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KMK Part II > Case 23: Flashes of Light > Flashcards

Case 23: Flashes of Light Flashcards

1
Q

Posterior vitreous detachments (PVDs) result from detachment of the _______ _____ of the vitreous from the retina

A

Posterior hyaloid

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2
Q

___% of people over the age of 50 have a PVD

A

50

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3
Q

Rhegmatogenous RDs are characterized by what 2 things?

A

Atrophic holes, retinal holes

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4
Q

Non-rhegamtogenous RDs are characterzied by what 2 things?

A

Exudate, traction

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5
Q

Photopsia in eyes w/ an acute posteior vitreous detachment is thought to result from traction on the retina at sites of _______ _____

A

Vitreoretinal adhesion

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6
Q

PVDs more common in which gender?

A

Females

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7
Q

Risk factors of PVD

A

diabetes mellitus, intraocular surgery, intraocular inflammation, vit heme, trauma

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8
Q

MC cause of retinal tear?

A

PVDs & vitreous liquefaction

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9
Q

RD

A

separation of sensory retina from underlying RPE

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10
Q

Rhegmatogenous OD

A

result from retinal break

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11
Q

Atrophic hole

A

Small, round, full-thickness defect caused by chronic atrophy of sensory retina (NOT vitreoretinal traction); assoc w/ low risk for a subsequent RD. Most often located in the temporal retina (superior> inf) often assoc w/ lattice degen

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12
Q

Retinal tears

A

Caused by vitreous traction

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13
Q

Flap tear

A

Result of uneven vitreous traction; the vitreous traction often persists after the retinal tear occurs (vitreous remains attached to the flap), leading to an increased risk of a subsequent RD compared to operculated tears

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14
Q

Operculated tear

A

symmetric & the result of even vit traction, vit traction no longer persists after the tear, reducing the risk of subsequent RD

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15
Q

Exudative RD

A

Accumulation of fluid underneath the sensory retna due to damage to the RPE

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16
Q

MC cause of exudative RD

A

ARMD

17
Q

MC cause of tractional RD

A

Proliferative diabetic ret

18
Q

RRDs MC occur in which gender?

A

Male

19
Q

___% of eyes that develop RRD will have assoc lattice, however only ___% of eyes w/ lattice degen will develop a RRD

A

20-33, 1

20
Q

____% of pts w/ an acute symptomatic PVD will have a retinal break

A

10-15

21
Q

In FHx of RRD or previous occurrence of RRD: both eyes are eventually affected in ____% of cases

A

10

22
Q

____% of all RDs occur in myopic eyes

A

40

23
Q

Signs of chronic RRD

A

Linear pigment demarcation line (takes 3 mo or longer to develop), intraretinal cysts (after 1 year), fixed folds, and/or subretinal precipitates

24
Q

The quadrant location in which pt reports ______ is of no value in predicting the location of the primary retinal break; however, the quadrant location for _____ is often valid

A

photopsia, VF defect

25
Q

Classical migraine

A

preceded by a visual aura that develops over 5-20 min & lasts less than 60 min

26
Q

Tx of symptomatic lattice degen (flashes/floaters)

A

Prophylactic tx w/ cryopexy or laser photocoagulation

27
Q

2nd MC lesion assoc w/ RD

A

vitreoretinal tuft

28
Q

When do you treat symptomatic retinal tear?

A

Immediately

29
Q

Retinal break tx

A

Laser photocoagulation or crytherapy; these techniques create a strong adhesion between the retina & RPE so vitreous fluid entering the retinal break cannot spread & create an RD

30
Q

Tx macular-detached RDs (“mac off”)

A

Usually result in a permanent reduction in vision; these RDs should be treated urgently (48-96 hours)

31
Q

Tx macular-threatening RDs (“mac on”)

A

Tx IMMEDIATELY 24 hours

32
Q

pneumatic retionpexy

A

intravitreal gas bubble is injected to temporarily tamponade the retinal tissue against the RPE: prevents additional vitreous fluid from entering the tear & allows the RPE to pump excess subretinal fluid into the choroid -> laser photocoagulation or cryotherapy is then used to permanently seal the retinal break

33
Q

Pneumatic retinopexy is primarily used for ______ retinal breaks

A

Superior

34
Q

Scleral buckle

A

A flexible silicone strip is permanently sutured on or within the sclera in order to indent the sclera & relieve vitreoretinal traction associated w/ the retinal break

35
Q

SE of scleral buckle

A

induced myopia, pain, hemorrhage, infection, diplopia

36
Q

vitrectomy

A

removal of the vitreous allows release of vitreoretinal traction

37
Q

Common indications for a vitrectomy w/ retinal breaks (2)

A
  1. inability to visualize the retinal break as a result of a cloudy vitreous 2. inability to close retinal breaks through standard techniques, typically as a result of a very large breaks, posterior breaks that include a macular hole, & severe vitreoretinal traction
38
Q

Post-operative complications of tx of RD

A

elevated IOP, cataracts, hemorrhage, infection, post-operative positioning complications

39
Q

Exudative RD secondary to ARMD or diabetic ret tx

A

anti-VEGF injection

KMK Part II (10 decks)

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