Posterior Segment Disease

Question 1

Pathophysiology of DME

Answer 1

Result of chronic micro vascular compromise and can be developed by inflammatory or ischemic mechanism. High plasma glucose levels cause breakdown of the BRB through the loss of pericytes. Leads to loss of endo cells function and release of VEGF.

Question 2

Define DME during fundus evaluation

Answer 2

Bending of vessels
Proximity of hemorrhage/micro aneurism to the macular or presence of hard exudates.
Evaluate retinal thickness
Elevation secondary to intraretinal or Subretinal fluid.

Question 3

Risk of vision loss with DME involving central of macula

Answer 3

10x greater risk of vision loss in one year

Question 4

Vascular cause of vision loss

Answer 4

1-Diabetic Retinopathy
2-BRVO
3-CRVO

Question 5

CRVO risk factors

Answer 5

HTN
DM
Cardiovascular disease
OAG

Question 6

Vision threatening complications of CRVO

Answer 6

Macular disease

Complication of neovascularization

Question 7

Ischemic CRVO

Answer 7

10 DD or more of capillary non perfusion in FA,

90% will present with 20/200 VA

Question 8

Etiologies of young patients presenting with CRVO

Answer 8

• Oral contraceptives
• protein S,C and antithrombin III deficiency
• Factor XII deficiency
• antiphopholipid antibody syndrome
• collagen vascular disease
• papillophlebitis
• AIDS

Question 9

Progressive night blindness (Nyctalopia)

Answer 9

• RP
• Gyrate atrophy
• Choroideremia

Question 10

RP clinical triad

Answer 10

-Retinal bone-spicule pigmentation
-arteriolar attenuation
-Waxy optic disc pallor
PSC, optic disc drusen( hyaline bodies 10%), CME, ERM, Keratoconus, myopia, annular Scotsman

Question 11

Photopsia is the

Answer 11

presence of perceived flashes of light.
associated with posterior vitreous detachment, migraine with aura, migraine aura without headache, retinal break or detachment, focal occipital lobe infarction, and sensory deprivation (ophthalmopathic hallucinations

Question 12

CSR ( central serous chorizo retinopathy)symptoms

Answer 12

Metamorphopsia
Sudden onset of Blurred vision
Relative scotoma if macula is involved

Question 13

AMD symptoms

Answer 13

Metamorphopsia
Progressive degeneration of RPE,
Bruch’s membrane and choriocapillaries

Question 14

Dry AMD

Answer 14

Hallmark is macular drusens
RPE abnormalities ( molting, granularity, geographic atrophy and focal hyperpigmentarion

Question 15

Risk factors of progression from demur AMD to Wet

Answer 15

Multiple soft drusens
Focal hyperpigmentation
Hypertension
Smoking

Question 16

Histoplasmosis triad

Answer 16

Peripapillary atrophy
Multifocal peripheral chorioretinal lesions
Maculopathy

Question 17

ERM risk factors

Answer 17

PVD
retinal breaks
Trauma
Cataract or other infra ocular surgery 
Intraocular inflammation

Question 18

Elschnig spots

Answer 18

• Focal areas of choroidal atrophy that develop from nonperfusion.
• Represent past episodes of acute hypertension.

Question 19

Sievert’ streaks

Answer 19

Linear hypopigmented areas over choroidal vessels.

Question 20

CWS

Answer 20

Common cause is the diabetic retinopathy.
Within NFL
Disappear within 5-7 weeks

Question 21

What is within NFL

Answer 21

CWS
Flame shape hemorrhage
Drance hemorrhage

Question 22

Common vascular cause of vision loss

Answer 22

1- Diabetic Retinopathy
2-BRVO
3-CRVO

Question 23

Systemic conditions associated with Optic Neuritis

Answer 23

MS
Iidiopathic
Syphilis
Cat-scratch disease 
Lyme disease
Meningitis 
Sarcoidosis 
SLE
Devic's disease

Question 24

Optic atrophy due to compression of the nerve fibers appear as

Answer 24

Bow tie atrophy

Question 25

Extraocular vascular obstruction, most likely from carotid artery disease signs

Answer 25

Normal intraocular pressure with rubeosis and angle closure, poor response to panretinal photocoagulation, or markedly asymmetric diabetic retinopathy