Hereditary Flashcards
Fundus Flavimaculatus
“Flecked” retina syndrome
Inheritance pattern of Fundus Flavimaculatus
AR
Fundus Flavimaculatus is (Uni/Bi)-Lateral
Bilateral (and symmetric)
When is FF usually diagnosed?
20-30
FF predominantly affects what area of retina?
Midperiphery/posterior pole
Shapes of flecks in FF
- Round
- Oval
- Linear
- Semilunar
- Pisciform
T/F: Fundus Flavimaculatus is an atrophic process
FALSE
Some say FF is a variant of
Stargardt
Treatment for FF
None, generally good prognosis
(unless CNV —> AntiVEGF, laser, or PDT)
Fundus Flavi results for:
1. ERG
2. EOG
3. FA
Slightly abnormal ERG
Abnormal EOG
FA: dark/silent choroid, early hypo due to blockage, then late hyper due to staining
Stargardt
“Beaten Bronze” appearance is associated with
Stargardt
Which form of Stargardt is more destructive and occurs earlier in life: AR or AD?
AR
Stargardt:
Unilateral or Bilateral?
Bilateral (and symmetric)
Most common juvenile macular dystrophy
Stargardt
Visible macular changes in Stargardt begin at age
6-20
Stargardt also known as
Juvenile Macular Degeneration
Symptoms of Stargardt
R/G color deficit and central scotoma
What do you have to r/o in late stage Stargardt?
Drug Toxicity (due to Bulls Eye)
Early Stage of Stargardt
Loss of FLR
Later stage of Stargardt
Oval atrophy with bulls eye configuration “beaten bronze”
Stargardt:
- EOG
- ERG
- FA
EOG and ERG normal (until central/peripheral retina affected)
FA: dark/quiet choroid and hyper in later stages
Typical VA for Stargardt
20/70-20/100 in at least one eye
Prognosis for Stargardt
Poor
Can suggest Omega3s and sun protection
But honestly… /:
Best Disease is also known as
Vitelliform Macular Dystrophy or Juvenile Best Macular Dystrophy
Definition of “Dystrophy”
Condition someone is born with
Definition of “Dystrophy”
Condition someone is born with
Retinal Dystrophy
Condition associated with reduced or deteriorating vision in both eyes
“Syndromic” Retinal Dystrophy
Dystrophy is a part of a pattern of problems involving other parts of the body
Degeneration
Deterioration of a tissue/organ in which vitality is diminished and structure impaired
T/F: Retinal Degenerations are typically bilateral and genetic
FALSE:
They can be unilateral or bilateral and may or may not be genetic
2 general types of degeneration
- Specialized cells replaced with unspecialized cells
- Cells functionally impaired
Inheritance pattern for Best
AD
Age of onset for Best
3-15, average 6
What imaging findings are pathognomonic for Best?
Abnormal EOG but normal ERG
What can be indicative of Best Disease prior to any fundus changes?
Abnormal EOG
Best Disease
Accumulation of lipofuscin in RPE, subretinal macrophages, and choroid
Describe “Egg Yolk” Lesion
Yellow Mound
Dark Border
Centered at Fovea
Describe “Scrambled Egg” appearance
Degeneration of “egg yolk” —> RPE atrophy —> CNV —> leaking, rupture, hemorrhage, macular scarring
Stage 1 of Best
Pre-Vitelliform
Abnormal EOG
Normal fundus
Asymptomatic
Stage 2 of Best
Vitelliform
Egg-Yolk
(Usually age 3-15)
Stage 3 of Best
Pseudohypopyon
Lesion can be absorbed
Little to no effect to vision
Stage 4 of Best
Vitelliruptive
Scrambled Egg
More vision loss