Retina Conditions

Question 1

pathophysiology of diabetic retinopathy

Answer 1

non proliferative > proliferative > diabetic macular oedema

Question 2

how does hyperglycaemia cause retinopathy

Answer 2

inc glucose causes damage to renal small vessels & endothelial cells > inc leakiness

Question 3

non-proliferative DR rundown

Answer 3

mild- microaneurysms
moderate- MAs, blot haemorrhages, hard exudates, cotton wool spots, venous bleeding
severe- signs in all 4 quadrants, venous beading in 2

Question 4

proliferative DR rundown

Answer 4

neovascularisation, vitreous haemorrhage

Question 5

s/s of diabetic retinopathy

Answer 5

asymptomatic, blurred vision

Question 6

intraretinal haemorrhages can be ___ or ____

Answer 6

dot or flame

Question 7

cotton wool spots show damage to..

Answer 7

nerve fibres in retina

Question 8

mx for diabetic retinopathy

Answer 8

laser, anti VEGF, SCREEN!!

Question 9

what do anti-VEGF do

Answer 9

reduced oedema, reduce neovascularisaiton

Question 10

T/F: NPDR is a leading cause of visual loss

Answer 10

F: PDR is

Question 11

Diabetic retinopathy is associated to

Answer 11

argyll-robertson pupil, cataracts, rubeotic glaucoma

Question 12

what is posterior vitreous detachment

Answer 12

when vitreous comes away from retina

Question 13

PVD causes a 70% chance of…

Answer 13

retinal tear

Question 14

s/s of PVD

Answer 14

painless spots of vision loss, floaters, flashing light

Question 15

what is a retinal detachment

Answer 15

retina separates from choroid

Question 16

what are the 2 types of retinal detachment

Answer 16

rhegmatogenous: retinal tear so vitreous fluid gets under retina making tear worse

non-rhegmatogenous: tractional- scar tissue pulls retina off wall

Question 17

s/s of retinal detachment

Answer 17

painless visual loss- like curtain coming across vision, flashes and floaters (tadpoles)

Question 18

T/F: RAPD is present with retinal detachment

Answer 18

T

Question 19

mx of retinal tear/detachment

Answer 19

tear: aim is to create adhesions between retina and choroid to prevent detachment
detachment: reattach retina and reduce traction- vitrectomy, scleral buckling, pneumatic retinoplexy

Question 20

why is retinal detachment emergent

Answer 20

retina rellies on choroid for blood supply

Question 21

aetiology of CRAO

Answer 21

carotid artery emboli, giant cell arteritis

Question 22

types of CRAO

Answer 22

branch- does less damage

transient (amaurosis fugax)- curtain, pre-stroke sign

Question 23

s/s of CRAO

Answer 23

sudden visual loss, pain

signs-RAPD, PALE retina*

Question 24

ix for CRAO

Answer 24

fluorescein angio, funds copy, temporal artery biopsy

Question 25

mx for CRAO

Answer 25

immediate- ocular massage, inhaling carbogen, isosorbide dinitrate
long term- treat RFs

Question 26

CRVO aetiology

Answer 26

virchow’s triad

Question 27

s/s of CRVO

Answer 27

sudden painless visual loss
signs- retinal haemorrhage, macular oedema, tortuous vessels, disc/macular swelling
DARK

Question 28

what are classic findings of CRVO fundoscopy

Answer 28

flame/dot haemorrhages, optic disc oedema, macular oedema

Question 29

mx of CRVO

Answer 29

laser, intra-vitreal steroids, anti-VEGF