12/29/2023 0 Comments Retinal reactivity definition1 The retinal venules typically present as both dilated and tortuous preceding and during a vascular occlusive event. Vascular occlusion is the second most common cause of blindness due to retinal disease, following diabetes. Here, we address the pathophysiology and commonly associated conditions that occur when patients present with abnormal vasculature, such as dilated, tortuous retinal veins dilated nontortuous retinal veins dilated retinal arteries tortuous retinal arteries and narrowed retinal arteries.ĭilated, tortuous retinal veins in an impending vein occlusion. Identifying anomalous vasculature, coupled with understanding the fundamental causes of pathological changes, can be crucial for identifying systemic conditions. Using it, you can obtain a side-by-side comparison of the retinal vasculature in each eye-a valuable indicator of worsening or resolving pathology. A reduced ratio could indicate retinal venular dilation, arteriolar attenuation or both.įundus photography can help monitor any changes in retinal vasculature and retinopathy. Examining the arteriolar-venular caliber ratio can assist in diagnosing vascular abnormalities and associated pathology. Changes in the shape, color and caliber of vessels can represent ocular manifestations of many systemic conditions. The retinal vessels should be studied during clinical examination. The eye allows for direct, noninvasive visualization of the body’s microvasculature (giving insight into the patient’s overall vascular health). However, the retinal venules and arterioles can provide vital diagnostic information. When performing fundus evaluations, you may be tempted to focus on the retina and optic nerve while overlooking the status of the retinal vessels. Gurwood, OD, Clinical Editor, retinal vascular miniseries I hope this educational experience becomes a useful resource for you in clinical practice. Without their expertise and willingness to participate, this miniseries would not have been possible. This four-part series introduces some of the root concepts of the neuro-retinal-systemic connection, along with some normal and abnormal retinal vascular phenomena. These associations support the use of the retinal vasculature as a biomarker for discovering, predicting or monitoring patients for potential retinal, systemic, neurological and cerebral vascular morbidities and risks-essentially broadening the responsibilities of the optometrist. Observable changes in retinal vascular architecture, such as increased retinal vein caliber (decreased artery-to-vein ratio), retinal vascular tortuosity, increased prominence of the retinal arterial reflex, venous nicking, “copper” or “silver wire” appearance as well as the discovery of cholesterol, calcium or thrombotic emboli are all associated with concurrent and future cerebrovascular events. Multiple studies demonstrate associations between newly forming and chronic retinal and cerebral vascular disease. Viewed through direct ophthalmoscopy, indirect ophthalmoscopy, indirect biomicroscopic ophthalmoscopy, ocular photography, fundus autofluorescence, optical coherence tomography (OCT), fluorescein angiography or OCT angiography, qualitative and quantitative retinal observations can reveal unfolding, worsening or impending retinal, systemic, neurologic or cerebrovascular disease. It’s the only part of the central nervous system we can observe noninvasively, along with its associated retinal, systemic and cerebrovascular pathologies. T he retina is a unique and fascinating anatomical structure. The Retinal Vasculature: A Marker for Ocular, Neurologic and Systemic Disease Part 4: Identify and Manage Retinal Vascular Tumors Part 3: Imaging Motion: a Review of OCT-A Part 2: Read the Retinal Vasculature Like a Pro Follow the links below to read the other installments in this miniseries:
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