Retina Flashcards
Conditions associated with asteroid hyalosis
DM, HTN
Early onset drusen associated with CNV in young adult
Sorsby macular dystrophy
Conditions associated with EFEMP1 mutation (3)
Doyne honeycomb dystrophy
Malattia leventinese
Radial drusen
Mutation associated with Sorsby macular dystrophy
TIMP3
Thioridazine retinal toxicity manifests as a ___ ___ macular pigmentary disturbance that can progress to a ___ ___ of the retinal pigment epithelium (RPE) and choriocapillaris.
Thioridazine retinal toxicity manifests as a bilateral granular macular pigmentary disturbance that can progress to a nummular atrophy of the retinal pigment epithelium (RPE) and choriocapillaris.
5 lesions predisposing to RD
- lattice degeneration
- vitreoretinal tufts
- meridional folds
- enclosed ora bays
- peripheral retinal excavations
What condition affects both photopic and scotopic vision, and demonstrates no choroidal perfusion on FA?
Stargardt disease
3 growth patterns of retinoblastoma
Diffuse infiltrating: pseudohypopyon, large clumps of vitreous cells
Endophytic: tumor growth extending into the vitreous cavity with seeding
Exophytic: tumor growth underneath the retina, serous retinal detachment
What percent of RB cases arise from somatic nonhereditary mutation of both RB1 alleles in a retinal cell?
60%
Other 40% arise from gremlin mutation
Systemic abnormalities in:
- Kearns-Sayre syndrome
- Usher syndrome
- Refsum disease
- Bassen-Kornzweig syndrome
Kearns-Sayre: cardiac conduction defects
Usher: hearing
Refsum: fasting serum phytanic acid level
Bassen-Kornzweig: lipid profile, serum lipoprotein electrophoresis
In what form of dichromacy is the long-wavelength (L-cone) photopigment absent?
Protanopia
In what form of dichromacy is the medium-wavelength (M-cone) photopigment absent?
Deuteranopia
In what form of dichromacy is the short-wavelength (S-cone) photopigment absent?
Tritanopia
A mutation of which gene in which cell type results in nonprogressive dysfunction in patients with nyctalopia and white dots?
RDH5 gene in RPE (fundus albipunctatus)
Gene mutation in retinitis punctata albescens
RLBP1
Findings in hypertensive choroidopathy
Lobular nonperfusion of choriocapillaris -> Elschnig spots (hyperpigmented spots surrounded by margins of hypopigmentation) or Siegrist streaks (linear configurations of hyperpigmentation following the meridional course of choroidal arteries)
What is the most likely complication of talc emboli?
Peripheral neovascularization
What are the complications of tamoxifen retinopathy?
CME
What are the complications of macular telangiectasia?
CME, subretinal neovascularization
What clinical manifestation and OCT abnormality does alkyl nitrite inhalation cause?
Yellow spot in central macula
OCT: central disruption of inner segment ellipsoid layer “poppers maculopathy”
What complication is seen more often after laser for proliferative sickle than diabetic retinopathy?
Retinal tears and detachment
Most common cause of endogenous endophthalmitis in Asia
Klebsiella liver abscesses
Differentiate diffuse from circumscribed choroidal hemangiomas
Diffuse choroidal hemangioma -> Sturge-Weber syndrome
Circumscribed choroidal hemangioma has no systemic association
Tumors associated with von Hippel-Lindau disease
Retinal capillary hemangioblastomas, cerebellar hemangioblastomas, pancreatic cysts, renal cell carcinomas, pheochromocytomas
Tumors associated with tuberous sclerosis
Retinal astrocytic hamartomas (astrocytomas), CNS astrocytomas (malignant)
Mechanism and visual prognosis of Terson syndrome
Acute rise in intraocular venous pressure; usually visual function unaffected once VH/subhyaloid hemorrhage clears
What wavelength does rhodopsin absorb green light best at?
510 nm (photoactivation = conversion of chemical by light energy, e.g. phototransduction in creation of all-trans-retinal)
Mechanism of avulsion of optic nerve
Sudden increase in IOP, causing rupture of lamina cribrosa
Common cause of commotion retinae
Closed-globe blunt trauma -> damage to outer retinal layers
Giant retinal tears extend at least __ clock-hours circumferentially, and typically occur at the ___ edge of the vitreous base.
Giant retinal tears extend at least 3 clock-hours circumferentially, and typically occur at the posterior edge of the vitreous base.
What distinguishes Purtscher from Purtscher-like retinopathy?
History of trauma (Purtscher-like due to non traumatic etiologies, e.g. amniotic fluid embolism, acute pancreatitis, retrobulbar anesthesia, fat emboli from long-bone fractures)
Mechanism of Purtscher and Purtscher-like retinopathy
Injury-induced complement activation that causes granulocyte aggregation and leukoembolization that occlude small arterioles
What agent used for retinal tamponade persists in the eye for 2 months after vitrectomy?
Perfluoropropane (C3F8)
What exam findings are associated with increased risk of progression to RD in eye with retinoschisis?
Inner and outer layer breaks
Most common cause of sudden vision loss in sickle cell retinopathy
Vitreous hemorrhage
Which eyes are at greatest risk for RPE tear after anti-VEGF?
Fibrovascular PED >600 um
In what part of the eye does endogenous fungal endophthalmitis usually begin?
Choroid (can subsequently break through into vitreous)
What type of hemorrhage is most characteristic of Valsalva retinopathy?
Sub-ILM hemorrhage
Scheie classification of hypertensive retinopathy
Grade 0: no changes
Grade 1: barely detectable arteriolar narrowing
Grade 2: generalized narrowing with some focal constriction and arteriovenous crossing changes
Grade 3: changes of grade 1 and 2 with hemorrhages, exudates, CWS
Grade 4: grade 3 changes with optic disc edema
What is pleiotropy?
Diverse phenotypes share mutations in a common causative gene
Criteria for ROP screening
Birth weight <1500g
Gestational age <30 weeks
When should first ROP examination take place?
Between 4-6 weeks postnatal age, or between 31-33 weeks post conceptional age, whichever is later
What feature of the choroid mitigates potential thermal damage associated with light absorption?
Rapid blood flow
According to EVS, acute postoperative endophthalmitis may develop during what interval following cataract surgery?
6 weeks
In which retinal cells is the response measured in the pattern ERG mainly generated?
Ganglion cells
Risk for progression to neovascular AMD after 5 years in stage 3 and 4 dry AMD
Stage 3: 18%
Stage 4: 40%
Gene mutation in Sorsby macular dystrophy
TIMP3
Gene mutation in Doyne honeycomb dystrophy, Malattia leventinese, radial drusen
EFEMP1
Gene mutation in cuticular drusen
Complement factor H
Gene mutation in CSNB
NYX
Inheritance and gene mutation in choroideremia
X-linked recessive, CHM gene
A ___ ___ in an eye with high myopia and posterior staphyloma can lead to rhegmatogenous macular detachment.
A macular hole in an eye with high myopia and posterior staphyloma can lead to rhegmatogenous macular detachment.
Angioid streaks are associated with deposition of ___ in the Bruch membrane.
Angioid streaks are associated with deposition of calcium in the Bruch membrane.
What characteristic is most commonly associated with macular holes?
Trauma
What is Usher syndrome?
Ciliopathy associated with RP and congenital sensorineural hearing loss
What is Bardet-Biedl syndrome?
Ciliopathy associated with pigmentary retinopathy and bull’s eye maculopathy, obesity, polydactyly, hypogonadism, renal disease, cognitive disability
When RPE atrophy develops, what other tissue also undergoes atrophy?
Choriocapillaris
PDE5 inhibitors cause transient tinting of vision in ___ color range.
PDE5 inhibitors cause transient tinting of vision in blue color range.
Reversible ___ tinting of vision can be caused by cardiac glycoside digitalis.
Reversible yellow tinting of vision (xanthopsia) can be caused by cardiac glycoside digitalis.
Most important risk factor for the development of radiation retinopathy following plaque brachytherapy?
Total radiation dose greater than 30 grays (3000 rads)
What paraneoplastic retinal degeneration is associated with antirecoverin antibodies?
Cancer-associated retinopathy
Pathophysiology, clinical manifestations and systemic associations of BDUMP
Bilateral proliferation of benign melanocytes
Diffuse thickening of choroid, reddish or brownish choroidal discoloration, serous retinal detachment, cataracts
Cancers of the ovary, uterus, lung, GI (colon, pancreas, gall bladder, esophaguses)
What percentage of patients with vitreous hemorrhage and acute PVD have a retinal tear?
60%
What metabolic disorders cause a cherry-red spot?
Tay-Sachs disease, Niemann-Pick disease
Inheritance pattern of FEVR
Autosomal dominant
Causative organisms of DUSN
Baylisascaris (raccoon roundworm), Ancylostoma caninum (dog hookworm)
What wavelength of light is absorbed by macular xanthophyll and should be avoided in retinal laser treatment?
Blue light
Where is a retinal tear most likely to be found in a patient with new onset PVD?
Posterior edge of the vitreous base
Inheritance of VHL
Autosomal dominant
Any late-onset rapidly progressive retinal dysfunction should raise suspicion of ___.
Any late-onset rapidly progressive retinal dysfunction should raise suspicion of malignancy.
