Midterm II

Question 1

What is a serous detachment usually from in younger patients?

Answer 1

central serous (type A) and usually transient that resolves on own`

Question 2

What is the stepwise process of a exudative/serous detachment occurring because of a choroidal nevus?

Answer 2

1. RPE leaks out fluid
2. fluid leaks in between RPE and sensory retina
3. fluid pushes up, away from the RPE

Question 3

What is drusen a result of inside of a choroidal nevus? 1. Is this a good or bad prognostic sign? 2

Answer 3

1. poor vascular supply from the choriocapillaris created by physical barrier
2. good sign because won’t convert to malignancy

Question 4

What are the three classifications and treatments by the optometrist of a choroidal nevus (with the size of each)?

Answer 4

1. benign, none (0.5-2 DD)
2. suspicious, recall 6 months (2-5 DD)
3. malignant, refer (5DD or larger)

Question 5

How is the size of a malignant melanoma measured?

Answer 5

1. ophthalmoscopy
2. ultrasound
3. FANG

Question 6

What is the best way to confirm that a spot is a choroidal nevi? 1. What should be done to monitor the nevi? 2

Answer 6

1. red free filter (will disappear)

2. take a photo

Question 7

What is the appearance of a serous RPE detachment?

Answer 7

elevated retina and smooth surface

Question 8

If their are none of the 8 factors that are more characteristic of a melanoma than a nevus than what is the probability of growth of the nevi in 5 years?

Answer 8

3%

Question 9

What is the term for a multi-colored nevi?

Answer 9

mottling

Question 10

What is a serous detachment usually from in older patients?

Answer 10

1. macular degeneration
2. cancer
3. central serous possible (not type A)

Question 11

What are the things to differentiate a nevus from a melanoma?

Answer 11

1. Thickness > 2mm
2. subretinal fluid
3. symptoms (flashes mostly and sometimes floaters)
4. orange pigment (lipofuscin)
5. margin within 3mm of optic disc (2DD)
6. ultrasonographic hollowness
7. absence of halo
8. absence of drusen

Question 12

What are the things to look for with any choroidal nevus?

Answer 12

1. how large?
2. is it changing (border, elevation, color)?
3. is it elevated
4. what color is it and how many colors involved?

Question 13

If their is one of the 8 factors that are more characteristic of a melanoma than a nevus than what is the probability of growth of the nevi in 5 years?

Answer 13

38%

Question 14

If their are three or more of the 8 factors that are more characteristic of a melanoma than a nevus than what is the probability of growth of the nevi in 5 years?

Answer 14

50%, probably a melanoma

Question 15

What is the outer 1/3 of the retina supplied by?

Answer 15

choroidal and choriocapillaris system

Question 16

What is the inner 2/3 of the retina supplied by?

Answer 16

branches of the central retinal artery

Question 17

Are arteries or veins more likely to break in vitreous detachment? 1. Why? 2

Answer 17

1. arteries

2. closer to vitreous b/c sit on top of veins

Question 18

What is the basement membrane of the RPE?

Answer 18

Bruch’s membrane

Question 19

Where is the choriocapillaris the densest?

Answer 19

at the fovea

Question 20

What is it called when the choroidal BV’s fill with fluid slightly earlier than the retinal circulation?

Answer 20

choroidal flush

Question 21

What are the phases of FANG?

Answer 21

1. choroidal flush
2. arterial phase
3. arteriovenous capillary phase
4. early venous phase
5. mid-venous phase
6. late venous phase

Question 22

Where is the blood located in dot-blot hemes?

Answer 22

1. inner nuclear layer
2. outer plexiform layer
3. outer nuclear layer`

Question 23

What layer are hard exudates usually found?

Answer 23

outer plexiform layer

Question 24

What are artery-to-vein collaterals that do not have capillary bed obstructions called?

Answer 24

shunts

Question 25

What do optic nerve head shunt vessels connect?

Answer 25

retina to choroid