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Ophthalmology

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Retina

Question
55 out of 120
 

Causes of cherry red spot in macula are A/E (AIPG 2010)



A Niemann Pick
B GM1 Gangliosidosis

C Tay-Sachs
D Gaucher’s

Ans. D Gaucher’s

(Ref. Kanski, 6th Edition, PG 682.)

Cherry red spot at macula is a clinical sign seen in contact of thickening and less of transparency of retina at past. Pole.

Systemic associations:

1. Tay Sach’s

2. Niemann – Pick disease

3. Sandhoff’s disease

4. Generalized gangliosidosis

5. Sialoidosi type 1 and 2

6. Cherry red spot myoclonus syndrome

7. Points:

a. Lipids accumulate in ganglion cell layer retina appears white.

8. Other cause of cherry red spot.

a. CRAO

c. Metachromatic leukodystrophy

d. Multiple sulfatase deficiency

e. Berlin edema

9. But least common in Gaucher (Answer of exclusion !!!)

10.Orbital Cellulitis

a. Extension of paranasal sinusitis into the orbit can initiate orbital cellulitis, which manifests as chemosis, exophthalmos, diplopia, and immobility of the globe. Orbital cellulites may evolve into orbital abscess with ophthalmoplegia, proptosis, and vision loss.

b. The spread of infection into the orbital structures is the most common complication of sinusitis. It is particularly common with ethmoid infection, which can directly extend into orbit though a single thin barrier of lamina papyracea.

c. Inflammatory edema is the sentinel of the orbital infection. Clinical it appears as lid edema with no limitation of extraocular movement and normal visual acuity.

d. The process gradually evolves into orbital cellulitis, which presents as a mild fever and diffuse edema of orbital contents, proptosis, and erythema with no discrete abscess formation.

e. Initially, extraocular muscle movements and funduscopic examination findings are usually normal; as cellulitis progresses, the increase in chemosis, developing ophthalmoplegia, and vascular congestion on the funduscopic examination becomes evident.

f. Fever may increase to 102oF to 104oF, but the patient usually is not systemically ill. Subperiosteal abscess is identified as a purulent collection beneath periosteum of the lamina papyracea with displacement of the globe downward and laterally.

g. It may evolve into an orbital abscess, which is characterized by the purulent collection within the orbit and presents as proptosis, chemosis, ophthalmoplegia, and decreased vision. If the cavernous sinus thrombosis takes place, the patient demonstrates bilateral eye findings, prostration, and meningismus.

h. Optic neuritis characterized by acute loss of vision, decreased pupillary response, and pain with eye movement can be caused by extension of posterior ethmoidal or sphenoidal sinusitis.

i. Orbital cellulitis is adequately treated with sinus drainage and intravenous antibiotics. Surgical drainage of the orbit is required if orbital cellulitis continues to progress despite adequate levels of an appropriate intravenous antibiotic therapy, if physical sign (e.g fever, erythema, edema, proptosis) stabilize without improvement or if they worsen, if there is definite evidence of an abscess on ultrasound examination or CT scan, or if there is loss of visual acuity

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