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RETINA ANAMOLIES DX/WU/TX > CHOROID ANOMALIES > Flashcards

CHOROID ANOMALIES Flashcards

1
Q

define choroidal nevus?

A

Benign focal accumulation of melanocytes within the choroid that is present at birth & are typically non-progressive.

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2
Q

what can a choroidal nevi convert to?

A

choroidal melanoma

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3
Q

choroial nevi symptoms?

A

asymptomatic

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4
Q

choroidal nevi signs? how to differentiate from CHRPE?

A
  • gray-green or brownish, circular mass with well-demarcated borders – surface drusen may be present.
  • will dissapear with red-free filter - “nev-us will leav-us”
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5
Q

tx/managment for choroidal nevus?

A
  • monitor with fundus photography - first f/u should be in 3 months.
  • second f/u can be every 1 year.
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6
Q

what is the most common primary intraocular malignancy in adults?

A

choroidal melanoma

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7
Q

define choroidal melanoma?

A

it is a an abnromal pigmented tumor of the choroid.

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8
Q

what is the nortality rate for choroidal melanoma if it metastasizes?

A

15-45% w/in 10 yrs

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9
Q

what is the most common sites a choroidal melanoma metastasizes? (in order from most to least common).

A

liver > lung > bone > skin > CNS

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10
Q

choroidal melanoma symptoms?

A
  • asymptomatic if in the peripheral
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11
Q

choroidal melanoma signs?

A
  • large gray-brown-yellow dome shape elevations.
  • may have yellow/orange lipofuscin – denotes metabolic activity.
  • borders are indistinct
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12
Q

risk factors for choroidal melanoma development?

A

Risk factors for malignant transformation: “To Find Small Ocular Melanoma Using Helpful Hints Daily”
T: thickness >2mm, size >5mm
F: Fluid-subretinal, serous RD
S: symptoms-flashes and floaters
O: orange pigment (lipofuscin) present over the lesion
M: margin of tumor <3mm from optic disc
U: ultrasonic hollowness
H: halo absent
D: Drusen-absent

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13
Q

w/u for choroidal melanoma?

A
  • B-scan ultrasonography detects potential elevation and the thickness of the tumor
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14
Q

tx/managment for choroidal melanoma?

A
  • refer to concologist - for blood testing, chest and abdominal x-ray (r/o metastasis).
  • enucleation - if choroidal melanoma.
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15
Q

what is choroidal metastasis?

A

spread of cancer from another place in the body to the eye.

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16
Q

which is the most common intraocular malignancy in adults?

A

choroidal metastasis

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17
Q

what are the most common sites of the primary tumor with somone with choroidal metastasis?

A
  • woman = breast
  • men = lung
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18
Q

what is choroideremia?

A
  • X-linked recessive disorder that ultimately results in choroidal degeneration and subsequent loss of retinal function.
19
Q

what type of inheritence is choroideremia? what gender is affected more?

A

X-linked recessive - meaning only males are affected while females are carriers.

20
Q

onset of choroideremia? is it progressive?

A
  • 20-30 yrs of age –> progresses to legal blindness by 50-60 yrs of age.
21
Q

symptoms of choroideremia?

A
  • nyctalopia – total night blindness in 10 within 10 yrs.
  • photophobia
  • peripheral vision loss
  • maintain central vision until later stage.
22
Q

signs of choroideremia?

A
  • Bilateral diffused peripheral atrophy of the RPE & choriocapillaris – “moth-eaten” appearance.
  • visible underlying sclera
  • RPE pigment clumping
23
Q

tx for choroideremia?

A
  • no tx
  • low vision consult.
24
Q

what is cobblestone degeneration aka pavingstone degeneration?

A

characterized by discrete yellow–white patches of focal chorioretinal atrophy that mayhave pigmented margins

25
Q

where is the most common location for pavingstone to occur in the retina?

A

inferior or inferior temporal retina

26
Q

what is pavingstone degeneration associated with?

A

high myopia

27
Q

what is birdshot retinochoroidopathy?

A

it is idiopathic, bilateral, chronic, recurrent inflammation of the choroid and retina.

28
Q

who gets birdshot retinochoroidopathy?

A
  • Healthy 20-50 y/o whites of northern European descent.
29
Q

what genetic association does birdshot have?

A

associated with HLA-A29 - suggests it is an autoimmune disease

30
Q

symptoms of birdshot?

A
  • Decreased night vision
  • Decreased color vision
  • Floaters
31
Q

signs of birdshot?

A
  • Bilateral, multiple, creamy round/oval, yellow/white splotches located in the posterior pole & extending to the periphery.
  • Low-grade vitritis
  • Secondary CME or CNVM in some - contributes to decrease VA
32
Q

tx for birdshot?

A

only tx id significant inflammation, reduced vision, CME/CNVM:
* steroids - inflammation
* cyclosporine - for vitritis & CME

33
Q

what is serpiginous choroidopathy?

A
  • It is idiopathic, chronic, progressive and recurrent inflammation of the RPE and choroid.
34
Q

what is genetic association does serpiginous choroidopathy have?

A

HLA-B7

35
Q

who gets serpiginous choroidopathy

A

50-60 yr old men

36
Q

symptoms of serpiginous choroidopathy

A
  • Decreased VA
  • Scotomas
  • Metamorphopsia
37
Q

signs of serpiginous choroidopathy?

A
  • Early – unilateral, ill-defined gray/yellow subretinal infiltrates that start at ONH and extend to the macula in “serpant-like” manner.
  • Late – retinal atrophy
  • possible CNVM in 25% of cases
38
Q

tx for serpiginous choroidopathy?

A
  • Resolves over 6-8 weeks but tends to recur.
  • steroids - for inflammation
  • PRP or anti-VEGF injections - CNVM
  • low vision consult - poor vision prognosis
39
Q

what is candidiasis? what species is involved?

A
  • Fungal infection due to Candida sp.
40
Q

candidiasis has the highest susceptibility during __?

A

o Endophthalmitis
o HIV
o Immunosuppression
o IV drug users
o Systemic mycotic infection
o Ocular trauma

41
Q

symptoms of candidiasis?

A
  • blurry vision
  • pain
  • floaters
42
Q

signs of candidiasis?

A
  • yellow-white choroidal lesions
  • vitritis
  • possible RD
43
Q

tx for candidiasis?

A
  • oral or IV antifungals
  • if vitreous is involved - tx with intravitreal antifungal injections
  • pts need to be monitor daily or hospitalized if they are noncompliant
  • consult with infectious dz specialist.

RETINA ANAMOLIES DX/WU/TX (11 decks)

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