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Ophthalmology > retina > Flashcards

retina Flashcards

1
Q

operculated hole treated if ?

A

associated with persistent vitreous traction, Vit Hg , superior or large

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2
Q

symtomatic PVD associated with retinal tear

A

7-18%
if with Vit Hg 75%

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3
Q

asymptomatic flap tear progress to RD in

A

5%

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4
Q

asymptomatic LD progress to RD in

A

1%

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5
Q

risk factors of RRD post phaco

A

male, young, myopia, high AL, PCR, absence of PVD
highst risk in the first year 11x
more risk of RRD than phakic by 1-3 %

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6
Q

risk of RRD in the fellow eye

A

10%

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7
Q

subclinical RD or asymptomatic RD

A

subretinal fluid that extend more than 1 DD form the break but not more than 2 DD posterior to the equater
30% risk to progress

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8
Q

RRD after trauma in young pt

A

12% in immediatly
30% in the first month
50% after 8 months
80% after 24 months
M.C retinal dialysis in inferotemoral or superonasal
vitreous avalsion
macular hole
horseshoe tear (equatorial, post to meridional fold, post margin of vitreous bsae)
often multiple

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9
Q

FFA dose

A

2-3 ml of 25% or 5ml of 10% sterile solution in anticubital vien

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10
Q

FFA component

A

fluorescein dye ( 80% bound to the plasma protien)
fundus camera
excitation filter (blue green 460-490 nm)
barrier filter (yellow 520-530 nm)

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11
Q

phases of FFA

A

choroidal flush 8-12 s from injection
arterial phase 11-18 s from injection
laminar phase 1-3 s later
venous phase 5-10s later
early recirculation 2-4 min
late recirculation 4-5 min

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12
Q

hypoflaurescence

A

vascular filling defect
blockage effect

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13
Q

drug causing ME

A

docetaxal
niacin
deforxamine
fingolimoid
prostaglandin F2a
glitazone

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14
Q

Risk factors for RVO

A

AGE, HTN, DM, dyslipidemia, smoking, glaucoma, hypercoagulable status, hypothyrodism

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15
Q

retinitis pigmentosa

A

rod cone dystrophy
tirad of : waxyy pallor of ON, bone specule , attenuated BV
pt complaining of paracentral ring scotoma or restricted peripheral VF and nyctalopia
associated with: vitreous cells, CME, PSC, ERM, ON Drusen
exudative RD and vascular hyperpermabilty (coats like) 2-5%

ERG: reduced both A and B wave
B wave prolonged in duration and diminished in amplitude

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16
Q

intraocular FB that cause reaction

A

Zinc and aluminium cause mild inflammation and becoma incapsulated
if lareg can cause severe inflammation and PVR, ERM, TRD , phthisis bulbi
iron and cupper( more) are very toxic to the eye
chalcosis&raquo_space; kayser fleischer ring, sunflower cataract , greenish discoloration of the iris, greenish particle in the aqueous , brownish to reddish opacities and strand in the vitreous, metalic fleck on the retina.

Sidrosis deposits on neuroepithelial cells, most toxic to the PR and RPE , early reduced A wave, later on reduced both A and B wave (electronegative ERG)
SOAG , mydriasis , stromal staining, cataract

symptoms: nyctalopia, restricted VF, DOV

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17
Q

pigmentary retinopathy and hearing loss DDx

A

alport syndrome
alstrom syndrome
refsum syndrome
congenital rubella syndrome
mucopolysaccridosis
cockayne syndrome

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18
Q

BDUMP

A
  • bilateral multiple melanocytic lesions in the choroid
  • acute PSCC
  • ERD
  • iris and CB cysts
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19
Q

terson syndrome %

A

1/3 of subdural or subarachnoid Hg
Sun ILM , Subhyaloid, Vit Hg
resolved spontaneously , may need vitrectomy

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20
Q

choroidal hemangioma Rx

A

Diffuse: external beam radiation
circumscribed: PDT
if asymptomatic: no treatment

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21
Q

choroidal hemangioma types

A

circumscribed: sporadic, usually at the macula, cystoid degenration of the outer retina, exudative retinal detachment.
DDX: amelanotic Choroidal melanoma, choroidal osteoma, choroidal mets, choroidal granuloma

Diffuse CH: SWS, tomato kechup , can cause SACG, ERD
A scan : high amplitude initial echo and high amplitude internal echo
B san: choroidal thickening with high internal reflictivity
FFA: early hyperflauorescnece of large choroidal vessels at choroidal phase followed by stainning of lesion or leakage or pooling of cystoid lesion of overlying retina

ICG: early hyperfluorescence , peak at 3-4 min, wash out at late frame leaving only hyperflourescence rim

infrared imaging

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22
Q

electrophysiologic retinal study

A

EOG: RPE
multifocal ERG: Macula cone-red fumction
pattern ERG: (checkerboard , contrast sensetivity) , P50 ( PR in the macule), N95 (GCL)
VEP: afferent visual system

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23
Q

types of ocular lymphoma

A
  1. primary intraocular or vitreoretinal lymphoma (most aggresive)
  2. primary uveal lymphoma
  3. primary ocular adnexa lymphoma
  4. secondary lymphoma
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24
Q

PVRL

A

25% of PCNSL will have PVRL
60% PF PVRL will have PCNSL
30% presented unilataral , 85% will affect fellow eye
any pt more than 50 presented with new onset bilateral posterior uveitis consider lymphoma
symptoms: decreased vision and floaters
signs: diffuse vitreous cells and flare, deep sub RPE/ subretina yellow white infiltrate +/- vascultits or vascular occlusion
FFA / ICG : hypofluorescence early and late
Dx: vitrectomy for vitreous +/- subretinal sample for flow cytometry, cytopathology , gene rearrangment study , PCR, IL10: IL6 >1 , MYD88 mutation , Brain imaging and LP
Rx: IV methotrexate +/- IVI methotrexta or rituximab or EB radiotherapy
poor prognosis

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25
Q

characteristic signs suggest PVRL

A

1-incomplete or partial response to steroid
2-atypical large vitreous cells which is white arranged like string of pearls or sheat like (aurora borealis effect)
3- subretinal/ sunRPE white lesion that is may be transient od shift the location with time

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26
Q

Uveal lypmphoma

A

more slow pattern
1/3 associated with systemic lymphoma
bridshot uveitis like retinopathy +/- ERD
thickening of uvea on B san
episcleral involvment» salmon patch

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27
Q

AREDS2 supplements

A

Vit C 500mg, Vit E 400IU, Lutien 10mg, Zeaxanthin 2mg, zinc 80mg, cupper 2mg
DEC porgression up to 25%, Dec moderate Vision loss (>3 lines) up to 19% in 5 years
foradvanced AMD in one eye: subfoveal GA or CNVM
forintermediate AMD:
* extensive intermediate drusen
* single large drusen
* nonfoveal GA

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28
Q

focal VMT

A

50% sponntaneously released

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29
Q

refsume disease

A

AR
elevated plasma phytanic acid
pigmentary retinopathy+ cerebellar ataxia+ hearing loss + icthyosis
nyctalopia early sign of the disease
restricted diatry intake of phytanic acid

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30
Q

HTN retinopathy severity

A

arteriolar narrowing , AV nikking

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31
Q

scheie classification of HTN retinopathy

A

0: no retinopathy
1:mild arterial narrowing
2:marked arterial narrowning
3: 2+ retinal Hgs and Exudate
4: 3+ optic nerve swelling

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32
Q

HTN choroidopathy

A

Young PT + acute increase in BP
ischemia of Choriocapillaris
elsching spot : hyperpigmented lesion surrounded by hypopigmented rim (late)
seigrist streaks: hyperpigmentation along choroidal vessels
FFA: early hypoF , multiple subretinal retinal leakage late +/- PED
SRD bilateral

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33
Q

toxo in pregnancy

A

for 4-6 weeks
spiramycin 400mg TID
intravitreal clindamycin + periocular short acting steroid
azithromycin / clindamycin /atovaquone
sulfonamide can be safely used in the first 2 trimester

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34
Q

finding in congenital toxo

A

bilateral macular chorioretinal scar

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35
Q

DX of toxoplasmosis

A

IgM» indicate aquired disease
IgG» if negative rule out the infection
ocular fluid for PCR or goldman whitmer coefficient

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36
Q

quadrable therapy

A
  1. sulfadiazine
  2. pyrimethamine
  3. prednisolone
  4. clindamycin
  5. +folate (to prevent the anemia)
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37
Q

fundus albipunctatus gene

A

RDH5 in RPE
coding for cis retinol dehydrogenase

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38
Q

CMV retinitis

A
  • CMV MC infectious congenital syndrome
  • CMV MC oppurtenistic infection in immunosuppressed pt
  • manifested as DOC and flaoters
  • area of opacitfied necrotic retin along the vessels with Hgs and CWS or frosted branch angiitis
  • usually if the CD4< 50 cells/ul
  • treated with oral valgancyclovir (induction 900mg BID for 2-3 weeks then maintainance 900mg once daily until the CD4 > 200 cells/ul) OR
    *systemic gancyclovir (5mg/kg BID for 2 weeks or foscarnet 90mg/kg BID for 2 weeks)
    +/- IVI gancyclovir** (2mg /0.1 ml)** or foscarnet (1.2-2.4 mg/0.1 ml)
  • complication 20% recovery inflammation leading to CME , ERM
  • 50% can lead to RRD
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39
Q

MC cause of ARN or PORN

A

VZV» HSV
ARN in both
PORN in immunocompromised Pt (more rapidly progressive)
syphilis work up and PCR for ( VZV,HSV,CMV,TOXO)
treatment systemic +/- IVI (foscarnet or gancyclovir)
1. acyclovir 10mg/kg TID for 10-14 days IV then oral 800mg 5X/day
2. oral valacyclovir 2g TID for 2-3 weels then 1g TID
3. prednisolone (optional) 0.5 mg/kg/day for 3-6 weeks

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40
Q

ERM

A
  • avascular ,transparent, fibrocellular membrane adhere to ILM , result from proliferation of Glial cells (astrocyte and muller) , RPE and hyalocytes
  • 20% above the age of 75y
  • 10-20% bilateral
  • PVD is a requisite for ERM development
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41
Q

causes of stationary Nyctalopia

A
  1. CSNL
  2. Fundus albipuncataus
  3. oguchi disease
42
Q

CSNB

A
  • XL (MC), AD (Rare) and AR
  • VA range 20/20-20/200
  • associated with high myopia, nyctalopia, paradoxical pupillary reflex
  • dark adaptometry reduced
  • negative ERG (normal A wave and reduced B wave)
  • XL CSNL devided into complete ( no Rod responce, NYX mutation) and incomplete (some Rod response , CACNA1F mutation)
43
Q

Fundus albipunctatus

A
  • RDH5» 11-cis retinol dehyrogenase
  • delay in rhodopsin regeneration» the level normalize after hours in the dark
  • yellow white dots in the midperiphery sparing the fovea
  • ERG>undetactable rod responce that normalize after time in dark adaptation
  • DDx: RP albescense (RLBP1)»progressive , attenuated BV , ERG does not normalize
44
Q

Oguchi disease

A
  • Rare , MC in japanese
  • the fundus normalize in the dark but after exposure to the light , peculiar iridescent sheen appears in the fundus (mizo nakamura phenomena)
  • rhodopsin kinsae mutation in GRK1 or SAG mutation in arrestin protien
45
Q

dyschromatopisa

A

congenital: stationary and bilateral (usually red green)
acquired:progressive / bi or uni (usually blue yellow)
deuteranomelous : decrease sensitivty to green
tritanomelous: decrease sensitivity to blue
protanomelous: decrease sensitivity to red
deutera/prota nomelous» XLR
tritanomelous»AD
Rod monochromatism (achromatopsia): AR
S cone monochromatism: XLR
monochromatism: associated with infantile nystagmus and poor vision ,photophobia, abnormal ERG ( only normal rod function)

46
Q

CSCR

A

35-55
M:F 3:1
all from of steroid except ocular steroid
hyperopic shift
20/20 - 20/200
shedding of photoreceptor outer segment in subretinal space (shaggy photoreceptor)
20% associated with CNVM in age >55y

47
Q

PVF

A

90% unilateral
MC sporadic
isolated
anterior: AS abnormality (cataract , AC shalloe, microcornea, long CB)
posterior: normal AS» lensectomy + vitrectomy improve the vision by 70%

48
Q

light injury to the eye 3

A

1- mechanical : yag laser
2-thermal : photocoagulation
3-photochemical: solar retinopathy , photic retinopathy (injury to the outer segment of PR)

49
Q

Vit Hg in children

A

trauma
XL retinoschesis
Pars planitis

50
Q

incontenintia pigmenti

A

XL
featal in males
manifested in female
streaky skin line
CNS and teeth abnormality
30-70% have ocular involvment: pigmentary retinopathy , peripheral nonperfusion , NV , TRD

51
Q

shaken baby syndrome

A
  1. retinal Hg and CWS
  2. retinal folds
  3. hemorrhagic schisis cavity
  4. pigmentary maculopathy
52
Q

risk of the fellow eye to have MH if the vitreous still attached to the retina

A

10%

53
Q

pseudoxanthoma elasticum

A

AR
ABCC6 gene
angiod streak, peripheral round atrophic scar with comet sign, peau de orange rpe changes , ON drusen
systemic: skin changes (plucked chicken), atheroschlerosis of coronaries, CNS and GIT bleeding

54
Q

FFA and ERG in OIS

A

delay choroidal filling 60%
prolonged AV transit time 95%
vessels staining 85%

ERG global depression in amplitude

20% bilateral
50% increase the risk of ICVD
40% mortality rate in 5 years

55
Q

XLR

A

RS1 gene ( retinoschisin) muller cells
XL (male affected and female carrier)
macular retinal schesis (spoke like retinal fold)
recurrent Vit Hg , vitreous viel, metalic sheen
dec VA up to 20/200
negative ERG
peripheral retinoscheisis 50% and peripheral pirmentation
genetic testing is the definitive test

56
Q

CWS Vs Purscher flecken

A

CWS: occlusion of precapillary arterioles» indistinct margin whitenning of retina with complete or partially obsecure the retinal vessels
PF: occulsion to the deeper arteriols» whitening with clear zone arround the arterioles and venules

57
Q

pneumatic retinopexy success rate

A

usually subretinal fluid absorbtion done within 6-8 hrs
trans scleral cryo at the time of produre or laser retinopexy after retinal apposition
73% in PRP and 82% in scleral buckle, not significant

58
Q

scleral buckle

A

best in young , phakic pt
PV still attached , complex detachment (multiple breaks)
detachment due to retinal dialysis

59
Q

high IOP after scleral buckle RX

A

subretinal fluid drainage
AC paracentesis

60
Q

scleral buckle with gas injection +/- darinage

A

chronic viscous SR fluid
fish mouthing of large retinal breaks
bollous RD

61
Q

complication of Scleral buckle

A

induced myopia
anterior ocular ischemia
diplopia
ptosis
orbital cellulitis
RM disinsertion
subretinal Hg from drainage site or retinal incarceration

62
Q

complex retinal detachment

A

PVR
VIT hG
recurrent RRD
GRT

63
Q

temponade in complex RRD

A

SF6 inferior to C3F8 and silicone
silicone have lower risk of post op hypotony

64
Q

prognosis of RRD Rx

A

80-90% reattachment
if PVR or previous detachment SX 70%
better prognosis with retinal dialysis , small break , demarcation line
worse prognosis with GRT , PVR, uveitis , choroidal detachment , post break due to trauma ,apahkia or pseudophakia

if macula on» usually they restore the pro op VA
if macula off» 1/3 -1/5 will have 20/50 or better
if macula off RRD repair done <1 week (75% will have 20/70 or better)
if macula OFF repair done < 8 weeks but > 10 days» 50% will have VA of 20/27 or better

65
Q

CNVM in pathological myopia

A

5-10 %
+/- laquer cracks or chorioretinal scar
usually need fewer IVI than CNVM related AMD
if regressed»hyperpigmentation and atrophy (fuchs spots)

66
Q

anti VEGF

A

5 types if VEGF (A-D+ PGF)
pegaptanib (mucagen): aptamer (RNA oligunucleotide ligand) bind to VEGF 165 only
ranibizumab : recombinent humenized antibody fragment bind to VEGF A
aflibercept: VEGF receptor decoy , bind to VEGF A and B and PGF
bavacizumab : full length monoclonal antibody , longer duration of life

brolucizumab : single chain antibody fragment , small molecules, cause more inflammation and retinal vascultitis

67
Q

Sorbsy macula dystrophy
early drusen associated with CNVM in young

A

TIMP3 gene

68
Q

DDx of young onset drusen

A

3 types:
1. large colloid drusen
2. malattia leventinese drusen
3. cuticular drusen ( basal laminar drusen)
DDx
familal drusen (extend beyond arcade and nasal to the ON )
malattia leventinese (honycomb macular dystrophy)
sorbsy macular dystrophy
atypical hemolytic uremic syndrome
membranoproliferative glumereolonephritis 2
alport syndrome

does not autofluoresence

69
Q

pattern macular dystrophy

A
  1. adult onset faveomacular vitilifrom D
  2. butterfly maculr D
  3. reticular macular D
  4. multiform pattern macular D
  5. fundus pulverulentus
70
Q

CRAO

A

65% will have vision 20/400 or worse
20% will have vision 20/40 or better (cilioretinal)
1-2 % caused by GCA
referr ro stroke center for neuroimaging and controlling the Risk factors
+/- angio
increase the risk of IM in the first week

Rx
if presented within 4.5 hours and no systemic CI intravenous tpa
if presented within 6 hours and the pt is not candidate for intravenous&raquo_space; intra arterial tpa through slective ipsilateral ophthalmic artery Cath

NVI 20% in CRAO from 1-12w (mean 4w)

71
Q

FEVR

A

peripheral exudative leakage and retinal Hg , peripheral retinal avascularization , contraction of FV membrane leads to macular dragging , staightnening of BV ( brush bordr), ERD

mostly bilateral and AD

syndroms associated with FEVR:
* coat plus syndrome
* progressive hemifacial atrophy
* dyskeratosis congenita
* facioscapulohumeral mascular dystrophy

72
Q

Eales Disease

A

primary occlusive retinopathy with unknown cause
middle age 20-40 , men
bilateral idiopathic peripheral nonperfusion and perivascultitis , NV , recurrent Vit Hg , TRD
associated with tuberculin hypersenstivity
both Aretery and vien affected
RX: PRP to the ischemic retina

73
Q

delayed pattern reversal VEP

A

P100
Optic neuritits
macular dysfunction

74
Q

types of VEP

A

flash VEP ( different between population , used to compare the stimulation of each hemisphere)
pattern reversal VEP ( consistent in time and waveform , different in amplitude between the population)

uses:
Optic neuritits
preverbal children
rule out organic VL
macular dysfunction
visual system resolution
crossing of NFL in albinism

75
Q

DM Studies

A
  1. UK prospective DM study :DM type 2
    * tight glycemic and Bp control by diet/medications
    * showed that tight control of BS and BP leads to slowed the progression of DM retinopathy and other microvascular complications
  2. diabetic control and complication study : DM type 1
    * tight control of BS in DM type 1
    * effect on prevention of microvascular complications and reduced progression of microvascular complications
    * prevent DM retinopathy by 75% , slowed the progression by 55%, reduced the neuropathy by 60%, nephropathy by 50%
  3. ETDRS: DME
    * effect of PRP (focal/ scatter) on ME and DM retinopathy progression
    * focal PRP to DME leads to reduced the risk of moderate vision loss (doubling the initial VA) and increase the chance of moderate vision gain )halving the initial VA)
    * scatter PRP there is small chance of reducing severe VL(<5/500), but not indicated in mild to moderate NPDR
    * aspirin not effective in DM retinopathy but reduced CVS morbidity and mortality
  4. DRS: PDR/Severe NPDR
    * effect of PRP in PDR and severe NPDR
    * reduced the risk of severe VL by 50% in 5 years
76
Q

DM protocols

A

B:IV triamcinilone VS PRP (focal/grid) in DME»laser more effective

I:Ranbizumab with initial or deffered focal PRP Vs IV triamcinilone with initial or deffered focal PRP Vs laser alone in DME» Rani with deffer focal leser is the best

S: Rani with deffer PRP Vs Promt PRP in PDR» Rani is not inferior tp PRP in treating PDR, however Rani after 5 years associated with less peripheral VFL and less DME and less DR requiring vitrectomy

T: comparing aflipercept Va RANI VS bevacizumab in DME» aflipercet has better outcome when the initial VA is 20/50 or worse at 1 year however at 2 years all the IVI anti VEGF are equal

U: in resistent DME not responding to anti VEGF, adding intraocular dexa to the anti VEGF reduced the DME but only in the first 6 months

V: eye with central involving DME and good VA (20/25 or better)» Eylea VS laser VS observation have the same VA after 2 years

W:pt with moderate to severe NPDR rando,ized to periodic Eylea injection VS sham injection» the risk of PDR and DME lower in Eylea group in 2 years f/u however there is no Visiual benefit more than starting the aflibercept after having PDR or DME

AB: Vit Hg in PDR rando,ised to vitrectomy or Eylea injection» no significant differance however vitrectomy result in faster visual recovery

Q: if pt has Hx of treated DME or noncentral involving DME&raquo_space; increase the risk of developping central involving DME after cataract sx

77
Q

familial amyloidosis

A

tranthyretin mutation
AD
ocular: vitreous opacity , glass wool like, CWS, retinal Hgs, peripheral NV, deposit in choroid, TM, retina Vessels
non ocular: upper nad lower peripheral neuropathy , CNS manifestation, deposition in skin , GIT, heart
RX: vitrectomy» stainning with congo red, birefringies in polar light
DDx: chronic Vit Hg , lymphoma, sarcodiosis , whipple disease

78
Q

choroideremia

A

XLR code for granylgranyl transferase of REP1
CHM gene
RPE and choriocapillaris atrophy starting in anterior retina and macula and then coelese to form scalloped area of atrophy , normal ON and BV
pt mainatin good central vision until foveal involvment
pt complainning of progressive VF loss and nyctalopia
ERG early subnormal» extinguishable late

79
Q

FAP

A

ABC gene
AD
colon polyps + skull osteoma, fibroma , epidermoid cyst, thyroid cancer
atypical or multiple CHRPE
ovoid , multiple , teardrop , halo tail, >4 lesions wildly spaced, bilataral, 4-5mm, midperiphery
bear track are not associated with FAP

80
Q

cryptococcus

A

yeast infection
cryptococcus neoforman
fungal endopthalmitits in AIDS
yellow- white lesions in the fundus +/- vitirits , vascular sheahthing, SRD and granulomatous Anterior uveitis
+/- meningitits (papilledema, CNP)
indian ink stain from CSF
intravenous amphotericin B or oral flucytosine

81
Q

photic retinopathy

A

after sx
pt complain from paracentral scotoma , metamorphopsia
fundus:deep irregular yellow white hypopigmented oval - round lesion at fovea
OCT: outer retinal cavitation
usually resolved after 3-6 months to 20/25 - 20/40
with somtimes remaining paracentral scotoma , metamorphopsia

82
Q

BEST disease

A

AD
Best 1 gene on chromosome 11
yellow vitiliform foveal lesion in childhood
normal ERG but abnormal EOG arden ratio <1.5
30% peripheral vitiliform lesion
20% complicated with CNVM

ARB ( autosomal recessive bestrophinopathy)» retinal dysfunction on full field ERG , diffuse RPE dysruption, progressive VA loss

83
Q

DDx of vitiliform lesion

A
  1. adult onset foveomacular vitiliform dystrophy
  2. vitiliform exudative macular detachemtn ( basal laminar (cuticular) drusen
  3. drusenoid RPE detachement ( soft drusen)
84
Q

ciliopathy

A

usher syndrome: RP+ SNHL
bardet biedl: pigmentary RP+ bull’s eye maculopathy + obesity + polydactly + mental retardation+ renal disease+ hypogonadism (AR)
joubert syndrome:retinal dystrophy + renal disease+ cerebellar malformation (molar tooth), hypotonia
jeune syndrome: retinal ciliopathy + asphyxating thoracic dystrophy + cystic renal disease

85
Q

Usher syndrome

A
  1. type 1: most severe , infantile onset , RP + profounf SNHL+ vestibular areflexia
  2. type 2 : moderate to severe SNHL + normal vestibular system + RP in 2nd decade
  3. type 3 : porgressive SNHL + RP of variable severity + sporadic vestibular function

AR in chromosome 16

86
Q

west nile virus

A
  • single stranded RNA virus
  • birds ( primary resevior), humen infected by mosquito (culex)
  • More severe encephalitis and meningitits in DM and advanced age
  • flu like symptoms
  • ocular manifestation: bilateral multifocal chorioretinal lesions arranged in curvilinear line along the NFL
  • good prognosis unless macular involvment
87
Q

Blood supply in retinal layer

A

NFL , GCL, Inner 2/3 of INL , IPL by CRA
OPL, ONL, PR, RPE, OUTER 1/3 of INL by choroid circulation

88
Q

Mac Tel

A

muller cells abnormality
1. type 1 : unilateral , M>F, congenital or aquired, mainly in parafoveal area aneurysmal dilatation, in temporal retina , complicated by ME (exudation) (poorly responding to VEGF)
2. Type 2 : bilataeral parafoveal progressive neurodegenrative D 5th -7th decade, M=F , aquired, greyish discloratiion, loss of foveal reflex, crystaline deposite, right angled retinal vessels, MC type ,Oct showed caviatation in INL complicated by CNVM
3. type 3 : Rare, bilateral parafoveal tlengiectasia with vascular occulsion

89
Q

DDx Of sporadic RP

A

diffuse uveitis
syphilis
CRAO
trauma
paraneoplastic syndrome
drug toxicity

90
Q

PCV

A

variant of AMD» multiple recurrent serosanguineous PED (fibrovascular)
muliple polyps associated with feeder vessels
MC in jabanese and african
female, HTN
+/- soft drusen
peripapillary area
associated more with vitreous Hg, pachychoroid
Rx better with combind therapy anti VEGF+PDT
better prognosis

91
Q

common MC cause of post IVI endophthalimitis

A

Strept viridans (oral droplet)

92
Q

metabolic disease and retina finding

A

Tay sachs and niemann Pick» cherry red spot
hunter and hurler» pigmentary retinopathy
gaucher» white preretinal opacity

93
Q

cantrast sensitivity test

A

pelli robson test

94
Q

color vision tests

A

anolamoscope
ishihara plates
hardy rand rittler plates
farnsworth panel

95
Q

dark adaptation test

A

goldman weekers adaptometer

96
Q

scleral rapture in blunt trauma

A

360 hemorrhagic chemosis+ low IOP+ Hyphema

97
Q

immediate vitrectomy in ROG

A
  1. RD
  2. IOFB
  3. ENOPHTHALMITIS
    should not be delayed more than 2 weeks» PVR and worse prognosis
98
Q

DUSN

A

diffuse unilateral subacute neuroretinitis
nematode (roundworm): ancylostoma caninum, balisascaris procyonis , toxocara
Acute: combination of vitiritis , papillitits multiple grey-while lesion of outer retina and choroid , S shape subretinal warm
Chronic: ON atrophy, retinal artery narrowing, RPE disruption, severe VL , resembling RP
Rx: laser to nematode +/- steroid

99
Q

PRP complications

A

small spot size, high intensity» perforate BV»vit HG
short duration, small spot size, high power» injury to bruch membrane» CNVM
extensice PRP» SRD
can leads to RPE tear

100
Q
A

Ophthalmology (3 decks)

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