Disorders Of The Retina, Vitreous And CHoroid

Question 1

What are the 3 posterior chambers/

Answer 1

Vitrueous -> retina -> choroid

Question 2

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

Answer 2

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

Question 3

What is the copositio of vitrueou?

Answer 3

99% water
1% ssolid portion

Question 4

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

Answer 4

Muller’s cells

Question 5

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

Answer 5

IBOP
Inner = Bipolar
Outer = Photoreceptor

Question 6

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

Answer 6

Choroid

Question 7

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

Answer 7

Direct ophthalmoscopy

Question 8

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

Answer 8

Slit-lamp biomicroscopy

Question 9

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

Answer 9

Indirect ophthamloscopy

Question 10

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

Answer 10

Fundus photo and retinal angiogram

Question 11

What layers of the retina are HYPERREFLECTIVE?

Answer 11

Plexiform and Fibrous layers

Question 12

What are the risk factors of diabetic retinopathy?

Answer 12

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

Question 13

What is the first clinical sign of Diabetic Retinopathy?

Answer 13

Microaneurysm

Question 14

What happens if there is ischemic hypoxia?

Answer 14

Upregulation pro-inflammatory factors such as VEGF

Question 15

What are the 2 classifications of Diabetic retinopathy?

Answer 15

Non-proligerative diabetic retinopathy
Proliferative diabetic retinopathy

Question 16

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

Answer 16

Non-proliferative diabetic retinopathy

Question 17

What is the cause of NPDR?

Answer 17

Microvascularization changes

Question 18

What aer hte typical fundus findings in NPDR?

Answer 18

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

Question 19

What is affected in severe NPDR?

Answer 19

All quadrants of the retina

Question 20

what is seen in severe nPDR?

Answer 20

Hyperfluorescent dots : microaneurysms
Dye leakage

Question 21

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

Answer 21

Proliferative diabetic retinopathy

Question 22

What is the hallmark of PDR?

Answer 22

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

Question 23

What are the diff tx options for diabetic retinopathy?

Answer 23

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

Question 24

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

Answer 24

Laser photocoagulation

Question 25

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

Answer 25

Panretinal photocoagulation

Question 26

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

Answer 26

Focal and grid laser tx

Question 27

Wjat is the diff betw FOcal and Grid laser tx?

Answer 27

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

Question 28

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

Answer 28

Itnravitreal injection for anti-VEGF

Question 29

What re the retinal manifesations of hypertension?

Answer 29

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)

Question 30

What is the KWB classification of hypertensive retinpathy?

Answer 30

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

Question 31

What causes retinal vein occlusion?

Answer 31

Thrombosis

Question 32

What are the characteristics of retinal vein occlusion?

Answer 32

Branch retinal vein occlusion Central retinal vein occlusion

Question 33

What causes branch retinal vein occlusion?

Answer 33

AV crossing defect Angiogram = blocked fluorescence from this hemorrhage

Question 34

What happens in central retinal vein occlusion?

Answer 34

Hemorrhages in 4 quadrants of the retina

Question 35

What is the tx used for retinal vein occlusion?

Answer 35

Anti-VEGF - earlier admin - to improve vision - 3 monthly dosing Lessen effects of ischemia (like neovascularizaation)

Question 36

What causes retinal artery occlusion?

Answer 36

Embolic phenomenon from calcificd internal carotid artery

Question 37

What are the 2 characteristics of retinal artery occlusion?

Answer 37

Branch retinal vein occlusion Central retinal vein occlusion

Question 38

What is the appearace of branch retinal vein occlusion?

Answer 38

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

Question 39

What are the characteristics of cental retinal vein occlusion?

Answer 39

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

Question 40

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

Answer 40

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

Question 41

What is the tx for retinal artery occlusion?

Answer 41

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

Question 42

What are the features of retinal detachment?

Answer 42

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

Question 43

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

Answer 43

Rhegmatogenou retinal detachment

Question 44

What ar theclinical features of rhegmatogenou retinal detachment?

Answer 44

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

Question 45

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

Answer 45

Non-rhegmatogenous retinal deatchment

Question 46

What are the 2 types of NRRD?

Answer 46

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

Question 47

What are the causes of exudative and tractional NRRD?

Answer 47

Exudative = inflammation, tumors, accelerated or malignant hypertension Tractional = diabetes, trauma and ischemic retinopathies

Question 48

What are the tx for retinal detachment?

Answer 48

Pars plana vitrectomy Tx of the underlying cause

Question 49

What is the main mode of management for exudative NRRD?

Answer 49

Treatment of undelrying medical cause

Question 50

What is the indication of Pars plana vitrectomy?

Answer 50

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