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Foundations II Exam 1 > Optic Nerve/Retina 2 > Flashcards

Optic Nerve/Retina 2 Flashcards

1
Q

What are the 2 basic changes to retinal vasculature w/ Diabetic Retinopathy?

A
  1. Abnormal permeability of vessels
  2. Vascular occlusion, leading to ischemia and subsequent neovascularization
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2
Q

What is the tx for Hypertensive Retinopathy?

A
  • Systemic blood pressure control
  • Ophtho referral (for newly diagnosed HTN, longstanding/severe HTN, vision loss)
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3
Q
  • Arteriolar Narrowing (copper wiring)
  • Arteriolar Sclerosis (silver wiring)
  • A:V crossing changes (AV nicking)
A

Mild Hypertensive Retinopathy

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4
Q
  • Under which circumstance would you evaluate etiology of Central Retinal Vein Occlusion?
  • What is the prognosis?
A
  • If the pt is young, evaluate for severe HTN and hypercoagulable states
  • Prognosis is variable
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5
Q

The 3 classifications of Hypertensive Retinopathy

A
  1. Mild
  2. Moderate
  3. Severe
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6
Q
  • Cotton-wool spots (areas of atrophy)
  • Retinal/Flame hemorrhages
  • Retinal edema/exudates (macular star)
A

Moderate Hypertensive Retinopathy

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7
Q
  • Sxs noticed first thing in AM upon waking
  • Acute painless unilateral vision loss (not complete vision loss)
  • No eye redness

Sxs of which eye condition?

A

Central Retinal Vein Occlusion

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8
Q

In which 3 circumstances should a pt w/ diabetes be examined by an ophthalmologist for Diabetic Retinopathy?

A
  1. Type 1 DM for over 5 years
  2. At first diagnosis of Type 2 DM
  3. If ocular sxs develop or if suspicious findings of retinopathy
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9
Q
  • Urgent referral to ophtho
  • Observation (most cases)
  • ASA (ONLY if pt w/ underlying coagulopathy)

Tx for which eye condition?

A

Central Retinal Vein Occlusion

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10
Q

Diabetic Retinopathy is present in what % of diabetic patients?

A

40%

*BUT, not all have visual disturbances

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11
Q

Asymptomatic w/ no vision complaints

A

Hypertensive Retinopathy

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12
Q
  • Typically asymptomatic until later stages
  • Blurred vision due to acute increases in serum glucose, causing lens swelling and refractive shift (even in absence of condition)
  • Sugar pushes on lens
A

Diabetic Retinopathy

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13
Q

37 yr old male, optic disc edema, cotton wool spots, flame hemorrhages, dot-blot hemorrhages, AV nicking, hard exudates. Asymptomatic, vision 20/20. BP is 198/142.

What is the diagnosis?

A

Hypertensive Retinopathy

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14
Q

1 cause of blindness in Western world of patients under 50 yrs old

A

Diabetic Retinopathy

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15
Q

3 ways Diabetic Retinopathy is classified

A
  1. Non-proliferative DR
  2. Proliferative DR
  3. Diabetic Macular Edema
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16
Q

Which DR has the worst prognosis?

A

Proliferative DR

17
Q

Prognosis for Central Retinal Artery Occlusion

A

Poor prognosis

18
Q

What is the goal after finding out pt has Central Retinal Artery Occlusion?

A
  • Determine etiology
  • Prevent further emboli
19
Q
  • NLP (no light perception)
  • Afferent pupillary defect
  • Pale retina w/ “cherry red spot” at fovea

Signs of which eye condition?

A

Central Retinal Artery Occlusion

20
Q

Ophthalmology referral for:

  • Laser photocoagulation
  • Anti-angiogenic injection
  • Vitrectomy (take out some vitreous humor)
A

Tx for Diabetic Retinopathy

21
Q

Occlusion by emboli, results in decreased blood flow and hypoxia to retina

A

Central Retinal Artery Occlusion

22
Q
  • Sudden painless, TOTAL monocular vision loss
  • No eye redness

Sxs of which eye condition?

A

Central Retinal Artery Occlusion

23
Q

To tx Diabetic Retinopathy, the patient needs to control their blood sugars.

  • What should their daily glucose remain under?
  • What should their HbA1C remain under?
A
  • 120
  • 7
24
Q

May have repeated transient episodes before complete loss of vision.

A

Central Retinal Artery Occlusion

25
Q

How often should diabetic patients have ophthalmoscopic exam through dilated pupils?

A

Yearly

26
Q

Retinal vascular changes due to systemic hypertension

A

Hypertensive Retinopathy

27
Q
  • Under which circumstance would you treat Central Retinal Vein Occlusion?
  • With what meds?
A
  • If there is macular edema
  • Give Intravitreal steroids
28
Q

Disc edema (papilledema)

A

Severe Hypertensive Retinopathy (includes sxs of mild/moderate)

29
Q
  • Neovascularization
  • Vitreous hemorrhage
  • Traction retinal detachment
A

Proliferative DR (includes features of non-prolif DR)

30
Q
  • Can occur at any stage of condition
  • Fundoscopic findings:
    • Retinal thickening
    • Microaneurysms
    • Hard exudates
A

Macular Edema (DR)

31
Q
  • Emergent referral to ophtho
  • Tx often not effective unless started within a few hours of onset
A

Central Retinal Artery Occlusion

32
Q

Occlusion due to thrombi

A

Central Retinal Vein Occlusion

33
Q
  • Microaneurysms (earliest sign)
  • Dot-blot hemorrhages
  • Cotton-wool spots (ischemia)
A

Non-Proliferative DR

34
Q

3 possible etiologies of Central Retinal Artery Occlusion

A
  1. Carotid plaques
  2. Cardiac emboli
  3. Temporal arteritis (if pt older than 55 yrs) - get carotid US
35
Q
  • +/- APD (afferent pupilary defect)
  • Variable visual acuity
  • Multiple hemorrhages
  • Venous dilation/tortuosity
  • “blood and thunder” fundus

Signs of which eye condition?

A

Central Retinal Vein Occlusion

Foundations II Exam 1 (25 decks)

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