Posterior

Question 1

Acute multifocal retinitis

Answer 1

self-limited, preceded by a flu-like. may be an atypical presentation of cat-scratch. sudden onset mild visual loss in young adults

Question 2

Secondary Frosted branch angiitis

Answer 2

associated with infectious retinitis, notably cytomegalovirus retinitis, toxoplasmosis and other conditions such as lymphoma, leukaemia, Behcet, SLE

Question 3

(Unilateral) acute idiopathic maculopathy (AIM)

Answer 3

self-limited unilateral, may be preceded by a flu-like. sudden marked reduction in central vision. An irregularly yellow or grey exudative retinal detachment at macula

Question 4

Krill disease

Answer 4

Acute retinal pigment epitheliitis

Question 5

Acute retinal pigment epitheliitis

Answer 5

self-limited condition of the RPE; it is unilateral in 75%, young adults with mild disturbance of central vision; 1–2 weeks after the onset of symptoms the macula shows 2–4 discrete clusters of subtle small (one-fourth disc diameter) grey spots at the level of the RPE, surrounded by hypopigmented yellow haloes

Question 6

Progressive subretinal fibrosis and uveitis syndrome (SFU)

Answer 6

causing gradual blurring of vision in one then both eyes. Anterior uveitis and vitritis accompanies subretinal mounds (kopce) at the posterior pole and midperiphery. to widespread subretinal fibrosis. Steroids may be effective early in the disease, but the prognosis is poor.

Question 7

Acute idiopathic blind spot enlargement syndrome (AIBSE)

Answer 7

many features with MEWDS. young to middle-aged women. Features include photopsia and decreased vision, with blind spot enlargement and mild disc swelling

Question 8

Acute macular neuroretinopathy (AMN)

Answer 8

self-limited, healthy young adult females. one or both eyes and may be preceded by a flu-like illness. Symptoms consist of decreased vision and paracentral scotomata. Red–brown wedgeshaped lesions are observed in a flower petal arrangement around the centre of the macula. FA is normal or shows faint hypofluorescence.

Question 9

Acute macular neuroretinopathy (AMN) - FA

Answer 9

normal or shows faint hypofluorescence.

Question 10

Acute syphilitic posterior placoid chorioretinopathy

Answer 10

characterized by large pale-yellowish subretinal lesions in the posterior pole

Question 11

‘ground glass’ appearance

Answer 11

syphilitic retinitis

Question 12

syphilitic retinitis

Answer 12

Retinitis has a ‘ground glass’ appearance; associated vasculitis may be occlusive and involve both arteries and veins

Question 13

Presumed ocular histoplasmosis syndrome

Answer 13

Histoplasma capsulatum, common in AIDS, immunemediated response to microbial antigen. asymptomatic unless macular choroidal neovascularization supervenes. • Classic triad: (i) multiple white atrophic chorioretinal ‘histo’ spots about 200 μm in diameter; (ii) peripapillary atrophy; (iii) vitritis is absent. HLA-B7 and DRw2.

Question 14

Acute retinal necrosis

Answer 14

healthy, young HSV, old VZV, uni, floaters, pain. 1. Prominent anterior uveitis and vitritis (panuveitis). Episcleritis and scleritis may occur. 2. One or more discrete foci of peripheral retinal necrosis. 3. Circumferential spread of retinal involvement 4. Occlusive retinal vasculitis including arteritis 5. Rapid without treatment

Question 15

Progressive retinal necrosis

Answer 15

rapidly progressive unilateral or bilateral visual loss, Anterior uveitis and vitritis are minimal. ○ Early. Multifocal homogeneous yellow–white deep retinal infiltrates. The macula may be involved at an early stage, often giving a cherry-red spot.
○ Established/middle. The signs typically spread rapidly around the retina, with very extensive full-thickness necrosis
○ Late. Scarring is plaque-like and characterized as ‘cracked mud’. Rhegmatogenous retinal detachment (RRD) is very common, as is optic atrophy.

Question 16

‘cracked mud’

Answer 16

Progressive retinal necrosis

Question 17

Cytomegalovirus retinitis

Answer 17

One eye is usually affected initially, progressing to both eyes in 50%. one or two areas of dense white retinal infiltration associated prominently with flame-shaped retinal haemorrhages (‘pizza pie’ or ‘Margherita pizza’), beginning peripherally (centrally in 10%) and extending along the course of the vascular arcades

Question 18

Immune recovery uveitis

Answer 18

This is a cause of limited visual outcome in CMV retinitis, thought to be due to a rejuvenated immune response against residual viral antigen following immune reconstitution with HAART. Manifestations can be severe, progressing to phthisis in some cases.

Question 19

Diffuse unilateral subacute neuroretinitis

Answer 19

presence of a single motile subretinal nematode such as Toxocara canis, Baylisascaris procyonis and Ancylostoma caninum

Question 20

Diffuse unilateral subacute neuroretinitis - treatment

Answer 20

Photocoagulation (200 μm, 0.2–0.5 s, 150–300 mW) is the treatment of choice when a worm can be visualized. Systemic albendazole (400 mg for 30 days) or vitrectomy.

Question 21

Most frequent retinopathy in patients with AIDS

Answer 21

HIV-related retinal microangiopathy, developing in up to 70% of patients

Question 22

Congenital toxoplasmosis - treatment

Answer 22

pyrimethamine, sulfadiazine, folinic acid