1、Systemic diseases and Eye diseases,The 4th Affilitated Hospital of China Medical UniversityEye Hospital of China Medical University,1.To understand that difficult ocular diseases may correlate to systemic diseases.2.To understand ocular manifestations of common systemic diseases.,Object,Internal dis
2、eases,Retinal Arteriosclerosis,Senile degenerative sclerosis and arteriolar sclerosisReflecting systemic arteriosclerosis to certain extent,Arteriosclerotic retinopathy,Fundus: A vessel course B caliber、color、arteriolar light reflex； C arterio-venous nicking； D retinal hemorrhage, exudates,Grading o
3、f chronic hypertensive retinopathy,Significance: different prognosis 70% 1%,Grade 1,Grade 2,Grade 4,Acute hypertensive retinopathy,Diabetic retinopathy (DR),DR is a serious complication of diabetes and a frequent cause of blindness50% of diabetic patients suffer from DR,Classification and grading of
4、 DR,Nonproliferative DRI. Red hemorrhage (microaneurysm、small bleeding spot)II. Yellow exudates (hard exudate、 small bleeding spot ) III. White cotton-wool spot (cotton-wool spot 、hard exudate)Proliferative DRIV. Neovascularization and/or vitreous hemorrhageV. Neovascularization , fibrotic prolifera
5、tion VI. Neovascularization, tractional retinal detachment,Nonproliferative diabetic retinopathy,Grade,Grade ,Grade ,Nonproliferative DR Grading,Proliferative Diabetic retinopathy,Proliferative DR,Grade ,Grade ,Grade ,Diagnosis,1.history of diabetes: more than 5 yrs；2.visual acuity decreased or not；
6、3.ocular signs：microaneurysm, hemorrhage, exudates, neovascularization, fibrotic proliferation, tractional retinal detachment4.FFA：leakage，telangiectasia；5.clincal staging :non-proliferative，proliferative,Treatment,Drug, Laser, surgery1.Blood glucose control 2.Blood pressure control 3.Thrombosis pre
7、vention 4.Improving capillary permeability 5.Improving axial transport, repairing neural fibers 6.Vitreous hemorrhage treatment 7.Laser,Tyroid related immune orbitopathy,TAOGraves ophthalmopathyImmune disease,TRIO,Eye: upper lid lag and retractionproptosisdiplopia、restricted extraocular movementconj
8、unctival injectionoptic neuropathy,urgent proptosis :,Acute orbital hypertension,TRIO,Treatment:Correction of thyroid status Corticosteroid Immunosupression Botox A injection Radiation of pituitary gland Supportive therapy orbital decompression,Brian trauma,Optic nerve duct fracture（pupil reflex）epi
9、dural hemotoma（hippocampal hernia-oculomotor palsy、pupil reflex）Subdural hemotoma（intracranial pressure increases、papillary edema）Skull-base fracture（bilateral eyelid,conjunctival ,subdermal bruise）Brain trauma（visual field、nerve palsy）,Purtscher retinopathy,Retinopathy of prematurity,Long time oxyg
10、en inspire, premature childFibrovascular proliferation of avascular retinaRetinal hemorrhage, vitreous hemorrhageTractional retinal detachmentSecondary glaucomaEyeball growth retardation、atrophy,Syphilis,Required：I stage-eyelid、conjunctival chancreII stage-acute iridocylitissyphilitic roseolachorior
11、etinitis stromal keratitisIII stage-Argyll Robertson pupil（90%）optic atrophy （20%）oculomotor palsy,Syphilis,Neurological disorders,myasthenia gravis : autoimmune disease（striated muscle ）Ach insufficiencyneuromuscular conducting disorderclinical manifestation：sudden or slow onsetsymptoms alleviation in the morning or after rest aggravated when continuous and repeated excerise0.5-1 mg neostigmine im20-40yrs，female,Neurological disorders,Brain tumor:tumor mass：papillary edema (high intracranial pressure)tumor compression ：visual field defect,Pupillary edema,Corticosteroid,
