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ophthalmology > diseases of the retina and choroid > Flashcards

diseases of the retina and choroid Flashcards

1
Q

what is chorioretinitis

A

inflammation of the choroid and retina

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2
Q

who most commonly gets chorioretinitis

A

immunosuppressed patients

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3
Q

what causes acute retinal necrosis

A

HSV/HZV

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4
Q

name the 2 causes of endogenous chorioretinitis

A

bacterial or fungal

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5
Q

what is endogenous chorioretinitis associated with (2)

A

bacterial endocarditis
indwelling catheters

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6
Q

what is toxoplasma gondii associated with (2)

A

contaminated soil or undercooked meat

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7
Q

clinical presentation of chorioretinitis

A

reduced visual acuity with floaters

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8
Q

investigations for chorioretinitis

A

swab:
culture for bacterial and viral
serology for toxoplasma and toxocara

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9
Q

management of sight-threatening toxoplasma gondii

A

clindamycin/azithromycin +/- steroids

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10
Q

management of chorioretinitis

A

antimicrobials ± topical steroids

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11
Q

what is an epiretinal membrane

A

scar tissue formation across the inner surface of the retina

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12
Q

what is the most common cause of epiretinal membrane

A

age-related vitreous retraction

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13
Q

name 2 other causes of epiretinal membrane

A

eye surgery or inflammation

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14
Q

clinical presentation of epiretinal membrane (2)

A

metamorphopsia
decreased acuity

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15
Q

what is metamorphopsia

A

where objects appear distorted or misshapen

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16
Q

epiretinal membrane on fundoscopy (2)

A

retinal striae
subretinal fluid or cystic damage

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17
Q

management of symptomatic epiretinal membrane

A

surgery

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18
Q

what is retinal detachment

A

detachment of the inner layer of the retina from the retinal pigment epithelium

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19
Q

most common cause of rhegmatogenous retinal detachment

A

tears or holes in the retina

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20
Q

what 2 things are required for rhegmatogenous retinal detachment

A

acute posterior vitreous detachment
predisposing peripheral retinal degeneration

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21
Q

state 4 risk factors for rhegmatogenous retinal detachment

A
  • Posterior vitreous detachment
  • Pathological myopia
  • Previous intraocular surgery
  • Trauma
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22
Q

what is non-rhegmatogenous retinal detachment

A

detachment without any retinal tears

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23
Q

2 main types of non-rhegmatogenous retinal detachment

A

tractional and exudative

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24
Q

exudative retinal detachment

A

subretinal fluid accumulation without retinal tears

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25
Q

most common cause of tractional retinal detachment

A

proliferative diabetic retinopathy

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26
Q

name some causes of exudative retinal detachment

A

choroidal tumours
inflammation
toxaemia of pregnancy
neovascularisation

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27
Q

what would detachment of the macula cause

A

central vision loss

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28
Q

clinical presentation of retinal detachment

A

painless progressive visual field loss
may describe a curtain/shaddow

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29
Q

fundoscopy of exudative RD

A

convex, smooth elevation
may be very mobile and deep with shifting fluid
leopard spots seen after flattening

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30
Q

fundoscopy of rhegmatogenous detachment

A

deep mobile elevation extending to ora serrata
slightly opaque with dark blood vessels
retinal tear may be visible

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31
Q

name 4 things associated with retinal tears/holes

A

age-related degeneration
myopia
eye injuries
eye surgery

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32
Q

what is a retinal break

A

full thickness defect in sensory retina

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33
Q

what causes a retinal hole

A

chronic retinal atrophy

34
Q

what causes a retinal tear

A

dynamic vitreoretinal traction

35
Q

clinical presentation of retinal hole or tear

A

usually asymptomatic
may see floaters

36
Q

investigation for a suspected retinal tear or hole

A

fundoscopy

37
Q

2 mainstays of treating retinal holes or tears

A

laser therapy or cryotherapy

38
Q

name a complication of a retinal hole/tear

A

retinal detachment

39
Q

what is posterior vitreous detachment

A

Detachment of the posterior vitreous cortex from the internal limiting membrane of the retina

40
Q

most common cause of posterior vitreous detachment

A

age-related generation of the vitreous body

41
Q

clinical presentation of posterior vitreous detachment

A

usually asymptomatic
photopsia with eye movements
floaters

42
Q

investigation for posterior vitreous detachment

A

fundscopy

43
Q

management of posterior vitreous detachment

A

no treatment needed, just reassurance

44
Q

complication associated with posterior vitreous detachment

A

can predispose to developing retinal tears or detachment

45
Q

who usually presents with central serous chorioretinopathy

A

otherwise health men aged 30-50 yrs

46
Q

clinical presentation of central serous chorioretinopathy (2)

A

hyperopia
metamorphopsia

47
Q

what is hyperopia

A

long-sightedness

48
Q

central serous chorioretinopathy on fundoscopy

A

roundish detachment of central retina

49
Q

central serous chorioretinopathy on fluoresceine angiography

A

small, focal hyperfluorescent RPE leak

50
Q

management of central serous chorioretinopathy

A

high rate of spontaneous resolution but medical and surgical options

51
Q

what is VMT

A

vitreomacular traction

52
Q

clinical presentation of VMT (2)

A

metamorphopsia
decreased vision

53
Q

investigation for VMT

A

optical coherence tomography

54
Q

what causes a macular hole

A

usually idiopathic

55
Q

clinical presentation of a macular hole (3)

A
  • Metamorphopsia
  • Central visual field losses
  • Severe reduction of visual acuity
56
Q

fundoscopy of a macular hole

A

sub-foveal spot or ring
partial or full thickness break is observed in more advanced cases

57
Q

what is CME

A

cystoid macular oedema

58
Q

what is cystoid macular oedema

A

retinal thickening of the macula due to accumulation of fluid in the outer plexiform layer

59
Q

name some causes of CME

A

postoperative
uveitis
retinal venous occlusions
choroidal neovascularisation
epiretinal membrane / VMT
retinitis pigmentosa

60
Q

clinical presentation of CME

A

blurred central vision

61
Q

management of CME

A

majority resolve spontaneously

62
Q

what is the most common cause of blindness in people >65

A

macular degeneration

63
Q

name 4 risk factors for macular degeneration

A

increasing age
smoking
family history
poor nutrition

64
Q

what causes dry ARMD

A

deposition of drusden in the retinal pigment epithelium causing progressive atrophy

65
Q

what causes wet ARMD

A

neovascularisation in the choroid, mediated by VEGF

66
Q

clinical presentation of wet ARMD (2)

A

rapid central visual loss
distortion

67
Q

clinical presentation of dry ARMD

A

gradual decline in vision
scotoma

68
Q

what is scotoma

A

a blind spot

69
Q

fundoscopy of wet ARMD

A

haemorrhage/exudate

70
Q

fundoscopy of dry ARMD (2)

A

drusden
atrophic patches of retina

71
Q

management of wet ARMD

A

anti-VEGF intravitreal injections

72
Q

management of dry ARMD

A

no cure - supportive low vision aids e.g. magnifiers

73
Q

axial length in pathologic myopia

A

> 26mm

74
Q

pathophysiology of pathologic myopia

A

environmental and genetic influences cause increased axial growth of the eyeball

75
Q

symptom of pathologic myopia

A

blurred vision

76
Q

clinical sign of pathological myopia

A

scleral thickening

77
Q

fundoscopy of pathologic myopia

A

lacquer cracks
subretinal haemorrhage
fuch’s spot - degeneration of the macula
posterior staphyloma
degeneration (cystoid, paving stone, lattice)

78
Q

what is posterior staphyloma

A

outpouching of scleral tissue typically involving the optic disc or macula

79
Q

why would we use fluorescein angiography

A

looking for development of choroidal neovascularisation

80
Q

management of pathologic myopia

A

annual check-ups
anti-VEGF if CNV develops

ophthalmology (10 decks)

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