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other other macular disorders Flashcards

1
Q

what is the peripheral retina

A

anterior to the equator, extending to the oraserrata (3dd away)

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2
Q

the peripheral retina encompasses what percentage of the fundus

A

40%

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3
Q

what changes occur with blood vessels in the peripheral retina

A

smaller
fewer
become basically parallel to ora

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4
Q

the ora is more scalloped on which side

A

nasally

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5
Q

what are oral bays

A

they are extensions of pars plana at the ora serrata

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6
Q

what are oral teeth (dentate processes)

A

extensions of retina between oral bays

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7
Q

oral bays and teeth together are called what

A

dentate processes

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8
Q

migraine headaches cause flashes that last for how long? unilateral or bilateral?

A

flashes usually last 10-60 minutes
usually unilateral
start central, move peripheral

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9
Q

if flashes occur from vitreal or retinal causes, how long do they last

A

only a few seconds, usually provoked by head movement. usually acute and sudden onset.

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10
Q

what kind of questions do you want to ask someone with floaters

A 
how long have the floaters been present
which eye
how many
whats the shape
what their story: trauma, disease, inflammation, etc.
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11
Q

what are some differentials for floaters

A
  1. pbd
  2. vitreal heme
  3. retinal operculum
  4. entoptic = gazing in sky, small white particles are white blood cells
  5. posterior uveitis
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12
Q

what could cause pseudo flashes

A

medical history,
media opacities
glare

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13
Q

what is another word for peripheral RPE degeneration

A

reticular degeneration

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14
Q

what is peripheral RPE degeneration and what is the prevalence

A

granular pigment deposits between the ora and the equator and 20% of population over 40

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15
Q

what causes peripheral RPE degeneration

A

caused by the break down of the RPE with deposition of pigment granules in sensory retina. ultimately loss of PRs and sclerosis of the choriocapilaris

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16
Q

how do you manage / treat peripheral RPE degeneration

A

monitor routine dilation every 1-2 years

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17
Q

what causes paving stone / cobble stone degeneration

A

occlusion of compartments of choriocapilaris which causes RPE degeneration and retinal thinning

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18
Q

pavingstone degeneration is common in what populations

A 
age related (greater than 40)
usually benign
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19
Q

paving stone degeneration is common in what quadrants

A

nasal and temporal quadrants

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20
Q

where is pavingstone degeneration located

A

located between ora and equator

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21
Q

describe the apparance of lesions in pavingstone

A

flat

distinct margins that may have pigmented edges that are several dd in size

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22
Q

what is the management of pavingstone degeneration

A

monitor and routine dialation every 1-2 years

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23
Q

how common is peripheral cystoid degeneration

A

occurs in virtually all patients over the age of 8

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24
Q

what causes peripheral cystoid degeneration

A

involves cystoid like changes in OPL that can extend to involve the entire sensory retina

if the cyst colalesce they can form large cystoid spaces, causing true splitting or retinoschisis of the sensory retina

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25
where is peripheral cystoid degeneration found and what does it look like
usually at ora and can extend to the equator | thickened area of retina, extending about 1/2 dd
26
how do you manage peripheral cystoid degeneration
just monitor and routine dialation every 1-2 years
27
t/f cystoid degeneration is a risk for developing retinal detachments
false
28
t/f white WITH pressure is a malignant condition
false
29
what causes white WITH pressure
a distinct milky white appearance when scleral depression is performed. without depression the retina appears normal its commonly observed in approx 30% of eyes examined with scleral depression, and is NOT associated with peripheral retinal breaks
30
white without pressure is usualyl seen in what kind of eyes
10x more often in darker fundi higher incidence in myops. associated with aging
31
what is the cause of white without pressure
unusual vitreal-retinal relationship that causes disorganization of NFL of sensory retina down to RPE
32
where does white without pressure occur
occurs between the ora and the equator
33
t/f white without pressure can lead to retinal detachments
true | its associated with abnormal vitreal-retinal adhesion
34
what is schaffer's sign
its presence of cells that are golden brown pigmented granules and anterior vitreous of phakic that suggests retinal breaks. sometimes called tobacco dust.
35
atrophic retinal holes are usually secondary to what
progressive retinal thinning due to underlying vascular insufficiency
36
atrophic retinal holes are usually about how big
pinpoint to 2 dd round red lesions
37
atrophic hole surrounded by pigment or RPE hyperplasia indicate what
indicates lesion has been prsent for approx 3 months
38
about how often do you get sensory retinal detachment from atrophic retinal holes
10% incidence
39
how to manage / treat atrophic retinal holes
if there is pigment around it, monitor it annually. if there is a cuff of adema, refer to OMD patient education. risks of retinal detachment
40
operculated retinal holes appear where and appear how
usually occur from equator to ora | round, red, holes with a free floating plug of retinal tissue attached to the vitreous
41
what causes horseshoe tears
usually due to abnormal vitreal-retinal adhesions and PVD
42
horse shoe tears put you at risk for what two things
1. retinal detachment | 2. vitreal hemes
43
how do you manage horse shoe tears
refer all horse shoe tears to a retinal specialist because they cause 30% of retinal detachments
44
lattice degeneration is what, found where, how many people have it
oval or elliptical area of retinal thinning near the equator found in approx 8% of the population
45
what causes lattice degeneration
a vitreal retinal degeneration affecting inner retinal layers and vitreal retinal surface
46
lattice degeneration is more commonly found in what quadrants and what size/appearance
usually found superior or inferior quadrants. usually parallel to ora serrata usually 2dd to a full quadrant in size 1/2 dd to 1.5 dd in width looks like fine white lines that look attenuated or sheathed vessels with some RPE hyperplasia changes vitreous liquefies over lattice
47
what is snail tracking degeneration
basically the same as lattice degeneration but looks like a whiteish trail instead.
48
what are vitreal retinal tufts
accumulation of proliferated glial cells on retinal surface causing retinal degeneration and subsequent vitreous attachment
49
vitreal retinal tufts are found where and what do they look like
found between equator and ora, usually nasal | look like grayish white pieces of tissue
50
what is a complication of vitreal retinal tufts
retinal detachment or tears may occur with vitreous liquefaction
51
where is retinal dialysis found if associated with trauma vs spontaneously
trauma = mostly in superior nasal quadrant | spontaneous in younger patients = inferior temporal quadrant and bilateral
52
what is the definition of retinal dialysis
its a retinal tear that occurs near the ora serrata that looksl ike a slow progressing retinal detachment
53
what is the treatment for retinal dialysis
refer all dialysis; needs prompt treatment
54
what are some causes for rhegamatogenous retinal detachments
20% caused by lattice 20% caused by blunt trauma high myopia
55
what is a non-rhegamatogenous retinal detachment
a definition has no loose end to a retinal break and often a sign of a space occupying lesion, like a tumor
56
what are the two types of acquired retinoschisis
``` flat = typical bullous = reticular ```
57
what is retinoschisis
splitting of sensory retina, outer plexiform and inner nuclear layer
58
with acquired retinoschisis, where is it usually found; uni or bilateral
usually bilateral, and found typically in inferior temporal quadrant
59
what is flat RS
believed to represent advanced cystoid degeneration, usually not associated with retinal holes.
60
what is bulluos RS, what does it look like, what is the cavity filled with
looks like thin transparent ballooning forward of retinal tissue cavity is filled with hyaluronic acid posterior edge may be serrated, but typically has no pigmented line progression is rare.
61
what is one possible complication of bullous RS
11% of patients with RS will develop retinal detachments
62
besides retinal detachments, what are some other complications of RS
can get multiple inner retinal holes or outer retinal holes that are larger than inner retinal holes, and typically only one.

PPO (10 decks)

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