MT 1 Flashcards
CME with leakage on FA
Diabetic Retinopathy, BRVO, Idiopathic retinal telangiectasia, psuedophakia or aphacia
CME without leakage on FA
macular hole, neovascularization, RP, nicotinic acid maculopathy.
Cause of Macular hole
Idiopathic-premenstrual women. Myopia-staphyloma Trauma, solar retinopathy
Cause of epiretinal membrane
Retinal vascular dz, intraocular inflammation, trauma, retinal procedures
Stage I of Macular hole
Decreased or absent foveal depression, yellow deposits, Macular cyst. no hole
Stage II of macular hole
Peripheral macular detachment. Increased yellow deposits. Takes weeks-months to get here from I.
Stage III of macular hole
Macular hole. Quick from II. 1/3DD punched out area. 20/200 or worse. May see operculum.
Stage IV of macular hole
May get better VA with lessening of edema. Complete hole cuff. Complete PVD. May see operculum.
What layers of retina get fluid in CME
OPL and INL.
Criteria for CSME
- Retinal edema within 500 nanometer of fovea 2. hard exudates within 500 nanometers of fovea with adjacent edema 3. edema 1 DD (1500) that is within 1DD to the fovea.
Central Serous Retinopathy vs. Pigment Epithelial Detachment
Central serous the RPE is still in place. PED the RPE is also displaces
What do you see on FA with CSR
Umbrella or smokestack.
How long does CSR typically recover
1-6 months. Can do photocoagulation for quicker results. Can also give low plus for hyperopic shift.
Selective Retinal Therapy
For CSR with PED. Treats RPE and spares photo.
Dioxide laser therapy
Can also be used to treat CSR.
Lacquer cracks
Breaks in brush’s membrane. Can lead to choroid neovascularization.
Findings with Myopic Macular Degeneration
Posterior staphyloma, lacquer cracks, fuch’s spots.
Plaqunil/hydroxycholorquine/cholorquine screening
Baseline DFE, DFE within one year, DFE every year after 5 years if no risk factors. Run 30-2 or 24-2 on Asians and 10-2 on all other patients.
Risk factors for plaqunil maculopathy
550 mg every day for 3 years. Worse with tamoxifine.
Where does plaqunil deposit
REP and chord. Pigment areas.
Cinchonism
Cause by an overdose of quinie. Fixed dilated pupils, retinal edema, VF restriction, ON atrophy, VA loss.
Thioridazine + chlorpromazine
Used to treat psychosis. 2400> of chlorpromazine and 800> thioridazine. Salt and pepper retinopathy. Decreased VAs and poor dark adaption. Pigmentation of macula–> geographical defects of RPE.
Tamoxifene
Drug used to treat breast cancer. Rarely vortex keratopathy and ON. Can get yellow crystal deposits in macula with VA loss.
Canthaxathin
Promotes suntanning. Can get yellow deposits in retina. Typically benign.