Retinal Diseases

Abstract

Retina is located at the innermost layer of the wall of the eyeball, which surrounds the vitreous together with the nonpigmented ciliary epithelium, suspensory ligament, and posterior capsular of the lens.

Retina is located at the innermost layer of the wall of the eyeball, which surrounds the vitreous together with the nonpigmented ciliary epithelium, suspensory ligament, and posterior capsular of the lens.

From the inside out, the retina consists of inner limiting membrane, neural fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer, outer nuclear layer, outer limiting membrane, and photoreceptors. The outer segment of photoreceptors is surrounded by the microvilli on top of the pigment epithelium. The pigment epithelium is connected by tight junction, which constitutes the inner barrier of the retina. Figure 2.1a, b show the biopsy section and schematic diagram of the retina.

Fig. 2.1

Schematic diagram of retina. (a) Biopsy section of the retina. (b) Schematic diagram of retina layers

The fovea is located in the center of the posterior retina, 3 mm lateral to the optic disc. The central of the fovea is the avascular foveola, which is the most sensitive part of visual acuity. The optic disc lies 3 mm medial to the macular. This pale pink/whitish area is 1.8 mm in diameter with a slightly raised rim. The central retinal vessels emerge at the center of the optic disc, pass over the rim, and radiate out to supply the retina.

The blood supply of the retina mainly comes from central retinal artery and its branches, which runs into the eye within the optic nerve and supplies a sector of the retina as in the superior temporal, superior nasal, inferior temporal, and inferior nasal area. Cilioretinal artery, which mainly supplies macular, can be occasionally seen in some eyes. Central retinal artery mainly supplies inner layers of the retina, i.e., the part inside of the outer nuclear layer. There are two main levels of capillary networks, which are spreading like a vast cobweb throughout the retina. The inner plexus is situated at the level of nerve fiber layer and the ganglion cell layer and the outer plexus at the level of inner nuclear cell (Fig. 2.2a). The capillary plexus between the nerve fiber layer and the inner nuclear layer is distributed three-dimensionally, just like a “hammock”(Fig. 2.2b). There is no anastomosis or short-cuts between the retinal arterioles and venules.

Fig. 2.2

Schematic diagram of retinal vessels. (a) Schematic diagram of retinal vessels. (b) Framework of retinal arteries and veins, which looks like a hammock

The most wide usage of stereo photography is in diabetic retinal study [1,2,3,4,5]. Since 1968, Airlie House Symposium established the first diabetic retinopathy classification system, stereo fundus photography had been a cornerstone of diabetic retinopathy assessment, and the stereo photography protocol and severity classifications were modified during the Diabetic Retinopathy Study and were later expanded in the Early Treatment Diabetic Retinopathy Study (ETDRS). Until now stereo, 30°, seven-field, 35-mm color slides remain the gold standard for clinically evaluating diabetic retinopathy and are widely used in the DR studies such as Diabetic Retinopathy Clinical Research Network studies, the Action to Control Cardiovascular Risk in Diabetes Eye Study, Epidemiology of Diabetes Interventions and Complications, and the Diabetes Control and Complications Trial. Telemedicine programs also include stereo photography.

It is generally assumed that depth perception helps in distinguishing subtle extraretinal neovascularization elevated above the plane of the retina from intraretinal microvascular abnormalities (IRMAs) [6]. This discrimination is important on the ETDRS severity scale. Stereopsis may also aid in detecting new vessels elsewhere (NVE), new vessels on the disc (NVD), and vitreous fibrosis and hemorrhages. Confusing these advanced abnormalities with other lesions could result in missed opportunities for timely intervention to prevent vision loss. Correct classification of the diabetic retinopathy severity level is also essential in clinical and epidemiology studies in which diabetic retinopathy progression is observed. It is also believed that stereo photography’s illusion of depth is useful for assessing the severity of diabetic macular edema. Detailed classification of macular edema is dependent on identifying and measuring retinal thickening on 90D/78D microscopy or stereo pairs.

Due to the improvement of digital camera and the burdens of stereo photography to photographers and the patients, many studies has forgone stereo photography, such as the Liverpool Diabetes Eye Study, the UK Prospective Diabetes Study et al. [4, 7, 8]. But until 2010, Li HK had reported monoscopic photography was equal to the reliability of stereo photography for full ETDRS DR severity scale grading and a stereo effect may not be critical for accurate classification of ETDRS diabetic retinopathy severity when using current technology and an optimized framework for fundus photography acquisition and reviewing [5].

Besides the colorful stereoscopic photography, FFA also can be captured in stereo [9]. This facilitates the interpretation of stereo FA by visually separating retinal and choroidal circulation. Both of them can deeply explain and differentiate the exact location and mechanism of the diseases. Though not always necessary, well-resolved stereo images can aid in the interpretation of angiogram with, for instance, choroidal neovascularization associated with age-related macular degeneration.

Comparing with OCT images with cross-section scan, SS-OCT, or even en-face OCT, stereoscopic photography takes advantages such as wider field, freely selected angles, dynamic observation, and more vivid discrimination.

Fig. 2.3

Retinal vein occlusion

I. The cup of the optic disc is deepening

II. Retinal arteries became narrow and straight

III. Retinal veins became tortuous and wider, A/V ratio = 1/2 to 1/3

IV. Multiple retinal hemorrhages

Fig. 2.4

Retinal vein occlusion

I. Retinal arteries became narrow and straight

II. Retinal veins became tortuous and wider, A/V ratio = 1/2

III. Arteriovenous nicking, the Gunn sign

IV. The retinal artery deflected the retinal vein and changed the course of the vein, the Salus sign

V. Multiple retinal hemorrhages

Fig. 2.5

Branch retinal vein occlusion

I. Superficial retinal hemorrhage

II. Superficial retinal exudates

III. Deep retinal exudates

IV. Macular edema

V. Dilated retinal vein

Fig. 2.6

Inferior hemi central retinal vein occlusion

I. Highly elevated retina in the inferior part, with flame-shaped retinal hemorrhage

II. Mild macular edema

III. Dilated retinal vein

IV. Flame-shaped retinal hemorrhage, less elevated than region I

Fig. 2.7

Branch retinal vein occlusion

I. Superficial retinal hemorrhage

II. Retinal exudates

III. Ghost vessel in the distal part of the temporal inferior branch retinal vein

IV. Deep retinal exudates

Fig. 2.8

Old branch retinal vein occlusion

I. Ghost vessel of retinal neovascularization, extended as a webbed membrane

II. Retinal artery looks like a white line and extended to the peripheral retina

III. Webbed membrane with thin underlying retina, suspected localized retinal detachment

IV. Retinal artery looks like a silver wire

V. Regressive neovascularization in the peripheral retina

Fig. 2.9

Old branch retinal vein occlusion

I. The fibrotic membrane originated from the optic disc extended to the peripheral retina as like a tree branch

II. Inferior temporal branch was distorted by the membrane

III. Ghost vessel in the distal part of the retinal vein

IV. Extension of membrane

V. Laser spot

Fig. 2.10

Central retinal vein occlusion

I. Retinal hemorrhage around the optic disc

II. Macular edema (most elevated part)

III. Macular edema (the second layer)

IV. Deep retinal hemorrhage

Fig. 2.11

Central retinal vein occlusion

I. Severe optic disc edema, with massive hemorrhage

II. Macular edema

III. Intermediate retinal exudates

IV. The retinal artery looks like a silver wire

V. Engorged retinal vein and narrowing of adjacent artery

Fig. 2.12

Central retinal vein occlusion

I. Superficial retinal hemorrhage

II. Retinal exudates

III. Arteriovenous crossing change

IV. Macular edema

Fig. 2.13

Fluorescein fundus angiography of central retinal vein occlusion

I. Cystoid macular edema

II. The apex of the edema

III. Vessels pushed up by edema

IV. Blocked fluorescence by hemorrhage

Fig. 2.14

High myopia with old branch retinal vein occlusion

I. Weiss ring

II. Ghost vessel in the temporal inferior retinal vein branch

III. Fuchs spot

IV. Atrophy of retinal pigment epithelium and exposure of sclera

V. Large choroidal vessels

Fig. 2.15

Chronic branch retinal vein occlusion after laser treatment

I. Proliferative membrane extended from the optic disc to peripheral retina

II. Venous loop sprouted to the vitreous cavity

III. Ghost vessel of retinal vein

IV. Atrophic retinal areas

V. Retinal pigment proliferation

Fig. 2.16

Branch retinal artery occlusion

I. Occlusive spot of retinal artery

II. Pale zone corresponding to the occlusive artery

III. Partial involvement of macula

Fig. 2.17

Central retinal artery occlusion

I. Ligulate sparing of retinal area

II. Two suspected cilioretinal artery

III. Grey-whitish retinal area

IV. Cherry-red spot

V. Segmentation of the blood column in the arterioles

Fig. 2.18

Branch choroidal artery occlusion

I. Choroidal atrophy of the choroidal artery occluded area

II. The retina was mildly depressed

Fig. 2.19

Coats disease

I. Superficial retinal hemorrhage

II. Cholesterol crystal

III. Suspending retinal vessels

IV. Intermediate retinal exudates

V. Dilated retinal vessels

Fig. 2.20

Coats disease after laser treatment

I. Pre-retinal hemorrhage

II. Superficial retinal hemorrhage

III. Abnormal dilated vessels and yellow-white exudates

IV. Suspending vessels with white sheath

V. Laser spots and atrophic retinal area

Fig. 2.21

Coat disease after laser treatment

I. Dilated superficial retinal vessel

II. Dilated deep retinal vessel

III. The end of the vessel was dilated and leaked fluorescein, which was near the base of the lesion

IV. The area of laser, where the retina was atrophied

Fig. 2.22

Von-Hippel retinal capillary hemangiomatosis

I. Hemangioma

II. Dilated feeder artery

III. Draining vein

IV. Deep exudates

V. Old vitreous hemorrhages

Fig. 2.23

Von-Hippel retinal capillary hemangiomatosis

I+II. Two capillary hemangiomas

III. Draining vein

IV. Peripheral vitreous opacities

Fig. 2.24

Retinal pigment epithelium detachment

I. Apex of detachment

II. Intermediate retinal exudates

III. Boundary of detachment

Fig. 2.25

Sensory retinal detachment in the posterior pole

I. Highly elevated sensory retinal detachment of the posterior pole

II. Yellow-white lipid exudates in the margin of detached retina

Fig. 2.26

Sensory retinal detachment with pigment epithelium detachment

I. Area of pigment epithelium detachment

II. Area of sensory retinal detachment

III+IV. Intermediate retinal exudates

Fig. 2.27

Retinal macroaneurysm near the optic disc

I. Retinal macroaneurysm near the optic disc

II. Superficial retinal hemorrhage

III. Deep retinal hemorrhage

IV. Sub-RPE hemorrhage

V. Intermediate retinal hard exudates

VI. Vitreous hemorrhage

Fig. 2.28

Retinal macroaneurysm

I. Suspected area of the aneurysm

II. Superficial retinal hemorrhage

III. Subretinal hemorrhage and arterioles on the top

IV. Superficial retinal hemorrhage

V. Deep retinal exudates

VI Retinal epithelium detachment

Fig. 2.29

Retinal macroaneurysm near the optic disc

I. Retinal macroaneurysm near the optic disc

II. Superficial retinal hemorrhage

III. Deep retinal hemorrhage

IV. Sub-RPE hemorrhage

Fig. 2.30

Retinal macroaneurysm

I. Suspected area of the retinal aneurysm

II. Narrowing retinal artery and ghost vessel in the distal part

III. Superficial retinal hemorrhage

IV. Suspected retinal neovascularization

V. Intermediate retinal hard exudates

VI. Dilated retinal vein

Fig. 2.31

Retinal macroaneurysm

I. Suspected area of the aneurysm

II. Narrowing retinal artery and dilating distal dilating part

III. Macular edema

IV. Intermediate retinal exudates

V. Deep retinal exudates

Fig. 2.32

Multiple retinal macroaneurysms

I. Superficial retinal macroaneurysm

II. Deep retinal macroaneurysm

III. Intermediate retinal annular exudates

IV. Retinal artery

V. Retinal vein

Fig. 2.33

Retinal macroaneurysm

I. Superficial retinal hemorrhage

II. Suspected area of the aneurysm

III. Intermediate retinal annular exudates

IV. retinal artery

V. Dilated retinal vein and white sheath

Fig. 2.34

Subretinal annular exudates in the posterior pole

I. Highly elevated sensory retinal detachment in the posterior pole

II. Superficial retinal hemorrhage

III. Subretinal hard exudates

IV. Sclerosis of deep retinal vessels like a cradle

V. Sclerosis of superficial retinal vessels with white sheath

Fig. 2.35

Retinal macroaneurysm

I. The elevated retina elevated like a dome

II. The area with abnormal retinal artery, suspected retinal macroaneurysm

III. Ghost vessel of the retinal vein in the detached retina

IV. Deep retinal exudates

Fig. 2.36

Retinal macroaneurysm

I. The depressed area of retinal macroaneurysm after laser treatment

II. Sensory retinal detachment of macula

III. Apex of elevated retina

Fig. 2.37

Epiretinal membrane

I. Fibrotic membrane originated from the optic disc

II. Superior temporal membrane

III. Inferior nasal membrane

IV. Inferior temporal membrane and tractional retinal detachment

V. Fresh vitreous hemorrhage like an arc

Fig. 2.38

Epiretinal membrane in the posterior pole

I. White fibrotic membrane originated from the optic disc

II. Tractional macular dislocation

III. Oxygonal shape of Superior temporal branch of the retinal vein in the elevated retina showed and tractional retinal detachment

IV. Subretinal membrane

Fig. 2.39

Subretinal membrane

I. Shallow retinal detachment in the macula area

II. Subretinal membrane

III. Pigmentation

Fig. 2.40

Subretinal fibrous membrane

I. Subretinal fibrous streak superior to the optic disc

II. Ghost vessel in the retinal vein

III. Ghost vessel in the retinal artery

IV. Neovascularization bud near the retinal vein

V. The retinal vein was distorted like a loop

Fig. 2.41

Curly retinal edge

I. The inferior temporal edge of the retina was curly into the vitreous cavity

II. The impending retinal vein and its shadow

III. Exposed choroid

Fig. 2.42

Tractional retinal detachment

I. The retinal neovascularization extended into the vitreous cavity

II. Vitreous fibrous membrane

III. Retinal detachment in the peripheral retina

IV. Ghost vessel of the retinal vein

V. Retinal arterial sclerosis with white sheath

Fig. 2.43

Tractional retinal detachment

I. Vitreous hemorrhage

II. Vitreous proliferative membrane

III. Subretinal proliferative streak

IV. Estimated area of proliferative membrane

Fig. 2.44

Stellate retinal fold and retinal detachment

I. Stellate retinal fold in the lowest part of retinal adhesive area

II. Retinal detachment

III. Tractional retinal dislocation

IV. Subretinal membrane

Fig. 2.45

Tractional retinal detachment

I. Subretinal streak like a clothesline pole

II. Retinal detachment

Fig. 2.46

Retinal detachment

I. Discontinuous blood flow in inferior nasal branch of retinal artery and ghost vessel in the distal part

II. Subretinal exudates and hemorrhage

III. Exudative retinal detachment

Fig. 2.47

Stargardt disease

I. Boundary of the lesion, irregular with pigmentation

II. Retinal and choroidal atrophy in the lesion like a basin

III. Retinal vessels that passed through the lesion went attenuated

Fig. 2.48

Rhegmatogenous retinal detachment

I. Horse-shoe tear

II. Anterior flap with curly edge

III. Extensive retinal detachment and the lowest area of retinal detachment

IV. Apex of retinal detachment

Fig. 2.49

Rhegmatogenous retinal detachment

I. U-tear and the floating flap

II. Strong adhesion with the vitreous

III. Base of the flap

IV. RPE exposed

V. Apex of the detached retina

Fig. 2.50

Rhegmatogenous retinal detachment

I. Anterior flap of the retinal tear

II. Retinal tear with exposed underlying choroid

III. Posterior flap of retinal tear

IV. Retinal fold

Fig. 2.51

Tractional retinal detachment

I. Embedded and tortuous retina vein

II. Epiretinal membrane

III. Macular detachment duo to fibrous tissue

Fig. 2.52

Funnel retinal detachment

I. Optic disc

II. Detached macula

III. Detached retina

Fig. 2.53

Funnel retinal detachment

I. Extensive subretinal membrane

II. Detached retina in the macula and dislocation of macula

Fig. 2.54

Retinal cyst due to long-term retinal detachment

I. Retinal cyst and its border

II. Retinal tear

III. Retinal detachment

Fig. 2.55

Hypertensive retinopathy complicated with enlarged cup/disc ratio

I. The retinal artery was attenuated and straight

II. Engorged retinal vein, the A/V ratio was 1:3 to 1:2

III. Deep retinal hemorrhage

IV. C/D ratio ≈ 0.9

V. The vessel around the optic disc was tortuous and dilated

Fig. 2.56

Acute hypertensive retinopathy

I. Superficial hemorrhage and cotton wool spots in the macula

II. The retinal vein is engorged and tortuous, the A/V ratio is 1:3

III. Superficial retinal cotton wool spot

IV. Deep retinal cotton wool spot

Fig. 2.57

Diabetic retinopathy

I. Deep microaneurysm

II. Superficial exudates

III. Dilated retinal vein

IV. Pigmentation of the laser spot

V. Intra-retinal microvascular abnormality (IRMA)

Fig. 2.58

Non-proliferative diabetic retinopathy

I. Vitreous hemorrhage

II. Intra-retinal microaneurysm

III. Hard exudates

Fig. 2.59

Non-proliferative diabetic retinopathy

I. Microaneurysm

II. Circular exudates

III. Macular edema

Fig. 2.60

Non-proliferative diabetic retinopathy

I. Retinal microaneurysm

II. Intermediate retinal exudates

III. Multiple drusen

Fig. 2.61

Severe non-proliferative diabetic retinopathy

I. Macular edema

II. Microaneurysm

III. Non-perfusion area (NPA)

IV. Intra-retinal microvascular abnormality (IRMA)

V. Neovascularization of the optic disc (NVD)

Fig. 2.62

Diabetic retinopathy

I. Localized edema of the optic disc

II. Flame-shaped superficial retinal hemorrhage

III. Freckle deep retinal hemorrhage

IV. Hard exudates

V. Cotton wool spot

VI. Microaneurysm

Fig. 2.63

Fluorescein fundus angiography of diabetic retinopathy (early phase)

I. Optic disc

II. Edematous retina and elevated retinal vein

III. Retinal microaneurysm

IV. Intra-retinal microvascular abnormality (IRMA)

Fig. 2.64

Fluorescein fundus angiography of diabetic retinopathy (middle phase)

I. Blocked fluorescence by the hemorrhage inferior to the optic disc

II. Edematous retina and elevated retinal vein

III. Retinal microaneurysm

IV. Intra-retinal microvascular abnormality (IRMA)

V. Non-perfusion area (NPA)

Fig. 2.65

Diabetic retinopathy

I. Thread-like superficial retinal hemorrhage superior to the optic disc

II. Spotted deep retinal hemorrhage

III. Retinal microaneurysm

IV. Soft exudates

Fig. 2.66

Fluorescein fundus angiography of diabetic retinopathy (middle phase)

I. Thread-like superficial retinal hemorrhage superior to the optic disc and showed blocked fluorescence

II. Deep retinal hemorrhage and blocked fluorescence

III. Retinal microaneurysm

IV. Soft exudates and non-perfusion area

Fig. 2.67

Fluorescein fundus angiography of diabetic retinopathy (late phase)

I. Thread-like superficial retinal hemorrhage superior to the optic disc and showed blocked fluorescence

II. Deep retinal hemorrhage and blocked fluorescence

III. Retinal microaneurysm

IV. Soft exudates and non-perfusion area

Fig. 2.68

Non-proliferative diabetic retinopathy

I. Macular edema and massive hard exudates

II. Flame-shaped superficial retinal hemorrhage

III. Retinal microaneurysm

IV. Sectional white sheath of retinal artery

V. Deep retinal exudates

Fig. 2.69

Proliferative diabetic retinopathy

I. Venous beading

II. IRMA

III. NVD

IV. NVE

V. Microaneurysm

VI. Epiretinal membrane

Fig. 2.70

Proliferative diabetic retinopathy

I. NVD

II. NVE

III. Proliferative membrane of the vitreous

IV. IRMA

V. Hemorrhage adhesive to the vitreous filaments

VI. Sub-hyaloid hemorrhage

Fig. 2.71

Proliferative diabetic retinopathy

I. NVD

II. NVE

III. Proliferative membrane in the posterior pole along the vascular arc

IV. Retinal detachment

V. Vitreous hemorrhage

Fig. 2.72

Proliferative diabetic retinopathy

I. Abnormal retinal vessels

II. Superficial retinal hemorrhage

III. Subretinal hemorrhage

IV. Neovascularization showed by FFA

V. Irregular retinal vessels

Fig. 2.73

NVE on FFA

I. NVE extending into vitreous cavity

II. Dilated vein

III. Laser spots

IV. Microaneurysm

Fig. 2.74

Proliferative diabetic retinopathy

I. NVD

II. Cystoid macular edema

III. NVE

IV. Deep NVD

Fig. 2.75

Proliferative diabetic retinopathy after anti-VEGF injection

I. Fibrosis of NVD after VEGF injection

II. Residual NVE

III. Intra-retinal hemorrhage

IV. Bean-like vein

Fig. 2.76

Diabetic retinopathy after pan-retinal photocoagulation

I. Atrophied lesion of retinal pigment epithelium

II. Pigmentation

III. Retinal vessels

IV. Choroidal vessels

V. Vitreous opacities

Fig. 2.77

Diabetic retinopathy after pan-retinal photocoagulation

I. Proliferative streak of the vitreous

II. Pigmentation

III. Subretinal membrane

IV. A/V crossing

Fig. 2.78

Myopic fundus changes

I. The optic disc artery over the retinal vein

II. Optic cup

III. Choroidal atrophy temporal to the optic disc and exposed large vessels

IV. Pigmentation around the area of choroidal atrophy

Fig. 2.79

Myopic fundus changes

I. Leopard fundus changes and large choroidal vessels

II. Myopic crescent

Fig. 2.80

Myopic fundus changes

I. Estimated boundary of the posterior scleral staphyloma

II. Fuchs spot

III. Pigmentation and elevation

IV. Choroidal neovascularization

V. Coloboma of choroid and exposed sclera

Fig. 2.81

Myopic fundus changes

I. Choroidal atrophy temporal to the optic disc and exposed large vessels

II. Retinal hemorrhage

III. Choroidal neovascularization

Fig. 2.82

Myopic fundus changes

I. Massive choroidal atrophy around the optic disc

II. Sub-macular choroidal neovascularization

III. Choroidal atrophic area

Fig. 2.83

Myopic fundus changes

I. Posterior scleral staphyloma like a basin

II. Exposure of large choroidal vessels

III. Macular atrophy

IV. Disappearance of choroidal vessels

Fig. 2.84

Myopic fundus changes

I. Estimated boundary of the posterior scleral staphyloma

II. Multiple choroidal atrophy

III. Pigmentation in front of the retinal vessels

IV. Pigmentation of retinal pigment epithelium

V. Exposed choroidal vessels

Fig. 2.85

Myopic fundus changes

I. Reflections of silicone oil

II. Pigmentation of retinal pigment epithelium

III. Pigment proliferation and atrophy

IV. Leopard fundus changes

Fig. 2.86

Myopic fundus changes

I. Stair-step shaped staphyloma

II. Boundary of staphyloma

III. Retinal and choroidal atrophy and impending retinal vessels, cavity change underneath and exposed large choroidal vessels

Fig. 2.87

Myopic fundus changes

I. Estimated boundary of the posterior scleral staphyloma

II. Multiple choroidal atrophy and impending retinal vessels

III. Choroidal atrophy temporal to the optic disc and exposed large vessels

IV. Elevated retina

V. Deep retinal hemorrhage (CNV suspected)

Fig. 2.88

Retinitis pigmentosa

I. The thickness of the macula is within normal range

II. Severe thinning of retina outside the vascular arc

III. Attenuated retinal arteries

IV. Bone spicule formation

Fig. 2.89

Subretinal yellow-white exudates

I. The lesion locates under the sensory retina and above the RPE

Fig. 2.90

Multiple dotted choroidopathy

I+II. The lesion locates under the retina and different degrees of pigment proliferation

III. Exposure of large choroidal vessels and sclera

IV. Pigment proliferation under the retina showed livid color

V. Subretinal pigment proliferation showed black color

Fig. 2.91

Familial exudates vitreoretinopathy

I+II. The superior and inferior temporal retinal vessels are straight

III. Vitreous opacities and their shadows on the retina

IV. Vessels of different layers

V. Leakage of fluorescence of neovascularization in the peripheral retina

Fig. 2.92

Dry age-related macular degeneration

I. Intermediate retinal exudates

II+III. Confluent drusen under the retina

IV. Confluent drusen between the optic disc and macula

V. Fovea

Fig. 2.93

Familial exudates vitreoretinopathy

I+II. The superior and inferior temporal retinal vessels go straightly

III. Macular dislocated far away from the papilla

Fig. 2.94

Familial exudates vitreoretinopathy

I+II. Dendritic retinal vascular endings

III. Bulged endings of retinal vessels

IV. Communicative ending among veins/arteries

V. Leakage of fluorescence of neovascularization in the peripheral retina

Fig. 2.95

Congenital retinal folds

I. Temporal dislocation of papilla and vessels

II. Macula dislocation

III. Partially dilated veins around papilla

Fig. 2.96

Roth dot

I. White-gray spot due to bacterial accumulation and inflammation

II. Bleeding around the white-gray spot

III. Vitreous exudates

Fig. 2.97

Subretinal abscess

I. Superior-temporal white-gray abscess under retina

II. Retinal bleeding spots

III. Dilated retinal vein

Fig. 2.98

Syphilis masquerade by retinal vasculitis

I. Vitreous opacities or PVR

II. Sheathed retinal arteries and veins

III. Laser spots

IV. Syphilis spot