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Posterior Segment > Block 15 Lectures 18, 19, and 21 > Flashcards

Block 15 Lectures 18, 19, and 21 Flashcards

1
Q

A full thickness defect (tear/hole/split) in sensory retina with may occur with or without detachment of the retina is known as ____?

A

Retinal break

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2
Q

What is a normal age-related process where the vitreous gel liquefies over time?

A

Vitreal Synchysis

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3
Q

What is most likely the reason for vitreal synchysis occurring in all eyes eventually?

A

Toxic effects of light irradiation and metabolic waste products

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4
Q

A normal age-related process where the solid vitreous collapses/contracts forward and liquid fills the retrahyaloid space is known as ____?

A

Posterior Vitreous Detachment

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5
Q

What are 2 features of the vitreous in posterior vitreous detachment?

A
  1. Synchysis

2. Syneresis (shrinkage/contraction)

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6
Q

What may occur at a strong vitreous-retina attachment point when the vitreous eventually detaches?

A

Retinal tear

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7
Q

What could cause a vitreous hemorrhage during a posterior vitreous detachment?

A

Vitreous pulling away from a retinal vessel

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8
Q

What is a common symptom that occurs when the retina is being pulled on by the vitreous during a posterior vitreous detachment?

A

Flashes (photopsia)

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9
Q

What are 3 ways floaters may be described by a patient experiencing a posterior vitreous detachment?
What is the cause of each different type of floater described?

A
  1. “Single large floater” - Weiss Ring
  2. “Cobwebs” - condensation of collagen fibers
  3. “Shower of small dark spots” - RBC’s
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10
Q

What is important to rule out in a patient experiencing a posterior vitreous detachment?

A

Retinal detachment

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11
Q

The formation of an area of confluent tiny vesicles in peripheral retina causing it to look thickened or less transparent is known as ____?

A

Microcystoid Degeneration

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12
Q

Where does microcystoid degeneration always extend from?

A

Ora serrata

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13
Q

Can microcystoid degeneration be the direct cause of a retinal detachment?

A

No

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14
Q

Microcystoid degeneration is usually benign, but progression to ___ should always be monitored for?

A

Retinoschisis

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15
Q

What condition refers to patches of chorioretinal atrophy aligned in a row parallel to the ora serrata?

A

Pavingstone Degeneration

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16
Q

What do the signs seen in Pavingstone Degeneration represent?

A

Thinned, intact retina and choroid overlying visible sclera

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17
Q

Does Pavingstone Degeneration lead to a retinal detachment?

A

No

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18
Q

Peripheral perivascular pigmentation that may extend posterior to the equator is known as ___?

A

Reticular Pigmentary Degeneration

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19
Q

What age group is Reticular Pigmentary Degeneration commonly seen in?

A

Older patients

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20
Q

What is an example of a pathological condition that looks similar to Reticular Pigmentary Degeneration?

A

Retinitis Pigmentosa

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21
Q

It is important to differentiate benign peripheral drusen from what other condition?

A

Progressive macular changes in AMD

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22
Q

Are patients with benign peripheral drusen at an increased risk for AMD?

A

No

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23
Q

A long area of thinned, atrophic retina that is beneath a pocket of liquefied vitreous and surrounded by strong vitreal attachments at the margins of the lesion is known as ____?

A

Lattice Degeneration

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24
Q

Lattice degeneration is very common, especially in hyperopes or myopes?

A

Myopes

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25
Q

Lattice degeneration is present in up to nearly 50% of eyes with _____?

A

Retinal detachment

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26
Q

What quadrant is lattice degeneration often present in?

A

Superotemporal

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27
Q

What are 4 common appearances often seen within the lesion in lattice degeneration?

A

White lines, “snowflakes”, pigmentation, and/or small holes

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28
Q

Most patients with lattice degeneration do or do not develop retinal detachments?

A

Do not

29
Q

What are 3 events that could take place in lattice degeneration that may lead to a retinal detachment?

A
  1. Flap tear formation during posterior vitreous detachment
  2. Tears at posterior margin of lesion
  3. Holes within lesion
30
Q

Elongated patches of “frosted” looking peripheral retina with overlying vitreous liquefaction and without strong vitreoretinal attachments is known as ___?

A

Snailtrack Degeneration

31
Q

Snailtrack degeneration lesions are typically longer or shorter than those seen in lattice degeneration?

A

longer

32
Q

Opaque appearance of islands of peripheral retina that are attached more strongly to cortical gel than normal only upon scleral indentation is known as ____?

A

White with pressure

33
Q

Although white without pressure rarely causes problem, what has been known to occur at posterior border?

A

Giant retinal tears

34
Q

A small, light-colored area of retinal elevation where focal vitreous traction pulls up is known as ____?

A

Retinal tuft

35
Q

Diffuse chorioretinal atrophy often seen in the equatorial region is most common in hyperopic or myopic eyes?

A

Highly myopic

36
Q

All chorioretinal atrophy represents what?

A

Thinning of choroid/retina

37
Q

Holes within the atrophied retina are often difficult to see why?

A

Lack of contrast between retina and choroid

38
Q

What are 4 retinal degenerations that occur more frequently in myopia?

A
  1. Lattice degeneration
  2. Snailtrack degeneration
  3. Diffuse chorioretinal atrophy
  4. Macular holes
39
Q

What are 3 processes/reasons myopes experience increased risk for retinal detachments?

A
  1. Vitreous degeneration occurs with myopia
  2. Posterior vitreous detachment occurs earlier in myopia
  3. Cataract surgery causing vitreous loss and laser posterior capsulotomy
40
Q

List 4 peripheral retinal degenerations that may lead to a retinal detachment?

A
  1. Lattice degeneration
  2. Snailtrack degeneration
  3. White with and without pressure
  4. Diffuse chorioretinal atrophy
41
Q

Splitting of retina due to degeneration is called ___?

A

Degenerative Retinoschisis

42
Q

Degenerative retinoschisis more commonly affects myopic or hyperopic eyes?

A

Hyperopic

43
Q

Degenerative retinoschisis is often overlooked or mistaken for _____?

A

Retinal detachment

44
Q

Cystic spaces that coalesce within an area of peripheral cystoid degeneration leads to ______ in degenerative retinoschisis?

A

Splitting of neurosensory retina into inner and outer layer

45
Q

How does the separation in retinoschisis differ from a retinal detachment?

A

Retinoschisis involves splitting/separation between different layers within the retina, but the photoreceptors still remain attached to the RPE.

46
Q

A stationary, shallow, smooth dome-shaped elevation of peripheral retina in the inferotemporal quadrant of both eyes of an asymptomatic patient is most likely ____?

A

Degenerative retinoschisis

47
Q

Are there pigmentary changes on the retina or pigment in the vitreous with degenerative retinoschisis?

A

No

48
Q

How is retinoschisis most often managed/treated?

A

Usually monitored without treatment

49
Q

What may be considered for retinoschisis that is very posterior and progressing?

A

laser therapy

50
Q

What occurs when fluid accumulates between choroid and sclera (suprachoroidal space)?

A

Choroidal detachment

51
Q

What is the most common association/cause of choroidal detachment?

A

Recent intraocular history - glaucoma filtering surgery

52
Q

What symptom might be reported for a choroidal detachment?

A

Shadow in vision (not flashes and floaters)

53
Q

If pain accompanies a choroidal detachment, what may be involved?

A

Hemorrhagic detachment

54
Q

What is a clinical sign that may obscure posterior pole in choroidal detachments?

A

Dome-shaped elevation of choroid and retina that is smooth and relatively immobile

55
Q

If choroidal detachment is excessive, how may the anterior chamber be affected?

A

Shallow AC

56
Q

How might IOP be affected if choroidal detachment is hemorrhagic?
If caused by hypotony?

A
  • Hemorrhagic: high IOP

- Hypotony: low IOP

57
Q

What test can confirm diagnosis of choroidal detachment?

A

B scan

58
Q

What test can differentiate a serous vs hemorrhagic choroidal detachment?

A

Ultrasound

59
Q

Hemorrhagic choroidal detachment cases with severe pain or extremely elevated IOP require what kind of treatment?

A

Prompt surgical drainage

60
Q

Acute angle closure could be caused by what drug?

A

Topamax

61
Q

How should acute angle closure caused by Topamax be treated? List 4.

A
  1. Discontinue Topamax
  2. Lower IOP with anti-glaucoma medications
  3. Atropine (strong cycloplegia)
  4. Prednisolone Acetate 1% (anti-inflammatory)
62
Q

There is no indication for ____ in acute angle closure caused by Topamax? List 2.

A
  1. Peripheral iridotomy

2. Miotic agent

63
Q

Choroidal effusion due to an unknown cause in association with an exudative retinal detachment is known as _______?

A

Uveal effusion syndrome

64
Q

Uveal effusion syndrome follows a chronic or acute course?

A

Chronic

65
Q

Uveal effusion syndrome may lead to what 2 effects?

A
  1. RPE changes

2. Permanently reduced vision

66
Q

Although extremely rare, who does uveal effusion syndrome typically affect?

A

Hyperopic, middle-aged men

67
Q

A reparative process in which cells migrate to either surface of the retina, form a fibrous cellular sheet, which then contracts causing fixed rigid folds is known as ____?

A

Proliferative vitreoretinopathy

68
Q

What is the most common cause of failure in retinal detachment surgery?

A

Proliferative vitreoretinopathy

69
Q

When is the typical occurrence of proliferative vitreoretinopathy?

A

A few weeks or months following retinal detachment surgery

Posterior Segment (5 decks)

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