de la vena central de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy

• Puede ser una pérdida de visión monocular indolora repentina o gradual
  • Escotomas u otros defectos parciales del campo visual
  • Puede estar precedido por síntomas visuales de advertencia llamados “centelleos”
• El examen de fondo de ojo revela
  • Disco óptico inflamado (papiledema) y venas retinianas congestionadas con hemorragia
  • Aspecto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum “sangre y trueno” por hemorragia extensa (tipo isquémico)
  • Manchas “algodonosas”: depósitos blancos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy debido a la hinchazón del nervio retiniano (tipo isquémico)

Diagnóstico

El diagnóstico de ambas condiciones suele ser clínico, pero se pueden ordenar investigaciones adicionales.

• Angiografía con fluoresceína (para diferenciar las formas isquémicas de las no isquémicas de CRVO)
• Tomografía de coherencia óptica (utilizada para evaluar la progresión de la oclusión de la vena retiniana o la respuesta al AL Amyloidosis tratamiento)
• Doppler Doppler Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. Ultrasound (Sonography) carotídeo
• Velocidad de eritrosedimentación (VES) y proteína C reactiva ( PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)): para descartar vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus

Diagnóstico Diferencial

• Hemorragia vítrea: sangrado intraocular en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum o alrededor del cuerpo vítreo, generalmente debido a un traumatismo, un desgarro retiniano o cualquier enfermedad que cause neovascularización. Los LOS Neisseria pacientes presentan moscas volantes y visión nublada. El tratamiento incluye cirugía y evitar los LOS Neisseria anticoagulantes. La hemorragia vítrea se diferencia de la oclusión de un vaso por un inicio más gradual y la presencia de miodesopsias.
• Desprendimiento de retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy: separación de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy neurosensorial del epitelio pigmentario de la retina Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outermost layer is pigmented, whereas the inner nine layers are transparent. Eye: Anatomy. Clásicamente, la condición se presenta como una cortina que desciende sobre el ojo y provoca una pérdida de visión indolora, pero también puede causar miodesopsias y fotopsias desde el principio. Las causas más comunes son el envejecimiento, hipertensión y los LOS Neisseria traumatismos. El diagnóstico se realiza con un examen ocular directo y un ultrasonido. El tratamiento es la cirugía por láser o por congelación.
• Cataratas: opacificación del cristalino del ojo, lo que conduce a una disminución de la visión. Las cataratas a menudo se desarrollan lentamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum uno o ambos ojos. Los LOS Neisseria factores de riesgo son la edad y las lesiones oculares. Los LOS Neisseria síntomas pueden incluir visión borrosa o doble, problemas con las luces brillantes, halos alrededor de la luz, colores desvanecidos y problemas para ver de noche. Las cataratas se pueden visualizar como un cristalino opaco en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el examen oftalmológico. El tratamiento curativo es el reemplazo quirúrgico del cristalino.