Lecture 4 Flashcards
Vitreoretinal tufts - 3 types and their main differences
Non cystic- 50% bilateral, small, adhered well, at base. Most common, found in 72%
Cystic- composed of degenerating retina, may cause traction, varying sizes, unilateral
Zonular- Extends towards zonules. 15%.
Meridional fold. How many people have? Unilateral or bilateral?
40% of pop
55% bilateral
Meridional fold is associated with
atrophic hole, oral pearl, cystic tuft
Common location of meridional fold
SN
Degenerative retinoschisis is considered an advanced form of
Cystoid degeneration.
Microcystoid degeneration –> macro cyst –> degenerative retinoschisis
Stats of degenerative retinoschisis
- Unilat or bilat?
- location in retina
- 10% progress to __
Bilat
Rare
70% IT
RD
2 types of degenerative retinoschisis
Flat/Typical
- Splitting at OPL
- bilateral in 64%
- Rarely associated with breaks
Bollous/Reticular
- Splitting of layers anterior to OPL
- Thin, transparent ballooning with sclerotic vessels.
- Associated with heme, neo, RD (1/3)
- More common than typical
- Bilateral in 15%
- Increased incidence of inner and outer layer breaks, often at the posterior boarder of the schsis.
Lattice appearance
85% RPE hyperplasia 80% sparkly, yellow specs Fishbone vessels Chorioretinal atrophy in the lesion May have flap tear at boarder
Lattice degeneration
- What is it
- percent of people with it
- Common locations and in who
Strong attachment of the vitreous to retina next to thin retina. Low risk of detachment, especially if pt has already had PVD.
8-11% of pop
12 and 6 o clock
Common in myopes
Differential- paving stone, retinal dialysis
Snail tracks
Variant of lattice
Atrophic hole makes up __% of retinal breaks
What about opercolated holes ?
Atrophic: 76%
Operculated 13%
Atrophic hole is usually associated with (4)
Lattice / myopes
Meridional fold
Cystic retinal tuft
Zonular traction tuft.
% of opercolated holes associated with PVD
80%
Commotio retinae is called __ When in the posterior pole
Berlins Edema
Which has a beaten metal appearance?
Flat retinoschisis
Difference between retinoschisis and retinal detachment
Retinoschisis- When looking with B scan, does not undulate with movements.
No pigment demarcation line (if so, indicates detachment)
Choroidal details usually visible
Retinoschisis without breaks. RTC when?
Retinoschisis with inner OR outer layer break?
Retinoschisis with Inner AND outer layer break?
6-12 months. Less than 1% of causing RD.
2x per year
2x per year
Refer
Does lattice cause a high risk of detachment?
Not really, 0.5% chance of detachment. Similar to retinoschisis.
30% of all detachments are associated with ___
Lattice, with horeshoe tear being the greatest risk.
Examine parents and siblings if pt has
Lattice
Size of atrophic retinal hole
Less than 0.5DD
76% of all retinal breaks are
Atrophic holes
__% of people with atrophic retinal holes have sub clinical detachment
80%
Operculated retinal holes are most commonly associated with
PVD or lattice.
Tx if you see an operculated hole and it’s old vs if new/symptomatic
old- annual
new- 6 week
sub clinic detachment- refer
Commotio Retinae RTC
2 weeks, should resolve
