Disorders of the Retina

Question 1

What piece of equipment allows a slit lamp to see the back of the eye?

Answer 1

A condensing lens

Question 2

What is a disadvantage of an opthalmoscope that doesn’t affect the slit lamp?

Answer 2

narrow field of view

sense of depth missing

Question 3

What is visible upon fluorescein angiography in a healthy eye?

Answer 3

Green colour in venules and arterioles.

Clouding in the background as it leaks out of the choriocapillaris

Question 4

What is a similarity between the brain and the eye with regard to vascularity?

Answer 4

Blood retinal barrier similar to blood brain barrier

Question 5

What is Optical coherence tomography used to look for?

Answer 5

Fluid around the fovea

Question 6

What is the most common condition in which you would expect to see fluid under membrane around fovea?

Answer 6

Macular degeneration

Question 7

What is the function of the RPE (retinal pigment epithelium)?

Answer 7

Phagocytoses the cells above it to keep turnover high.

Question 8

What imaging cell type are concentrated at the fovea? and their function?

Answer 8

Cones - colour vision

Question 9

What is electrophysiology?

Answer 9

Investigations that record electrical signals in the eye and brain in response to visual stimuli

Question 10

What does an Electroretinogram (ERG) do?

Answer 10

Measures retinal function by recording action potentials from retina.

Question 11

What does an electrooculogram do? (EOG)

Answer 11

Measures function of RPE and photoreceptors

Question 12

What test can give away when someone is feigning blindness?

Answer 12

VEP (visually evoked potentials measured in the visual cortex)

Question 13

What is RAPD a measure of?

Answer 13

Objective measure of optic nerve function

Question 14

4 vascular causes of sudden vision loss?

Answer 14

Central retinal vein occlusion
Central retinal artery occlusion
Ischaemic optic neuropathy
Stroke

Question 15

Roughly what happens in Central retinal vein occlusion?

Answer 15

Blood comes in but cannot leave so pools in the eye

Question 16

Common causes of CRVO?

Answer 16

hypertension
glaucoma
hyperviscosity (leukaemia/lymphoma)
Inflammation

Question 17

What would be seen on Fluorescein angiography with CRVO?

Answer 17

A masked choroid due to blood

Question 18

What is noticed upon examination of an eye with CRAO?

Answer 18

Pale fundus and cherry red spot (fovea)

Question 19

Common causes of CRAO

Answer 19

Emboli

Inflammation

Question 20

How does the optic disk look in ischaemic optic neuropathy?

Answer 20

Pale with poorly defined borders

Some cases can look quite normal

Question 21

High levels of what are a giveaway to Giant cell arteritis?

Answer 21

Inflammatory markers

Question 22

What artery is used in biopsy for Giant cell arteritis and why?

Answer 22

Temporal artery - it isn’t 100% necessary and is quite accessible

Question 23

What type of vision is usually the first to be lost in optic neuritis?

Answer 23

colour, particularly red

Question 24

What optical condition can be the first presentation of MS?

Answer 24

Optic neuritis - check should be done after diagnosis

Question 25

What are the risk factors for Age related macular degeneration?

Answer 25

Age smoking poor diet

Question 26

What are the two types of AR macular degeneration? Which is more aggressive?

Answer 26

``` Dry type (atrophy) Wet Type (blood/fluid in membrane) - most aggressive ```

Question 27

What does VEGF do?

Answer 27

drives the growth of new blood vessels. | Is released after ischaemia.

Question 28

How can Wet type macular degeneration be treated?

Answer 28

Anti VEGF injections

Question 29

What would be seen on OCT in age related mac degen?

Answer 29

Fluid blister in the retina

Question 30

What are pericytes and what disease are they involved in?

Answer 30

Cells that line the walls of the eye epithelium | Diabetic retinopathy.

Question 31

How does diabetes lead to retinopathy?

Answer 31

Excess sugar damages pericytes These either occlude or anneurism. Leakage follows of either blood from weak vessels or lipid from the sugar imbalance in the cells.

Question 32

Is type 1 or 2 diabetes more likely to suffer blindness?

Answer 32

Type 1

Question 33

What is a complication of vessels growing in the iris?

Answer 33

Block trabecular network, which increases IOP

Question 34

What treatment is prefered in diabetic retinopathy?

Answer 34

antiVEGF, laser used to be used but significant vision loss occurred

Question 35

What condition would you test for BP and sugar levels?

Answer 35

Hypertensive retinopathy

Question 36

What are the two main groups of retinal dystrophy?

Answer 36

Choroidal | Vitreoretinal

Question 37

What is a telltale sign of retinitis?

Answer 37

bone spicules on retina

Question 38

Which forms of reinitis pigmentosa are the most common?

Answer 38

Dominant inherited Sporadic mutations Both of these are also the least severe types

Question 39

What photoreceptors are primarily affected in Retinits pigmentosa?

Answer 39

Rods - progressive tunnel vision as the rods die off. Eventually all the cones will go as well, but later.

Question 40

Drugs for what conditions can cause retinopathy?

Answer 40

TB Rheumatoid arthritis Breast cancer