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Retina > Retina 1 > Flashcards

Retina 1 Flashcards

1
Q

hyaloideocapsular ligament of (weiger)

A

attaches anterior vitreous to posterior lens

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2
Q

patellar fossa

A

this is the groove that the vitreous has for the lens to sit in.

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3
Q

retrolental space of berger

A

space where lens and vitreous are not attached

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4
Q

Where is the vitreous based attached to?

A

2mm anterior and 3mm posterior to ora serata

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5
Q

area martegiani

A

posterior end of the canal, where the hyaloid artery once emerged from the optic disc

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6
Q

Precortical vitreous pocket

A

Vitreous space formed by macular attachments

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7
Q

What are the different areas of the macula and the anatomic descriptions?

A
  1. Macula: Area between peripheral arcades2. Fovea: Central macula about 1 DD (1.5mm) in diameter)3. Foveola: 0.35mm of central macula (inner nuclear and ganglion cell layers are laterally displace)4. Umbo: Depression at center of fovea5. Parafovea: 0.5 mm in width surrounding fovea6. Perifovea: 15.mm in width surrounding the parafovea
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8
Q

Meridional fold

A

pleats of redudant retina extending radially into pars plana

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9
Q

What cells make the internal limiting membrane? What about the external limiting mebrane (XTL)

A

Made by footplates of Muller’s cells. XTL is not actual membrane but junctional complex between Muller cells and photoreceptors.

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10
Q

What are some of the functions of RPE cells?

A
  • absorbs light * phagocytoses rod and cones outer segments * participates in retinal and polyunsaturated fatty acid metabolism * forms the out blood-ocular barrier * maintains the subretinal space * heals and forms scar tissue
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11
Q

What are physical properties that make fluoroscein different from ICG? What is ICG good for evaluating?

A

ICG is 98% protein bound and fluoresceine is 80% protein bound. ICG is good for looking at choroidal vasculature

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12
Q

What is the doasage thought to start toxicity for chloroquine? Hydroxychloquine?

A

300g cumulative; 400mg/day over months to years with cumulative dose of > 1000g although highly weight dependent

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13
Q

What are the two topographic areas of the vitreous?

A

Core and cortical

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14
Q

Aside from water, what is vitreous composed of?

A

Collagen, hyaluronan

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15
Q

What is the definition of a giant retinal tear?

A

An rt extending more than 3 clock hours circumferentially

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16
Q

What is the most common cause for a dialysis tear?

A

Trauma

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17
Q

When there is avulsion of the vitreous base, what must have assuredly happened?

A

Trauma of some sort

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18
Q

Do traumatic retinal breaks in young patients generally occur/manifest early on or late?

A

Late

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19
Q

What is the incidence of PVd over age of 70?

A

Over 60 percent

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20
Q

What is the incidence of retinal tear in patients with hemorrhagic vs non-hemorrhagic tears? Total combined incidence?

A

70 percent10 percent15 percent

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21
Q

How common is lattice in the general population?

A

About 10%, more common in myopes

22
Q

What are the 3 types of retinal tufts?

A

Cystic, non-cystic, and zonular (extends over the pars plana)

23
Q

Lattice degeneration, vitreoretinal tufts, and meridional folds all increase the risk of….

A

Retinal tears and detachments

24
Q

How common is cobblestoning or paving stone degeneration in the general population?

A

20%

25
Q

Cobblestoning, rpe hyperplasia, peripheral cystoid degeneration all ______ the risk of retinal detachment?

A

Have no affect on

26
Q

Approximately what percentage of eyes in the general population have a retinal break?

A

5%, most are sub clinical and undetected and rarely go on to retinal detachment

27
Q

What is highly characteristic of a exudative detachment vs RRD or TRD?

A

Shifting sub retinal fluid and smooth areas of detachment

28
Q

Peripheral cystoid degeneration does not predispose to retinal detachment but is associated with what?

A

Retinoschisis

29
Q

What retinal findings can be seen in Gardners syndrome (familial adenomatous polyposis)?

A

Ovoid CHRPE like lesions that are multiple and bilateral

30
Q

What are some exam findings seen in birdshot retinochoroidopathy? Symptoms?

A

Vitritis 100% of timeDisc edemaCmeNasal choroidal/retinal vitelliform lesions (spares temporal retina often), vasulitis, bilateral diseaseNyctalopia, loss of color vision, vision loss

31
Q

What is the Hla associated with birdshot retinochoroiditis?

A

HLA-A29 in >90%

32
Q

What is the treatment for Birdshot retinochoroidopathy?

A

Intravitreal steroid/systemic steroid that often requires chronic steroid sparing immunomodulatory agents

33
Q

What is the typical clinical presentation of APMPPE (acute posterior multifocal placoid pigment epitheliopathy)?

A

Acute onset vision loss in one eye followed days later by involvement in the other eye.

34
Q

What is the treatment for APMPPE?

A

Observation

35
Q

What is usually the treatment for active serpiginous choroidopathy?

A

Corticosteroids and immunomodulatory medications combined

36
Q

What is the size classification for intermediate druse?

A

64-124 microns; remember this number and you can remember the large and small druse size

37
Q

What is the purpose of following patients with angioid streaks?

A

Monitor for development of cnv which can be treated.

38
Q

What preventative measure should patients with angioid streaks take?

A

Protective eye wear as their blood vessels are more prone to break

39
Q

What are the specific micro vascular findings that happen with diabetic retinopathy?

A

Pericyte damage/lossBasement membrane thickening

40
Q

What are the three criteria for CSME?

A
  1. Macula edema within 500 microns of foveal center2. Exudates within 500 microns of foveal center if associated with edema3. 1 disc diameter of edema within 1 disc diameter of foveal center
41
Q

What is the definition (4 criteria) of high risk PDR?

A
  1. NV within 1 DD of disc greater than 1/4 DD2. NVD associated with vitreous hem3. NVE associated with vitreous hem4. NVI/NVA
42
Q

What are FIPTs in regards to hypertensive retinopathy?

A

Focal intraretinal prearteriolar transudates that are similar to cotton wool spots but deeper, smaller, and less white

43
Q

What is the mutational change in sickle cell (Hb S) disease?

A

Glutamate to valine in the sixth position of the beta polypeptide

44
Q

What is the mutational change in hemoglobin C (Hb C) disease?

A

Glutamate to lysine in the sixth position of beta polypeptide

45
Q

What is a basic ddx for disc edema associated with flame hemorrhages and macular star Exudates?

A

Neuroretinitis, diabetic papillopathy, hypertensive retinopathy, CRVO, AION, and radiation papillopathy

46
Q

What are some characteristics of PSR (sickle cell retinopathy) compared to PDR?

A

PSR is usually more peripheral and associated with “sea fan” neovascularization that is white in appearance

47
Q

What is the most common quadrant for BRVO?

A

Superotemporal

48
Q

What are the two categories of CRVO?

A

Ischemic and non ischemic

49
Q

What is an exam technique to distinguish CRVO from OIS

A

Placing pressure on the globe while examining the central retinal artery to see if it collapses or not. A collapsible artery is consistent with ocular ischemic syndrome.

50
Q

What are the three major categories of retinal emboli?

A
  1. Cholesterol (holenhorst plaques)2. Platelet-fibrin ( associated with large arteriosclerotic disease)3. Calcific emboli (from diseases cardiac valves)

Retina (4 decks)

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