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Retinoblastoma
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Claire Hartnett, Mandeep S. Sagoo, M. Ashwin Reddy
A detailed retinal examination under general anesthesia (EUA) is required for an accurate diagnosis to first confirm the condition by clinical phenotype from potential differential diagnoses such as Coats disease, persistent fetal vasculature, toxocara, medulloepithelioma, and vitreous hemorrhage. The anterior segment of the eye must also be examined carefully for signs of disease involvement including intraocular pressure and horizontal corneal diameter measurements. A thorough fundus examination with scleral depression must be performed with visualization of the retina to the ora serrata.
Retinal Tears and Detachments
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Fundus: Dilated indirect ophthalmoscopy should be performed with a 90-diopter or widefield viewing lens. A thorough examination of the peripheral retina should be undertaken out to the ora serrata in search of retinal breaks. If this is not possible then a contact lens such as a three mirror lens should be used to visualise the peripheral retina out to the ora serrata.
Vitreoretinal
Published in Mostafa Khalil, Omar Kouli, The Duke Elder Exam of Ophthalmology, 2019
A disinsertion of the retina at the ora serrata involving anterior and posterior to the vitreous base. Traumatic retinal dialysis is more common and located superonasally. Idiopathic dialysis is more commonly located inferotemporally. Retinal dialysis is the leading cause of traumatic RD in children and young adults. Management is with laser retinopexy if there is no associated RD, otherwise scleral buckle is used.
Bilateral Ciliochoroidal Effusion with Secondary Angle Closure and Myopic Shift in Dengue Fever
Published in Ocular Immunology and Inflammation, 2023
On slit-lamp examination, anterior chamber was shallow in both eyes with no cellular reaction. Pupils were mid-dilated and sluggishly reactive to direct light. Intraocular pressure (IOP) was 24.8 mm Hg (right eye) and 23.3 mm Hg (left eye). Anterior segment optical coherence tomography (ASOCT) confirmed closure of iridocorneal angles in both eyes with reduction in the depth of the anterior chambers (Figures 1 and 2). Ultrasonography revealed choroidal detachment peripherally (Figures 3 and 4). Humphrey visual fields were normal. Fundus examination post dilatation later showed macular striae and brownish choroidal mounts with normal retinal vessels without haemorrhages (Figures 5–7). Ora serrata could be seen without indentation with the presence of peripheral lattice degeneration and retinal hole in right eye (Figure 8). Optical coherence tomography (OCT) showed the absence of cystoid spaces (Figure 9). Next day, she received single donor platelet transfusion in view of low platelet count (40,000/μL).
The Eyes Have It: How Critical are Ophthalmic Findings to the Diagnosis of Pediatric Abusive Head Trauma?
Published in Seminars in Ophthalmology, 2023
Cynthia K Harris, Anna M Stagner
In conclusion, does AHT exist? Yes. The described findings have been extensively documented and replicated in the medical literature for over 50 years. The retinal findings include retinal hemorrhages, often too numerous to count, occurring in all layers of the retina (preretinal, intraretinal, subretinal), and covering the peripheral pole and extending to the ora serrata. Such hemorrhages are often accompanied by retinoschisis and other ocular and periocular hemorrhages.25,57 Nevertheless, is one set of intraocular findings pathognomonic for AHT? No. But can these findings still be diagnostic of AHT? Yes, with the caveat that there is no competing and more compelling explanation, such as a motor vehicle accident, a fall from a significant height, a crush injury, ruptured vascular malformation, or severe coagulopathy (like in leukemia). In the absence of such alternative explanations, the diagnosis of AHT can be made with confidence.
Visualisation of peripheral retinal degenerations and anomalies with ocular imaging
Published in Seminars in Ophthalmology, 2022
Rene Cheung, Angelica Ly, Paula Katalinic, Minas Theodore Coroneo, Andrew Chang, Michael Kalloniatis, Michele C. Madigan, Lisa Nivison-Smith
The retinal periphery has been defined as the area from the ora serrata to the equator. It has also been defined geometrically or using retinal landmarks such as vortex veins (Figure 1). The geometric equator of the globe has been described as a ‘vertically orientated circle around the eye, perpendicular to the geometric axis.’12 The equatorial zone is frequently defined as the circumferential area extending 2.5 mm posterior and anterior to the geometric equator.13,14 Clinically, artificial boundaries delimited by the retinal vascular arcades and vortex veins have been used to define the central retina, mid-periphery and far peripheral retina, respectively.15 Self-devised16 and adapted grading grids17,18 have also been utilised to define peripheral retinal zones.