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Y2 Ophthalmology > Retina and Choroid > Flashcards

Retina and Choroid Flashcards

(47 cards)

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1
Q

What is retinal detachment

A

Detachment of the inner layer of the retina from retinal pigment epithelium

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2
Q

Types of causes of retinal detachment

A

Rhegmatogenous
Non-rhegmatogenous

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3
Q

What is the rhegmatogenous cause of retinal detachment

A

Caused by Retinal tear
Retinal tear -> vitreous humour pass through the tear to behind the retina and cause it to detach

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4
Q

What is the non-rhegmatogenous cause of retinal detachment

A

Detachment without any retinal tears

Tractional / exudative causes

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5
Q

What is tractional retinal detachment

A

Extensive growth of abnormal blood vessels in proliferative diabetic retinopathy
The blood vessels eventually becomes scar tissue
When the scar tissue contracts, it can pull the retina and cause it to detach

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6
Q

Tractional retinal detachment is most commonly seen in

A

Diabetic patients with proliferative diabetic retinopathy

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7
Q

What is the exudative cause of retinal detachment

A

Subretinal fluid accumulation without retinal tears

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8
Q

Which type of retinal detachment is more common

A

Rhegmatogenous

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9
Q

Risk factors of retinal detachment

A

Diabetes
Myopia
Increasing age
Previous surgery for cataracts
Eye trauma

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10
Q

Symptoms of retinal detachment

A

New onset floaters or flashes
Painless progressive visual loss
“curtain descending”
Central visual acuity can be reduced if macula is affected
RAPD

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11
Q

What are the fundoscope findings for retinal detachment

A

Retinal tear may be visible in rhegmatogenous
No retinal tear in non-rhegmatogenosu
Retinal folds may be pale / wrinkled/ opaque

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12
Q

management of retinal detachment

A

Urgent referral to ophthalmologist if new onset of floaters
Surgery to reattach retina

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13
Q

What is posterior vitreous detachment

A

Separation of vitreous membrane from the retina

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14
Q

Cause of posterior vitreous detachment

A

Increasing age -> degeneration of vitreous body
Highly myopic
Eye trauma

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15
Q

Why do myopic patients have higher risk of posterior vitreous detachment

A

Because myopic eye has longer axial length

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16
Q

What are the degenerative changes of vitreous fluid that causes posterior vitreous detachment

A

Vitreous fluid becomes less viscous hence does not hold its shape well
So pulls the membrane away from the retina

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17
Q

Symptoms of posterior vitreous detachment

A

New onset of floaters
Flashes of light in vision
Blurred vision

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18
Q

New onset of floaters + flashes are most commonly caused by

A

posterior vitreous detachment

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19
Q

If a patient with suspected posterior vitreous detachment describes a “curtain descending” what can this mean

Study These Flashcards
A

This can mean that there is also retinal detachment

20
Q

Sign of posterior vitreous detachment

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A

Weiss ring on ophthalmoscopy - due to detachment of vitreous membrane around optic nerve to form a ring shaped floater

21
Q

Management for posterior vitreous detachment

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A

Urgent referral to ophthalmologist to examine
Most do not need treatment - resolves in 6 months

22
Q

Complication of posterior vitreous detachment

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A

Retinal detachment

23
Q

What is vitreomacular traction

Study These Flashcards
A

Incomplete posterior vitreous detachment with the persistent tractional pull on the macula

24
Q

Symptom of vitreomacular traction

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A

Metamorphopsia - dysfunction that causes straight lines to appear warped, distorted or bent
Visual loss

25
What is central serous chorioretinopathy
Dysfunction of retinal pigment epithelium causing fluid from choroid to leak into subretinal space
26
Central serous chorioretinopathy most commonly affect
Men 30-50 years old
27
Symptoms of central serous chorioretinopathy
Hyperopia Metamorphopsia
28
Investigations for central serous chorioretinopathy
Fundoscopy Fluorescein angiography
29
Fundoscope findings of central serous chorioretinopathy
Roundish detachment of central retina
30
What is the most common cause of blindness
Age related macular degeneration
31
Risk factors of age related macular degeneration
Females Increasing age Smoking Family history Hypertension Diabetes Dyslipidaemia
32
Age related macular degeneration more commonly affects females / males
Females
33
Types of ARMD
Dry macular degeneration Wet macular degeneration
34
Which type of ARMD is the most common
Dry macular degeneration
35
What is dry ARMD
Deposition of drusen in Bruch's membrane causing slow progressive atrophy of the RPE
36
What is drusen
accumulation of proteins, lipids, and inflammatory mediators - yellow round spots
37
Where is Bruch's membrane
Between the RPE and choriocapillaries of choroid
38
What is wet macular degeneration
Neovascularisation in choroid due to VEGF causing leakage of fluid and blood -> vision loss
39
Symptom of wet ARMD
Rapid central visual loss Metamorphopsis Photopsia - Flashing lights Deterioration in vision at night fluctuations in visual disturbance vary from day to day
40
Symptoms of dry ARMD
Progressive central visual loss Central vision missing - scotoma Photopsia fluctuations in visual disturbance vary from day to day Deterioration in vision at night
41
Investigations for ARMD
Amsler grid testing Fundoscopy Slit lamp Ocular coherence tomography (OCT)
42
What is amsler grid testing used to
To check for distortion of line perception
43
Fundoscope findings for dry ARMD
Drusen - yellow round spots Areas of atrophy
44
Fundoscope findings for wet ARMD
well demarcated red patches - intraretinal/subretinal fluid leakage or haemorrhage
45
Why is OCT used for ARMD
visualise the retina in three dimensions because it can reveal areas of disease which aren't visible using slit lamp microscopy
46
Management of wet ARMD
Anti-VEGF
47
Management of dry ARMD
No cure Zinc with anti-oxidant vitamins A,C and E (for moderate and above dry ARMD) Magnifier vision aids

Y2 Ophthalmology (8 decks)

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