1 - Diagnostics - Part 1

Question 1

What is the transparent gel composed of collagen fibrils filled with?

Answer 1

Hyaluronan hydrated with water

Question 2

What is the name of the ligament attached to the lens?

Answer 2

Wieger’s ligament

Question 3

Name the space between lens zonules and vitreous?

Answer 3

Space of Garnier

Question 4

Where is the Vitreous base located?

Answer 4

Ora serrata

2mm anterior and 3 mm posterior to the ora, ringlike area extends

Question 5

Where is the most common area that may have an RD near the Ora serrata?

Answer 5

Meridional folds

Question 6

What anatomical structures does the IS/OS junction tell you when observing the OCT?

Answer 6

Mitchondria (Ellisoid),
Endoplasmic Reticulum (Myoid), cilia and inner discs

Question 7

True or False. At the fovea there is no middle limiting membrane?

Answer 7

False. The middle plexiform layer is there area where photoreceptors reside.
(From Inner plexiform layer to the IS/OS junction)

Question 8

Where is the greatest density of rods in the retina?

Answer 8

20 degrees from fixation

Question 9

Person born with a cilioretinal artery, will have blood derived from what supply?

Answer 9

Ciliary circulation

Question 10

Retinal vasculature, including its capillaries, retains the BBB with ___________ between ____________?

Answer 10

TIGHT JUNCTIONS and CAPILLARY ENDOTHELIAL CELLS

Question 11

What is the percentage of vasculature provided by the choroid?

Answer 11

95%

Question 12

Since the RPE villous processes wrap around the bottom of the photoreceptors, what is the name of the tight junctions holding onto the lateral surfaces?

Answer 12

Zonulae Occuldentes

Note: This is junction is only the Apical portion of the RPE. The basal surface shows rich infolding of the plasma membrane.

Question 13

Which layer would you find PUFA, lipids or oxidatively damaged materials? Think of Drusen

Answer 13

Bruch’s membrane

Question 14

RPE is generated from what layer of the optic layer?

Answer 14

Outer layer.

Pigmentation begins at 5 weeks

Question 15

Secretion of the inner layer of Bruch’s membrane occurs by __ weeks.

Answer 15

6 weeks

Question 16

What is present during the 7 month of gestation?

Answer 16

Bipolar, Amacrine, Ganglion cells and nerve fibers

Question 17

When does macular development complete?

Answer 17

6 months

Question 18

What occurs during 3 to 6 weeks, in regards to the Vitreous?

Answer 18

3–6 weeks: Fibrils from Cells and fibroblasts derived from mesenchyme at the rim of the optic cup or associated with the hyaloid vascular system, together with minor contributions from the embryonic lens and the inner layer of the optic vesicle: Ultimately, the primary vitreous comes to lie just behind the posterior pole of the lens in association with remnants of the hyaloid vessels (Cloquet’s canal).

Question 19

What occurs during 6 to 10 weeks, in regards to the Vitreous?

Answer 19

Fibrils and cells (hyalocytes) originate from the vascular primary vitreous. Anterior: firm attachment to the internal limiting membrane of the retina constitutes the early stages of formation of the vitreous base. The hyaloid system develops a set of vitreous vessels as well as vessels on the lens capsule surface (tunica vasculosa lentis). The hyaloid system is at its height at 2 months and then atrophies from posterior to anterior

Question 20

What occurs during 10 weeks, in regards to the Vitreous?

Answer 20

During the third month, the marginal bundle of Drualt is forming. This consists of vitreous fibrillar condensations extending from the future ciliary epithelium of the optic cup to the equator of the lens. Condensations then form the suspensory ligament of the lens, which is well developed by 4 months. The hyaloid system atrophies complete during this stage

Question 21

How long after is AK-Fluor removed from the kidney’s?

Answer 21

24 to 36 hours

Question 22

How long does the Choroidal flush take?

Answer 22

10 seconds

Question 23

How much time has elapsed once Arterial phase has come?

Answer 23

12 seconds

Question 24

How do you know the Arteriovenous phase has arrived?

Answer 24

The lining of the veins becomes illuminated

Question 25

How much time has elapsed once the venous phase has arrived?

Answer 25

30 seconds

Question 26

The mid phase or Recirculation phase indicates how much time has elapsed?

Answer 26

2 to 4 mins

Question 27

The late phase, indicates how much time has elapsed?

Answer 27

7 to 15 mins

Question 28

What are the two type of Hypofluorescence?

Answer 28

Vascular defect and Blocked fluorescence

Question 29

What are the four type of Hyperfluorescence?

Answer 29

1. Window Defect- Increased chorodial fluorescence
2. Staining- increase in fluorescence but stays the same and margins are distinct
3. Pooling - accumulation in a fluid filled space
4. Leaking - margins are blur in late phase

Question 30

ONH Drusen can be observed through what type of fluorescence?

Answer 30

Autofluoresence

Note: ON Hemartoma is also another type

Question 31

If the Dye extravasates, what should be done to resolve it?

Answer 31

Ice cold compresses for 5 to 10 mins. Reassessed over hour or days, until edema, pain and redness resolve

Question 32

When should you avoid giving fluorescein to pregnant women?

Answer 32

First trimester