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OPOT 4002 > Ophthaa RD > Flashcards

Ophthaa RD Flashcards

1
Q

Ocular anatomy ant. to pos.

A

Cornea > aqueous humor > Iris > Lens/ciliary body > Vitreous humor > Retina/ON > choroid > Sclera
Limbus > Pars plica(2m) > Pars plana (4mm) > Ora serrata

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2
Q

Layers of the retina Ant. to Pos.

A

ILM
NFL
GCL
IPL
INL
OPL
ONL
ELM
PR
RPE
Bruchs membrane
Choroid

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3
Q

Vitreous humor content and adhesion points:

A

99% water, 1% hyaluronic acid, collagen, hyalocytes
Optic disc, Fovea, BVs, Lattice degenerations
Vitreous base (overlays ora.)

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4
Q

RRD risk factors:

A

^age, myopic (>6D)
Ocular surgery (20x Cat.)
Trauma (retinal break / Vit. liquifaction)
RD in fellow eye (10%)
Retinal degenerations: lattice, white w/wo pressure (retina thinning)
FOH (myopia)
Systemic: Marfan’s (Tall), Ehler-Danlos, Sticklers (collagen disorder > scleral elongation)

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5
Q

Pathogenesis of RRD:

A

Vitreous degeneration > liquefaction > acute PVD w/ collapse > traction > tear > fluid influx via break > layer separation > dome shaped elevation
* Vit. liquifaction + retinal break > RRD

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6
Q

RRD symptoms:

A

Flashes 60% (Vit. pulls on PR’s)
Floaters (Weiss ring, cobweb, shower of red spots)
Painless vision loss
VF defect (curtaining)

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7
Q

RRD signs:

A

VA loss
RAPD (Extensive RD)
IOP decrease (ciliary shock > low aqueous production or aqueous misdirection)
Iritis
Shafer’s sign (RPE pigment in AC)
Retinal break (50% will have several breaks)
Lattice degeneration
Vit. haem

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8
Q

TRD causes:

A
  • Any condition causing Vit. Haem or ischemia to pos. retina
    DR > PDR
    CRAO/CRVO
    retinopathy of prematurity
    retinal vasculitis
    sickle cell anaemia
    penetrating trauma
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8
Q

RRD visualization:

A

Convex, opaque, corrugated, loss of choroid pattern, dark/blurred BV’s

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9
Q

Pathogenesis of TRD:

A

Pos. retina ischemia > Hypoxia > VEGF release > leaky BV’s > Vit. Haem > clotting/scar tissue > contraction
* Scar tissue formation > NSR pulled from RPE
* U/ partial PVD

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10
Q

TRD symptoms:

A

Gradual painless vision loss
Hx eye condition (DR/BV occlusion)
No flashes (gradual/incomplete PVD)
Floaters (If vit. haem)

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10
Q

Exudative RD causes:

A

Infection (TB, syphilis, Lyme)
Inflammation (Uveitis, scleritis)
Choroidal tumors (melanoma, hemangioma)
CSR
Hydrostatic (malignant hypertension)
Vascular (microaneurysm)
Sx (PRP)

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11
Q

TRD signs:

A

Fibrovascular membrane
RD
Features of underlying cause (retinal haem. / CWS / Exudates)

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12
Q

Pathogenesis of exudative RD:

A

RPE pump failiure > retinal/choroidal BV fluid influx > Accumulation of subretinal fluid > NSR seperation from RPE

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13
Q

Exudative RD symptoms:

A

Blurry vision
No flashes/pain
R/ floaters (if vitritis)
Assoc. symptoms of panuveitis (pain, redness, photophobia)

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13
Q

Signs of exudative RD:

A

Mobile retinal detachment
RD convex, smooth, no corrugation
Assoc. findings (retinitis, choroiditis, tumor)

14
Q

TRD visualisation

A

Concave, taut, shallow
U/ no retinal breaks

15
Q

Signs of long standing RD:

A

Retinal thinning
Fixed retinal folds
Secondary intraretinal cysts
Subretinal demarcation lines
Proliferative vitreoretinopathy

16
Q

RD vs retinoschisis:

A

RD: convex/corrugated, unilateral, relative scotoma, demarcation line, breaks, cells in vitreous
Retinoschisis: Convex/smooth, U/bilateral, absolute scotoma, no demarkation, no breaks, clear vitreous

17
Q

RD referral details:

A

Px details
VA, latest RA/BCVA
IOP
Status of lens
Presence of tears
Locations and extent of RD
Macula status

18
Q

Sx for RRD:

A

Pars plana Vitrectomy (common)
Scleral buckle (anterior break w/clear media)
Pneumatic retinopexy (small/superior break)

18
Q

Indications for RD Sx:

A

recent onset
Superior RD
Macula off < 3 days (or mac on)

19
Q

Pneumatic retinopexy procedure:

A

Perfluropropane injection > supine position > laser around break
only for small breaks in superior 8’ clock hour of retina

20
Q

Scleral buckle:

A

explant sutured on sclera > RPE connected to NSR
Requires clear media
can induce refractive error, strabismis, ^IOP, anterior segment ischemia

20
Q

Pars plana vitrectomy complications:

A

Cataract
Hypotony
Vit. Haem
Endopthalmitis
Glaucoma
Latogenic breaks

OPOT 4002 (6 decks)

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