Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OD3 - Clinical Optometry Practice > DIS - Myopic Pathology - Week 8 > Flashcards

DIS - Myopic Pathology - Week 8 Flashcards

1
Q

What percentage of Australians are myopic?

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Does myopia prevalence vary with ethnicity?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is myopia a leading cause of blindness and vision impairment?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens to the ocular globe with myopia?

A

Ocular elongation and stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is considered a high myope and what percentage of them have pathological changes? Can retinal pathology be associated with mild myopia?

A

High myopes have >6.00D
77% of high myopes have pathology
Retinal pathology can be associated with mild myopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What percentage of high myopes have macular pathology? Does incidence increase with axial length? What about age?

A

7%

-incidence increases with AL/age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the retinal at the macula and RNFL like in a myopic eye?

A

Thinned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What appearance does the retina of a myopic eye generally have? Are choroidal vessels more or less visible? Does this appearance increase or decrease with age?

A

Tesselated/tigroid appearance

  • increased visibility of choroidal vessels
  • decreases with age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does early atrophy appear in myopic eyes (colour/border) and in what percentage of high myopes?

A

Patchy/diffuse atrophy
-greyish/white lesions with distinct borders
-widespread yellow lesions
20-40% of high myopes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are lacquer cracks, how do they appear, what are their borders like and in what percentage of high myopes do they appear?

A

Irregular pale yellow/white thin lesions branching and crisscrossing the retina
May have pigmented borders
7% of high myopes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Does choroidal vasculature tend to be visible if lacquer cracks are present?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are lacquer cracks suggested to be (4)?

A

Healed mechanical breaks in the RPE, bruchs membrane, and choriocapillaris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What percentage of lacquer cracks progress?

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What 7 things are associated with lacquer cracks?

A 
CRA
Age
Axial length
Vision loss
Fuchs spot
CNVM
Haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is usually seen at the ONH/macula with staphyloma?

A

Posterior ectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does staphyloma appear (colour/margins)?

A

Pallor, atrophyc retina, distinct margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Are choroidal vasculature prominent with staphyloma?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What six things is staphyloma associated with?

A 
Progressive RD
Macular holes
CNVM
Macular retinoschisis
Lacquer cracks
Vitreous abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What percentage od high myopes have staphyloma?

A

12-25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List four common ONH pathologies associated with myopia.

A

PPA/myopic crescents
Peripapillary retinal detachment
Tilted disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does a tilted disc predispose you to?

A

Glaucoma damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What percentage of normal eyes and high myopes have PPA/myopic crescents?

A

23-38% in high myopes

14% in normal eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What happens to the area of PPA with age and axial length?

A

Increases with age and axial length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is meant by zone β and zone α in terms of location for PPA?

A

Zone β - clostest, complete CRA/crescent/ring

Zone α - outer, hypo and hyper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does peripapillary retinal detachments appear (colour and location)? What is it due to and what could be used to detect this?

A

Tellow/orange lesions localised near the ONH
Cystoid spaces in the choroid
-OCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What kind of traction is often seen in a tilted disc?

A

Supra-traction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the association between PVD, myopia, and axial length? Explain what ocular enlargement entails for the vitreous (2).

A

Develop PVD earlier with increasing myopia and axial length

Ocular enlargement associated with peripheral changes, but no significant associations with peripheral degenerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Compare the incidence of lattice degeneration in normal eyes vs myopes.

A

General <10%

Myopic 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When does lattice degeneration develop and is it age-related?

A

2nd/3rd decades, not age related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe what lattice degeneration looks like.

A

Sharp bordered, white arborising/branching lines
Irregular pigment
Spiral shaped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Where are lattice degenerations often seen? Is it often bilateral?

A

Temporal

Often bilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What do the white branching lines of lattice degeneration indicate?

A

Sclerosed retinal vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the vitreous overlying lattice degeneration often like (2)?

A

Liquefied

Abnrmal vitreoretinal adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is meant by an atypical lattce degeneration? What is it possibly?

A

No white lines, local accumuation of snowflakes (muller remnants?)
Possibly RPE clumping only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most significant peripheral retinal change in myopic pathology?

A

Lattice degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What does lattice degeneration have a significant association with?

A

RD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is a retina with lattice degeneration prone to and from what? Along what edge and when does it frequently develop?

A

Prone to retinal tears from vitreous traction

  • typically along posterior edge
  • frequently develop at onset of acute PVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is a snail trail thought to be?

A

Probably a precursor or variant of lattice degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Do snail trails have similar size, shape, and distribution to lattice degeneration?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe what snail trails look like.

A

Bands of tightly packed snowflakes on the inner retinal surface, glistening or frost-like surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the risk of vitreous changes, tears, and detachment like in snail trails vs lattice degeneration?

A

Less risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Are snail trails often uni- or bilateral? What part of pathological myopic eyes often has them?

A

Often bilateral and temporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What do snowflakes look like and with what do they have approximately the same size?

A

They are small white intraretinal patches

-same size as drusen

44
Q

What four structures can snowflakes be often seen directly within?

A

Lattice degeneration
Snail track
Elsewhere in eyes with lattice degeneration
Inner retinal leaf od retinoschisis

45
Q

Are snowflakes often found in multiples or single?

A

Most commonly multiple

46
Q

What is peripheral cystoid degeneration (2) and what does it look like? Are they true cysts? Explain.

A

Disintegration of middle retinal layers
-glia and retina
Cyst-like intra-retinal spaces but no walls to the cysts
-not true cysts

47
Q

What is peripheral cystoid degeneration typically adjacent to and how many rows?

A

Ora serrata, 2-3 rows of vesicles

48
Q

Can cystoid spaces in peripheral cystoid degneration coalesce or do they keep separate?

A

They can coalesce to spread

49
Q

What appearance does peripheral cystoid degeneration have with anatomy?

A

Honeycomb appearance

50
Q

Where in the eye in peripheral cystoid degeneration very common?

A

Far periphery

51
Q

Is peripheral cystoid degeneration usually uni- or bilateral?

A

Bilateral

52
Q

What is the prevalence of peripheral cytoid degeneration like with age and myopia?

A

Increases

53
Q

Define acquired retinoschisis.

A

Retinal splitting following peripheral cystoid degeneration

54
Q

What percentage of all eyes have acquired retinoschisis?

A

4-5%

55
Q

True or false

Acquired retinoschisis is common in hyperopes and myopes.

A

True

56
Q

How does acquired retinoschisis appear?

A

Smooth transparent elevation of the retina with a beaten copper surface that glistens

57
Q

True or false

There are high watermarks, movement, or folds in acquired retinoschisis

A

False

There are none

58
Q

Describe regular retinoschisis, what it follows, and whether it is benign or sinister. Does it commonly extend beyond the equator?

A

OPL, splitting along that plane
Follows regular cystoid degeneration
Benign, rarely extends beyond the equator

59
Q

Describe reticular retinoschisis and compare its severity to regular retinoschisis. Does it commonly extend beyond the equator?

A

INL or NFL - reticular cystoid

More serious, but rarely reaches the posterior pole

60
Q

What is essential for acquired retinoschisis?

A

OCT

61
Q

What does acquired retinoschisis disrupt and does it give vision loss? What happens as a result and do patients typically notice?

A

Disrupts retinal neurons, giving vision loss
Results in an absolute visual field defect
Patients usually asymptomatic

62
Q

List two risks associated with acquired retinoschisis.

A

Small risk of retinal detachment or spread to the macula

63
Q

What does white without pressure look like?

A

Semitranslucent greyish-white focal or circumferential areas

64
Q

Where is white without pressure most often located?

A

Between the equator and the ora serrata

65
Q

What kind of border does white without pressure often have (3)?

A

A scalloped border with a deep red margin, may be smooth

66
Q

What is the cause of white without pressure (2)? Is retinal atrophy likely?

A

Poorly understood
Retinal atrophy unlikely
More likely to be vitroretinal degeneration/adhesion/traction

67
Q

What risk is associated with white without pressure along the posterior edges?

A

Slight risk of giant retinal tears

68
Q

What percentage of normal eyes and high myopes have white without pressure?

A

25% of normal eyes

85% of high myopes

69
Q

What three things is white without pressure often confused for?

A

Shallow detachment
Hole
Schisis

70
Q

What is pavingstone degeneration (2)?

A

Thinning of the RPE and sensory retina

71
Q

How does pavingstone degeneration apear? Is it an elevation or depression?

A

Rows of irregularly shaped yellow patches

-depressed

72
Q

What can often be seen within lesions of pavingstone degeneration (2)?

A

Large choroidal vessels

-but also atrophic

73
Q

What is the margin of lesions in pavingstone degeneration like?

A

Lightly pigmented

74
Q

Where does pavingstone degeneration tend to manifest?

A

Equator to the ora serrata

75
Q

What percentage of normal eyes and myopes have pavingstone degneration? Is it benign or sinister?

A

Common
22% of myopes
25% of all eyes
Usually harmless

76
Q

What is peripheral drusen (what layer)? Histologically, what is it similar to? Is it associated with retinal detachment?

A

Small yellow deposits in bruchs membrane
Histologically similar to macular drusen
Not associated with RD

77
Q

What is reticular degeneration and is it uni- or bilateral? Where in the eye does it occur (2)? What pattern does it have?

A

Bilateral senile pigmentary change
Periphery and mid-periphery
Polygonal pattern of patchy hypopigmentation surrounded by vague pigment lines

78
Q

What should be excluded if reticular degeneration is suspected?

A

Retinitis pigmentosa

79
Q

What is retinoapthy of prematurity characterised by (3)?

A

Avascular peripheral retina
Dysregulation of VEGF
Pathological neovascularisation

80
Q

When does normal retinal neovascularisation occur (nasal and temporal)?

A

Begins early 2nd trimester
Nasal - 8 months
Temporal - 10 months

81
Q

What drives VEGF release during retinal vascularisation?

A

Relative hypoxia in the periphery

82
Q

What prevents normal development of the peripheral vasculature in retinoapthy of prematurity? Explain what happens post-natally and once the infant leaves hospital.

A

High O2 levels in humidi-cribs
VEGF is downregulated
On O2 removal, peripheral retina is hypoxic, new vessels form at the junction between vascular and avascular retina

83
Q

What infant weight is retinopathy of prematurity often found?

A

<1,300g

84
Q

What is the involvement of optoemtry for retinopathy of prematurity (3)?

A

Strabismus
Myopia
Amblyopia

85
Q

What is stickler syndrome a disorder of?

A

Connective tissue/collagen

86
Q

What kind of myopia is present in stickler syndrome?

A

Syndromic myopua - early childhood, high non-progressuve myopia

87
Q

What is the vitreous humour like in stickler syndrome?

A

Optically empty or with vitreous opacities

88
Q

What degeneration is seen in stickler syndrome?

A

Lattice degneration

89
Q

What two non-ocular abnormalities do individuals with sticklers syndrome have?

A

Facial and skeletal abnormalities

90
Q

What is the most common cause of retinal detachment in children?

A

Stickler syndrome

91
Q

What are three ocular diseases associated with stickler syndrome?

A

Glaucoma
Cataract
Ectopia lentis

92
Q

Describe wagner syndrome and the level of myopia individuals tend to have. What syndrome is it similar to?

A

Erosive retinopathy
Similar to stickler syndrome but no systemic associations
Low myopia (-3.00D)

93
Q

What is the vitreous humour like in wagner syndrome (30? What is this due to? What retinal structure can be seen and what happens to the fovea?

A 
Vitreous syneresis, strands and veils
-due to abnormal proteoglycans
Preretinal membranes can be seen
Temporal displacement of the fovea
-pseudostrabismus
94
Q

What is marfan syndrome a mutation to?

A

Fibrillin gene

95
Q

How do individuals with marfan syndrome tend to look physically (limbs)?

A

Tall, thin, disproportionately long limbs, fingers, toes

-arachnodactyl

96
Q

List 5 ocular associations with marfan syndrome.

A 
Ectopia lentis
Subluxated lens
Lattice degeneration
Retinal detachment
Glaucoma
97
Q

List three cardiac abnormalities associated with marfan syndrome.

A

Aortic aneurysm
Mitral valve prolapse
Dilation of the aortic root

98
Q

List two syndromic conditions associated with hyperopic retinopathy.

A

Posterior microphthalmos

Nano-ophthalmos

99
Q

What happens to the risk of angle closure glaucoma with increasing magnitude of hyperopia?

A

Increases

100
Q

What are choroidal folds (3)? What is it associated with?

A

Undulations in the choroid, RPE, retina
Associated with hyperopia
-small globe

101
Q

List 5 differential diagnoses for choroidal folds.

A 
Orbital mass
Autoimmune diseases
ARM
Lymphoma
Uveal effusion syndrome
102
Q

List three autoimmune diaseases that could be a differential diagnosis for choroidal folds.

A

Posterior scleritis
TEDs
RA

103
Q

What is the pathogenesis of choroidal folds (6).

A

Compressive stress either external or within the choroid, bruchs membrane, or retina, causing them to buckle

104
Q

What happens to the choroid with choroidal folds?

A

Choroidal swellng

105
Q

What happens to the inner scleral wall with choroidal folds (2)?

A

Shrinking

Mechanical deformation

106
Q

List 5 sequelae of choroidal folds if long standing.

A 
RPE atrophy
Breaks in bruchs membrane
Vascular incompetence/leakage
CNVM
Poor systemic health

OD3 - Clinical Optometry Practice (114 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions