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Ophthalmology > Disorders Of The Retina, Vitreous And CHoroid > Flashcards

Disorders Of The Retina, Vitreous And CHoroid Flashcards

1
Q

What are the 3 posterior chambers/

A

Vitrueous -> retina -> choroid

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2
Q

What arteries supply in the inner and outer layers of the rretina?

A

Central retinal artery = inner layers
Ciliary arteries - supply the outer layre

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3
Q

What is the copositio of vitrueou?

A

99% water
1% ssolid portion

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4
Q

Whaat cells span all the 10 layers of the retina but does not contribute to neural transduction?

A

Muller’s cells

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5
Q

What is the layer of the neuron relaysystem of the light signal transduction?

A

IBOP
Inner = Bipolar
Outer = Photoreceptor

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6
Q

What is the vascular layer that comes from the long and short posterior ancillary arteries???

A

Choroid

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7
Q

What proceure is used to enable physicians to monocularly view the central 15deg of the retinA?

A

Direct ophthalmoscopy

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8
Q

What procedure is done in combination with a condensing lens wither 78 diopter or a 90D condensing lens?

A

Slit-lamp biomicroscopy

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9
Q

What procedure is done to give the widest stereoscopic view of the retina?

A

Indirect ophthamloscopy

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10
Q

What proceudre is done to take pictures of the eye by IV inkection of sodium fluorescein dye?

A

Fundus photo and retinal angiogram

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11
Q

What layers of the retina are HYPERREFLECTIVE?

A

Plexiform and Fibrous layers

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12
Q

What are the risk factors of diabetic retinopathy?

A

Duration of DM
Age of dix: younger age
Glycemic control
BP control
Serum lipids: INC
Nephropathy
Anemia: LOW HCT
Pregnancy: high levels of estogen

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13
Q

What is the first clinical sign of Diabetic Retinopathy?

A

Microaneurysm

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14
Q

What happens if there is ischemic hypoxia?

A

Upregulation pro-inflammatory factors such as VEGF

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15
Q

What are the 2 classifications of Diabetic retinopathy?

A

Non-proligerative diabetic retinopathy
Proliferative diabetic retinopathy

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16
Q

What clasification of diabetic retinopathy is characterized by capillary damage & breakdown of the retinal blood barrier?

A

Non-proliferative diabetic retinopathy

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17
Q

What is the cause of NPDR?

A

Microvascularization changes

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18
Q

What aer hte typical fundus findings in NPDR?

A

Microaneurysm
Dot and blot retinal hemorrhages
Circinate exudates
Macular edema
Macular ischemia

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19
Q

What is affected in severe NPDR?

A

All quadrants of the retina

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20
Q

what is seen in severe nPDR?

A

Hyperfluorescent dots : microaneurysms
Dye leakage

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21
Q

What classification of diabetic retinopathy has sustained capillary damage and progresses into angiogenesis caused by extensive ischemia?

A

Proliferative diabetic retinopathy

22
Q

What is the hallmark of PDR?

A

Growht of abnormal new vessels either on the disc or on the retina

23
Q

What are the diff tx options for diabetic retinopathy?

A

Laster photocoagulation
Panretinal photocoagulation
Focal and grid laser treatment
Retinal photocoagulation
Intravitreal anti-VEGF
Retinal surgery for vitreous hemorrhage

24
Q

What DR tx is used to decrease the O2 demande by use of laser tx?

A

Laser photocoagulation

25
Q

What DR tx is used when the disease reahes the proliferative high risk stage?

A

Panretinal photocoagulation

26
Q

What DR tx is used to treat px with macular edema?

A

Focal and grid laser tx

27
Q

Wjat is the diff betw FOcal and Grid laser tx?

A

Focal treatment = macular edema due to focal leakage
Grid treatment = macular edema due to diffuse leakage

28
Q

What is the best form of management for edema secondaty to diabetic retinopathy?

A

Itnravitreal injection for anti-VEGF

29
Q

What re the retinal manifesations of hypertension?

A

Vasoconstriction = focal/diffuse

Leakage = retinal hemorrhages, hard exudates, soft exudates, optic nerve edema

Arteriosclerosis = AV ratio 1:2 or 1:3 (normally retina AV ratio is 2:3)

30
Q

What is the KWB classification of hypertensive retinpathy?

A

Grade 1: slight sclerosis
Grade 2: definite sclerosis & AV nicking
Grade 3: leakages, hemorrhages
Grade 4: uncontrollable high leaking, papilledema is evident

31
Q

What causes retinal vein occlusion?

A

Thrombosis

32
Q

What are the characteristics of retinal vein occlusion?

A

Branch retinal vein occlusion
Central retinal vein occlusion

33
Q

What causes branch retinal vein occlusion?

A

AV crossing defect
Angiogram = blocked fluorescence from this hemorrhage

34
Q

What happens in central retinal vein occlusion?

A

Hemorrhages in 4 quadrants of the retina

35
Q

What is the tx used for retinal vein occlusion?

A

Anti-VEGF
- earlier admin
- to improve vision
- 3 monthly dosing

Lessen effects of ischemia (like neovascularizaation)

36
Q

What causes retinal artery occlusion?

A

Embolic phenomenon from calcificd internal carotid artery

37
Q

What are the 2 characteristics of retinal artery occlusion?

A

Branch retinal vein occlusion
Central retinal vein occlusion

38
Q

What is the appearace of branch retinal vein occlusion?

A

Retina lwhitening in the area of the occluded artery
Sudden painless loss of vision
Pallor of the superior retina

39
Q

What are the characteristics of cental retinal vein occlusion?

A

Fundus with a cherry red spot
-> increased pigmentation fo the fovea (excessive pallor of surrounding edematou retina)

40
Q

What is the 90 mins golden period of central retina vein occlusion?

A

This is 1 of 2 absolute ophthalmic emergencies bcos it can cause signfiicant and irreversible damge if not treated within 90mins

41
Q

What is the tx for retinal artery occlusion?

A

Reperfusion below 90 mins = if severe and permanent visual loss is ecptected

Dislodged emboli

42
Q

What are the features of retinal detachment?

A

RPE pump dysfunction
Subretinal fluid
Floaters
Flashes of light
Scotoma beginning from the periphery vision proceeding/encroaching centrally

43
Q

What is a type of retinal detachment with retinal break/tear?

A

Rhegmatogenou retinal detachment

44
Q

What ar theclinical features of rhegmatogenou retinal detachment?

A

Suddent onset of blurry vision, wavy vision, visual field cuts, flashes and floaters

45
Q

What type of retinal detachment does not have retinal break or tear and causes blurry vision of variable onset?

A

Non-rhegmatogenous retinal deatchment

46
Q

What are the 2 types of NRRD?

A

Exudative = iNC exudation beneath the retina -> accumulation of fluid

Tractional

47
Q

What are the causes of exudative and tractional NRRD?

A

Exudative = inflammation, tumors, accelerated or malignant hypertension

Tractional = diabetes, trauma and ischemic retinopathies

48
Q

What are the tx for retinal detachment?

A

Pars plana vitrectomy
Tx of the underlying cause

49
Q

What is the main mode of management for exudative NRRD?

A

Treatment of undelrying medical cause

50
Q

What is the indication of Pars plana vitrectomy?

A

If retinal detachment is secondary to a retinal break or tractional RD

Ophthalmology (4 decks)

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