Retina Flashcards
layer of the retina where rod and cone membranes fuse together, creating an impediment to ion flow
external limiting membrane
layer of the retina of cell bodies of the photoreceptors
outer nuclear layer
layer of the retina where synapses are between photoreceptors and bipolar cells
outer plexiform layer
layer of the retina where cell bodies of BP cells, horizontal cells, glial cells, amacrine cells are
inner nuclear layer
layer of the retina with synapses between BP cells and ganglion cells
inner plexiform layer
layer of the retina with the footplates of Mueller cells
internal limiting membrane
rod free zone at 100 days before birth is:
large (1600 um in diameter)
rod free zone at birth is:
still not adult like, 400-600 um in diameter
rod free zone doesn’t reach adult like levels until:
200 days after birth (when it is 200 um)
what is the cone like at 22 weeks gestation
looks like epithelial cells, no outer segments no photopigment, cannot transduce light
how many days post birth is the cone the full length and pretty much adult like
45 days post birth
describe changes in retina as it reaches ora errata
all retinal layers form down to a single layer to the non pigmented ciliary epithelium
-lose photoreceptors first, then INL/ ONL merge, then ganglion cells lost
diameter of optic disc
1500 microns
what layers does the central retinal artery (CRA) supply?
- nerve fiber layer
- ganglion cell layer
- inner plexiform layer
- inner nuclear layer
- little of outer plexiform layer (by diffusion?)
what are the cilia-retinal arteries?
- coming from choroid and running to macula
- crossover vessel seen in 1/3 of population, usually see 1 but can see 2
choroidal circulation includes what ciliaries
- long posterior
- anterior
- short posterior
2 main ways choroidal circulation is different than retinal circulation
- a lot more choroidal vessels than central vessels
- choroidal vessels are larger- larger lumen diameter
what layers does choroidal circulation supply?
photoreceptors and RPE
size of retinal circulation capillaries vs. choroidal capillaries
retinal: smaller, < 10 nm
choroidal: larger, > 20 nm
differences in circulation leakiness of choroidal versus retinal
choroidal circulation more leaky and the large molecules that pass out of circulation can not enter retina because of the RPE (tight junctions at base of RPE)
mathematical formula for heart pressure
heart pressure= 80 + 1/3 (pulse pressure or 60) which =100
what is clinical ophthalmodynamometry used to measure?
arterial diastolic pressure
the small retinal vessels have what type of resistance and flow rate?
- small vessels
- high resistance
- low flow rate (1.7 ml/min/gm)
the large choroidal vessels have what type of resistance and flow rate?
- large vessels
- lower resistance
- high flow rate (19 ml/min/gm)
choroidal vasculature is under the control of the:
sympathetic nervous system (superior cervical ganglion)
relationship between IOP and blood flow in choroid
linear relationship
increased IOP = decreased blood flow
relationship between IOP and blood flow in retina
- no change between 20-70 mmHg because pericytes
- linear decrease in blood flow after 70
oxygen consumption rate of the retina
67 ul/gm/hr
glucose consumption rate of the retina
106 ug/mg/hr
70% of the oxygen consumed in the retina is used for:
glucose oxidation
80% of the glucose used in the retina goes through:
glycolysis
other 20% goes to pentose shunt
photoreceptors use ___ the energy produced in the retina
half
neurotransmitter for photoreceptors
glutamate
neurotransmitter for bipolar cells
glutamate
neurotransmitter for horizontal cells
GABA
neurotransmitters for amacrine cells
Ach, dopamine, noradrenalin, serotonin, GABA, glycine, aspartate, taurine
neurotransmitters for ganglion cells
glycine, aspartate, taurine
ERG:
A-wave is from the
photoreceptors
(-) wave
ERG:
B-wave is from the
bipolar cells and Mueller cells
(+) wave
ERG:
C-wave is from the
RPE
ERG:
D-wave is from the
off response (light going off retina)
ERG:
oscillatory potentials are from the
amacrine cells
b/w A and B wave in the ascending limb of B wave
flash ERG used for
mueller cells
-retinal dystrophies such as retinitis pigments, Stargardts, Bests
pattern ERG used for
ganglion cells
-glaucoma, diabetes
multifocal ERG used for
cones, cone BP cells
-macular dystrophy
type of occlusion with sudden loss of vision, ischemic retina with macula as cherry red spot
retinal artery occlusion
what is the order of ERG drop out in retinal artery occlusion
- oscillatory potentials first (amacrine cells most sensitive to lack of oxygen)
- b wave
- a wave does not disappear (b/c photoreceptors get nourished from choroid)
type of occlusion with extensive retinal hemorrhages, dilated veins, possible cotton wool spots
retinal vein occlusion
in an ischemic retinal vein occlusion, what ERG change can you see?
decrease in B wave amplitude
as the glucose level is decreased in the retina, when do you see B-wave and A-wave disappear?
B-wave after 15 minutes without glucose
A-wave gone after 30 minutes
(because Mueller cells more sensitive to lack of glucose than photoreceptors)
how many amino acids in sequence of opsin
348
where does vitamin A bind to opsin
296th amino acid in sequence (lysine)
opsin: where are amino terminal and carboxyl terminal
amino: inside disc
carboxyl: outside disc (in cytoplasm)
1 rhodopsin can generate ____ T-GTPs
500
1 rhodopsin can break down ___ cGMPs
1 million
the disc is 50% protein, and 85% of that protein is:
rhodopsin
the disc is 50% lipid, and that lipid is:
phospholipid, so that membrane is fluid
difference in rod shedding versus cone shedding
- rods shed when light comes on
- cones shed with light goes off
how many days is life cycle of disc production?
9-13
3 functions of RPE
- discs that are shed from photoreceptors are phagocytized by RPE
- RPE contains melanin- decreases light scatter
- vitamin A storage, all-trans retinol-regeneration of rhodopsin
most common inherited disease affecting RPE
retinitis pigmentosa
where retinitis pigmentosa usually begins:
mid-periphery (20 degrees from fovea where highest concentration of rods are)
possible chromosomes affected by genetic mutation in retinitis pigmentosa
1-11, 14-17, 19, X
retinitis pigmentosa
% X linked recessive and types
10%
2 types
short arm of X chromosome
retinitis pigmentosa
% autosomal dominant and types
20%
over 70-100 types
retinitis pigmentosa
% autosomal recessive
15%
retinitis pigmentosa
% undetermined
50%
common proteins affected in retinitis pigmentosa
- proline (CCC) -> histadine (CAC) point mutation
- RDS or cGMP
common signs of retinitis pigmentosa
- blood vessels thinner and less blood to retina
- optic disc pale
- cells in vitreous floating around
- posterior subcapsular cataract (PSC)- 50% of people
what is the most clinically significant test for retinitis pigmentosa
ERG (16-18% decrease per year)
after ERG flatlines, then do VFs
in electroculargrams done for retinitis pigmentosa, what ARDN ratio is considered abnormal?
< 1.7
inheritance pattern and cause of Bests disease
autosomal dominant
-macula not normal from increased lipofuscin