Basic Retinal Anatomy

Transcript

1. ANATOMICAL CONCEPTS AND SDOCT A New Way to Look at Retinal/Choroidal Disease Larry J Alexander, OD FAAO
2. Understanding In Vivo Clinical Histology Introduction Part 1 Basic Retinal Anatomy Part 2 Vitreo-Retinal Interface Anomalies Part 3 Neurosensory Retinal Issues Part 4 Neurosensory Retinal Detachment Part 5 Retinal Pigment Epithelium Issues Part 6 The Choroidal Complex Part 7 The Concept of En Face Summary
3. THE BASIC CONCEPTS… WHAT IS THIS?
4. THE BASIC CONCEPTS… WHAT IS THIS?
5. THE BASIC CONCEPTS… WHAT IS THIS?
6. THE BASIC CONCEPTS… WHAT IS THIS?
7. THE BASIC CONCEPTS… WHAT IS HAPPENING? 20/30 20/20
8. Part 1 Basic Clinical Retinal Anatomy
9. BASIC CONCEPTS • THE ILM KEEPS THE RETINA OUT OF THE VITREOUS • THE INNER RETINA IS MORE RESISTANT TO EDEMA THAN THE OUTER RETINA • A BREAK IN THE PIL INDICATES COMPROMISE OF VISION • THE VITREOUS IS BOUND TIGHTLY TO THE RETINA AT THE ORA, THE DISC AND THE MACULA
10. BASIC CONCEPTS • THE RPE/BRUCHS COMPLEX KEEPS THE CHOROID OUT OF THE RETINA • THE RPE IS TIGHTLY BOUND TO BRUCHS • THE NEUROSENSORY RETINA IS LOOSELY BOUND TO THE RPE • THE VITREOUS STRUCTURE IS INSTRUMENTAL IN ALTERING THE RETINA
11. LEGEND NORMAL RETINA 1. INTERNAL LIMITING MEMBRANE 2. RETINAL NERVE FIBER LAYER (RNFL) 3. GANGLION CELL LAYER 4. INNER PLEXIFORM LAYER 5. INNER NUCLEAR LAYER 6. OUTER PLEXIFORM LAYER 7. OUTER NUCLEAR LAYER 8. PHOTORECEPTOR IS/OS BOUNDARY 9. RETINAL PIGMENT EPITHELIUM/BRUCH’S MEMBRANE COMPLEX 10. SUPERFICIAL RETINAL BLOOD VESSEL CASTING A SHADOW
12. BASIC CONCEPTS • IF YOU UNDERSTAND SIMPLE CLINICAL ANATOMY…. • YOU WILL UNDERSTAND SDOCT… • BUT IF YOU DO NOT… • YOU WILL NEVER UNDERSTAND SDOCT
13. THE BASIC CONCEPT IS WHERE IT IS TELLS YOU WHAT IT IS.
16. Example of Disease at the Vitreo- Retinal Interface
18. Example of Disease Within the Neurosensory Retina
20. Example of Disease Below the Retinal Pigment Epithelium
22. WITH SDOCT THE CLINICIAN IS ASSESSING ALTERATION OF CLINICAL ANATOMY. SPECIFIC CONDITIONS ALTER SPECIFIC ANATOMY. ARTERIAL BASED DISEASE = INNER RETINA VENOUS BASED DISEASE = OUTER RETINA
23. WHERE IS THIS?
24. Post Test • Which of the following has the tightest binding to one another? – A. RPE to Bruchs – B. RPE to ILM – C. Neurosensory Retina to RPE – D. The Outer Retina to the Inner Retina
25. Post Test • Which of the following has the tightest binding to one another? – A. RPE to Bruchs – B. RPE to ILM – C. Neurosensory Retina to RPE – D. The Outer Retina to the Inner Retina
26. Post Test • The vitreous is bonded to the retina at – A. The Macula – B. The Ora – C. The Optic Nerve Head – D. All of the Above
27. Post Test • The vitreous is bonded to the retina at – A. The Macula – B. The Ora – C. The Optic Nerve Head – D. All of the Above
28. Post Test • The choroid is like a swamp and really wants to leak up under and into the retina. What keeps it out? – A. The Photoreceptor Integrity Line – B. Bruch’s/RPE complex – C. The Internal Limiting membrane – D. None of the above
29. Post Test • The choroid is like a swamp and really wants to leak up under and into the retina. What keeps it out? – A. The Photoreceptor Integrity Line – B. Bruch’s/RPE complex – C. The Internal Limiting membrane – D. None of the above
30. Post Test • Which of the following is true? – A. Arterial based disease most often affects the inner retinal layers – B. Arterial based disease most often affects the outer retinal layers – C. Venous based disease most often affects the inner retinal layers – D. None of the above
31. Post Test • Which of the following is true? – A. Arterial based disease most often affects the inner retinal layers – B. Arterial based disease most often affects the outer retinal layers – C. Venous based disease most often affects the inner retinal layers – D. None of the above
32. Post Test • Where is this? – A. Under the RPE/Bruchs Complex – B. On the retinal surface – C. In the outer retinal layer – D. in the inner retinal layer – E. B, C and D
33. Post Test • Where is this? – A. Under the RPE/Bruchs Complex – B. On the retinal surface – C. In the outer retinal layer – D. in the inner retinal layer – E. B, C and D
34. CONGRATULATIONS YOU HAVE COMPLETED ANATOMICAL CONCEPTS AND SDOCT PART 1 BASIC RETINAL ANATOMY