Lecture 3

Question 1

Peripheral senile pigmentary degeneration / Peripheral tepetochoroidal degeneration

Answer 1

Band of pigment between ora and equator 360 due to degenerating RPE cells. Honeycomb.
Overlying photoreceptor loss and underlying choroidal sclerosis.

Question 2

% of the population over 40 with Peripheral senile pigmentary degeneration / Peripheral tepetochoroidal degeneration

Answer 2

20%

Question 3

A variation of Peripheral senile pigmentary degeneration / Peripheral tepetochoroidal degeneration

Answer 3

Senile reticular pigmentary degeneration

Pigment surrounds venules as MO carry the pigment to the vessels. Creates bone spicule appearance.

Question 4

Senile reticular pigmentary degeneration is associated with

Answer 4

ARMD

Question 5

Cobblestone/pavingstone/Primary chorioretinal atrophy

Answer 5

Compromised blood flow to choroid causes overlying degeneration of RPE
Bilateral
Pale yellow surrounded by pigment

Question 6

Post inflammatory chorioretinal scar

Answer 6

May see white/yellow area of fibrosis (watch out for traction)
RPE hyperplasia

Question 7

Typical peripheral cystoid degeneration

Answer 7

Hazy gray area of thickened retina beginning at ora. Red dots in thickened area with overlying vitreous haze.

IT
Bilateral
May be precursor to retinoschisis

Question 8

Reticular peripheral cystoid degeneration

Answer 8

Continuous with peripheral cystoid degeneration but triangle border. Fish bone sclerotic vessels.
Bilateral

Question 9

Atypical CHRPE

Answer 9

Associated with FAP, especially 4+ lesions
80% with FAP have atypical CHRPE
Teardrop lesions 4-5mm in size in midperiph
autofluoress

Question 10

Why do you get RPE hyperplasia?

Answer 10

Insult to the retina. Replicating RPE cells invade the retina in attempt to repair.
Seen with red free.
Indicates condition has been there for 60-90 days

Question 11

% of pop with WWoP? and demographics

Answer 11

30% 
AA
5% under 20 years 
66% over 70 years 
See scalloped boarders? maybe more likely for retinal detach

Question 12

Oral pearls

Answer 12

At ora, drusen structure.
Seen in 20% of eyes
May break loose

Question 13

Pars Plana Cysts

• What is it
• Appearance
• Associated with (2)

Answer 13

Equiv to retinal detachment of the pars plana.
Transparent, smooth
Assoc with RD or posterior uveitis

Question 14

Average thickness of periphery and equator

Answer 14

100 microns, equator is 200 microns

Since periphery is thinner, see a color change and decrease in vessel size.

Question 15

Vortex vein Varix

Answer 15

Elevated and darker in color, do indo green to see choroidal circulation.

Question 16

Long posterior ciliary arteries in reference to the nerves

Answer 16

Above nasal, below temporal

Question 17

How many short posterior ciliary arteries per eye?

Vortex veins?

Answer 17

10-20

up to 10

Question 18

Scalloping of the ora is more pronounced

Answer 18

Nasal

More dentate processes nasal. 16-48 per eye.

Question 19

Pars plana extends from

Answer 19

Ora to ciliary process

Question 20

Ora

Answer 20

Anterior limit of the neural retina

Question 21

Does cobblestone predispose pt to holes/tears?

Answer 21

No because there is pigment deposition- strong attachment between choroid and retina.

Question 22

Cobblestone common location

Answer 22

IT (80%) and bilateral

May become confluent

Question 23

Cobblestone differentials

Answer 23

Gyrate atrophy 
Chorioretinal scars 
Trauma 
CHRPE 
Coloboma 
Atrophic holes

Question 24

Typical peripheral cystoid degeneration is usually found where in the retina

Answer 24

IT

Bilateral (41%)

Question 25

Difference between typical and reticular cystoid degeneration

Answer 25

Reticular has triangle boarder and sclerotic vessels.

Question 26

reticular peripheral cystoid degeneration is associated with the development of

Answer 26

Degenerative retinoschisis

Question 27

scotoma with CHRPE?

Answer 27

Yes

Question 28

Oral pearls seen in what % of eyes

Answer 28

20

Question 29

Risk of enclosed oral bays

Answer 29

Altered attachment at vitreous base- may cause retinal tear during PVD adjacent to this location.

May mimic retinal hole