PPV Flashcards
Pars Plana
ciliary body 1mm limbus posteriorly 6 mm. 2mm pars plicata 4 mm flattened pars plana
surgical incision
phakic 4mm, pseudophakic 3.5mm
Innocuous peripheral retinal degeneration
microcystoid (peripheral cystoid) degeneration, Paving stone degeneration, Reticular (honeycomb) degeneration, Pars plana cyst
Dentate processes
nasally, retina extensions onto the pars plana
Oral bays
scalloped edges of pars plana epi between dentate processes
Meridional folds
superonasal, may small hole, thickened retina in line with dentate processes
microcystoid (peripheral cystoid) degeneration
tiny vesicles on grey-white background, all eyes, increase with age, may degenerative schisis
Paving stone degeneration
inferior, between equator and ora, yellow-white chorioretinal atrophy, 25% of normal
Reticular (honeycomb) degeneration
age-related perivascular pigmentation
Pars plana cyst
temporally, 5-10% eyes, from non-pigmented ciliary epithelium
Lattice degeneration
8% eyes, 40% of RD, bi, temporal superior, between equator and posterior border of vitreous base, discontinuity of ILM
Snailtrack degeneration
demarcated snowflakes, white frost-like appearance
Cystic retinal tuft
5% eyes, in 5-10% of RD, temporally, discrete elevated whitish lesion, glial, vitreoretinal adhesion
Degenerative retinoschisis
inferotemporal, bi in 80%, typical-outer plexiform layer,anteriorly to equator, reticular-NFL,worse,posteriorly. convex, smooth, thin, immobile
Zonular traction tuft
nasally, 15%, near ora serrata
white with pressure
translucent white-gray, indentation, normal eyes, may with lattice, snailtrack, retinoschisis
white without pressure
without indentation. condensed vitreous. retinal breaks, giant tears
Myopic choroidal atrophy
posterior pole and equatorial area. may lead to RD
synchysis
liquefaction
liquefaction
synchysis
condensation
syneresis
syneresis
condensation
PVD - kolejność
perifoveal - foveal - posterior retina/equator - optic disc - vitreous base. complications 27%. 20% retinal tear
Retinal tear - location
upper temporal
retinal detachment - definition
tear more than one disc diameter
dialyses - what, where, when
circumferential tears along ora serrata, vitreous gel attached to the posterior margin. blunt trauma
giant retinal tear - definition
U-tear involving 90st or more. vitreous gel attached to the anterior margin
risk for RD
symptomatic>asymptomatic, traction, larger, superior, equatorial>oral breaks, operculated-very low, asymptomatic U-tears-low risk
Cryotherapy - when, parameters
multiple contiguous tears, extensive tears, hazy media, small pupils. 0.1s 200-300 um 3-mirror or 100-200 wide-field. start 200mW
rRD - how many in myopic
40%
rRD - how many symptoms
60%
rRD - location order
60% superotemporal - 15% superonasal/inferotermporal - 10% inferonasal
rRD - how many more than one break
50%
rRD - location of more quickly appreciated symptoms
lower field defect
flashes - where in visual field
temporal
Schwartz-Matsuo syndrome
raised IOP, rRD, mild anterior uveitis, often due to a dialysis due to prior blunt trauma in a young man
Choroidal detachment - when, features
hypotony, uvetitis, posterior scleritis, choroidal tumors, cyclodialysis cleft, RD, uveal effusion syndrome. Brown, convex, smooth, relatively immobile
Pneumatic retinopaxy - definition, jaki gas, when
intravitreal gas bubble with cryotherapy or laser. SF6, C3F8, uncomplicated IR with small break. cluster breaks more than 2 clock hour in upper 2/3
SF6
sulfur hexafluoride, doubles volume, lasts 10-14 days
sulfur hexafluoride
SF6, doubles volume, lasts 10-14 days
C3F8
perfluoropropane, quadruples its volume, lasts 55-65 days
perfluoropropane
C3F8, quadruples its volume, lasts 55-65 days
complications of scleral buckle
diplopia, CME 25%, ERM 15%, persistent subfoveal fluid, foveal disruption, anterior segment ischemia, extrusion/intrusion/infection, elevated IOP, choroidal detachment, PVR, reopening of break
tRD - features
no photopsia, concave, mobility reduced, shallower SRF
eRD - causes
melanoma, hemangioma, meta, Harada disease, posterior scleritis, bullous CSR, RD surgery, panretinal photocoagulation, CNV, hypertensive choroidopathy, uveal effusion syndrome
eRD - features
convex, smooth, not corrugated, very mobile, shifting fluid
PPV devices
vitreous cutter, fibreoptic probe, infusion cannula, scissors, forceps, flute needle, endodiathermy, endolaser delivery systems
C2F6
perfluorethane, triples volume, lasts 30-35 days
perfluorethane
C2F6, triples volume, lasts 30-35 days
When PPV for rDR
breaks cannot be visualized (hemor, debris, PCO), giant tears, large posterior breaks, presence of PVD (last 3 - unlikely to be closed with buckle)
PPV complications
Raised IOP (overexpansion gas, silicone early-pupillary block, emulsified late, ghost cell, inflammatory, steroid), cataract (gas-induced feathering of posterior capsule, silicone, delayed-nuclear sclerosis), band keratopathy (extended silicone oil)
