Diagnosis Tree (Posterior Segment) Flashcards
C: Optic Nerve
F: C:D Ratio > 0.4
60%
Glaucoma Suspect, Low
Plan: Regular Monitoring with:
OCTn (Optical Coherence Tomography) ,
DFE (Dilated Fundus Exam),
FP,
HVF (Humphrey Visual Field)
C: Optic Nerve
F: C:D Ratio > 0.4
40%
Primary Open Angle Glaucoma, Mild/Mod/Severe
Plan: Monitoring as above, plus SLT vs. Medications
C: Optic Nerve
F: Peripapillary Atrophy
Chorioretinal Scars
C: Optic Nerve
F: Peripapillary SRH
Neovascular AMD (Age-related Macular Degeneration)
C: Optic Nerve
F: Optic Nerve Noch
Glaucoma Suspect, Low
C: Optic Nerve
F: Saucerized
Dry AMD
C: Optic Nerve
F: Disc Hemorrhage
Disc Hemorrhage
C: Optic Nerve
F: Disc Pallor
Glaucoma Suspect, Low;
Anatomic Narrrow Angles;
POAG
C: Optic Nerve
F: Disc Edema
Central Retinal Vein Occlusion
C: Optic Nerve
F: NVD
Proliferative Diabetic Retinopathy;
NPDR (Nonproliferative Diabetic Retinopathy);
Neovascular Glaucoma
C: Vitreous
F: PVD
Posterior Vitreous Detachment
Plan: No RT/RD (Retinal Tear/ Retinal Detachment). RD precautions (Retinal Detachment)
C: Vitreous
F: Vitreous Syneresis/ Vitreous Floaters
Vitreous Opacities;
Posterior Vitreous Detachment;
Vitreous Debris
C: Vitreous
F: Asteroid Hyalosis
Asteroid Hyalosis
C: Vessels
F: Attenuated Vessels
NPDR/PDR;
Retinal Vein Occlusion;
Neovascular Glaucoma;
Macular Edema
C: Vessels
F: AV nicking
NPDR/PDR;
Retinal Vein Occlusion;
Macular Edema
C: Macula
F: Drusen w/o Pigment Changes
Macular Drusen
Plan: Amsler, monitor
C: Macula
F: Drusen w/ pigment changes
Macular Degeneration: Early/Int/Advanced
Plan: Amsler, AREDS, no neovascularization, monitor
C: Macula
F: Nevus
Choroidal nevus
Plan: Monitoring with FP
May refer to oncologist for further evaluation
NPDR
F: Microaneurysms
**Mild
Plan: D/w patient the importance of blood sugar control, routine f/u exam (DFE/FP/OCTm q1yr)
NPDR
F: Hemorrhage or MA’s, and/or; retinal hemorrhages, hard exudates, cotton wool spots, venous beading
**Moderate
Plan: D/w patient the importance of blood sugar control, routine f/u exam (DFE/FP/OCTm), refer to retina specialist,
NPDR
F: >20 intraretinal hemorrhages in each four quad, venous beading, IRMA
**Severe
Plan: F/u exam (OCTm, fluorescein angiography, DFE q3-4mos), referral to retinal specialist, importance of blood sugar control and close observation
CSME
F: neovascularization, vitreous/preretinal hemorrhage
Immediate referral to retinal specialist, Peripheral neovascularization with photocoagulation treatment, anti-VEGF injections in conjuction with PRP.
Once stabilized, monitor by retinal specialist q6-12mos
Dry AMD, (early-advanced)
F: numerous small soft drusen
**Early Dry
Plan: OCTm, FP, AREDS2, monitor
Dry AMD, (early-advanced)
F: small or intermediate size of extensive drusen
**Intermediate Dry
Plan: OCTm, FP, AREDS2, monitor
Dry AMD, (early-advanced)
F: geographic atrophy or choroidal neovascularization, RPE hemorrhage, serous fluid, subretinal fibrosis
**Late/Advanced Dry or Wet
Plan: Anti-VEGF injections, Photodynamic therapy (PDT), FFA, OCTm, FP, AREDS2
Dry AMD, (early-advanced)
F: intra/subretinal leakage, hemorrhage, RPE detachment
Neovascular AMD
Plan: OCTm, FP
Dry AMD, (early-advanced)
C: Periphery
F: Lattice Degeneration
Lattice Degeneration
Dry AMD, (early-advanced)
F: Horseshoe Tear
Horseshoe Tear
Dry AMD, (early-advanced)
F: Retinal Hemorrhage
NPDR/PDR;
Retinal Vein Occlusion
Dry AMD, (early-advanced)
F: Peripheral RPE Changes
Dry AMD;
Neovascular AMD
Dry AMD, (early-advanced)
F: Scleral Buckle
S/P Vitreo-Retinal Surgery;
Retinal Detachment
Dry AMD, (early-advanced)
F: Choroidal Nevus
Choroidal Nevus
Dry AMD, (early-advanced)
F: Hard Exudates (Lipid)
Diabetes, Type I or II
