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PPO > other macular > Flashcards

other macular Flashcards

1
Q

macular holes are more common in what population

A

women over the age of 50

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2
Q

what is the difference between a full thickness hole vs lamellar hole

A 
full = loss of sensory retina
lamellar = loss of retina to the photoreceptor layer
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3
Q

list three different possible causes of macular holes

A
  1. CSME
  2. Trama
  3. Vitreal traction
  4. idiopathic = macular thinning
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4
Q

t/f in a full thickness macular hole, RPE and choroid are still intact

A

true

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5
Q

how do macular holes (full thickness) affect vision

A

usually about 2100-2200, possibly worse
usually sudden decrease in vision
scotoma

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6
Q

describe the appearance of macular holes

A

usually 1/4 DD.
may have a gray halo around the hole
may have operculum around the hole

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7
Q

yellow spots within the macula hole may represent what

A

xanthophyll; means that the hole has been there for a long time

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8
Q

what is stage one of the macular hole

A

no vitreal fovial separation has occurred.
OCT will show cystic changes
yellow ring in fovial area

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9
Q

what is stage two of the macular hole

A

opening typically small in size
neural retinal defect can be eccentic or central or horse shoe shaped
pseudo operculum maybe

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10
Q

what is stage three of the macular hole

A

stage 3 = established
full thickness hole, but vitreous still attached
rim of subretinal fluid around the hole
yellow deposits in the hole

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11
Q

what is stage four of the macular hole

A

full thickness hole with complete PVD

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12
Q

what is the watzke-allen test

A

when you shine a slit beam into the patients eye and the patient notices a break in the beam

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13
Q

what is the cystoid macular edema?

A

extra vascular accumulation of serous fluid in outer plexiform layer

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14
Q

what is cystoid macular edema associated with

A
  1. aphakes
  2. surgery (cateract)
  3. retinovascular disease
  4. trauma
  5. drug use (epi)
  6. epi-retinal membranes
  7. vitreal traction
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15
Q

how does cystoid macular edema affect visual acuity

A

20/50 - 20/100

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16
Q

what is cystoid macular edema look like on slit lamp evaluation

A

subtle orange yellow hue

difficult to detect

17
Q

what does cystoid macular edema look like on FL angiography

A

late phase of hyper FL = flower pedal appearance

18
Q

how do you manage and treat cystoid macular edema

A

most resolve over several months (3-9).

treatment: possibly N-SAIDS or steroids or surgery

19
Q

pohs primarily affects what organ

A

lung

20
Q

t/f POHS is contagious?

A

false

21
Q

causes of POHS become symptomatic in how many and what kind of individuals

A

only 10% are symptomatic

in immunosurpressed people, infants, and people with lung problems.

22
Q

what is the habitat for POHS

A

in the soil from droppings from chickens and bats

23
Q

what do you see in the fundus with POHS

A
  1. histo spots which = yellow white scars, may have pigment.
    multiple 1/8 - 1/2 DD.
    bilateral
    between posterior pole and equator
  2. PPA; usually involves choroid and RPE
  3. Exudative maculopathy (causes loss of vision)
24
Q

what are streak lesions

A

found in POHS.
parallel the aura or equator.
bands of deep pigmentation

25
Q

how many clinical signs do you need to see in the retina to diagnose POHS

A

2/4

26
Q

how do you manage / treat POHS

A

monitor / take home ansler grid
then if there is a CNV, treat similar to wet AMD
either laser EDT or VEGF

27
Q

what are some other causes of CNVM

A

angioid streaks
pathological myopia
choroidal ruptures
idiopathic

28
Q

what is pathological myopia

A 
greater than 12-15 diopeters
axial length > 30mm
fitting of the retina
pigment changes
usually posterior staphyloma
possible CNV
lacquer cracks or breaks in bruchs
29
Q

what are lacquer cracks

A

pale yellow or white single or branching lesions that surround the macular area

30
Q

what are some systemic diseases associated with angioid streaks

A

PEPSI

pseudo-xanthama elasticum
ehlosdanlos syndrome
paget's
sickle cell
idiopathic
31
Q

angioid streaks occur at what level of the retina

A

breaks and bruchs

32
Q

where are angioid streaks usually found

A

usually radiate from the disc or parallel to the disk

33
Q

describe the appearance of choroidal ruptures and what causes them

A

caused by blunt trauma
damage to bruchs
concave in shape
potential for a CNV

34
Q

what is peaud’orange

A

mottling of RPE associated with angioid streaks

PPO (10 decks)

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