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Retina / Optic nerve Flashcards

1
Q

MAR primary affects what?

A

RODS

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2
Q

Circulating autoantibodies cross react with retinal recoverin in what dx?

A

CAR

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3
Q

Nasal radiating fibers causes what type of defect?

A

Temporal wedge defect

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4
Q

On FA delay in disc filling and normal chorodial perfusion is seen in what?

A

NAION

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5
Q

Which dz has greater optic disc edema: Optic neuritis or NAION?

A

NAION (100%) vs ON (33%)

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6
Q

Unilateral retinal venous congestion and disc edema in healthy young patient with normal VA is?

A

Papillophelbitis

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7
Q

What 2 dz is astrocytic harmartoma present?

A
  1. Tuberous sclerosis

2. NF!!

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8
Q

What lesion obscures optic nerve vessels, is vascular, and is fleshy pink?

A

Astrocytic hamarotoma

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9
Q

Which LHON mutation is the most common?

A

11778

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10
Q

Which LHON mutation has the best prognosis - most likely to recover?

A

14484

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11
Q

A wedge-shaped temporal excavation of the optic disc is highly suggestive of?

A

AD optic atrophy

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12
Q

Disc edema is seen in LCA or LHON?

A

LCA - disc edema, irregularity of RPE, extensive CR atrophy, macular coloboma, white dots, marbleized retinal appearance
LHON - circumpapillary telangiectasia, pseudoedema of disc with NO FA staining, PALLOR OF ENTIRE DISC

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13
Q

Which tumor has extradural tumor extension: ONGlioma or ONmeningioma?

A

ON meningioma

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14
Q

What is more common ON glioma or ON meningioma?

A

ON Glioma

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15
Q

What is the most common presenting sign for ON glioma (pilocytic astrocytoma)?

A
  1. Proptosis
  2. Visual loss
  3. OD pallor
  4. OD edema
  5. Strabismus
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16
Q

What is the demographic for ON menigioma?

A

40-50s - women

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17
Q

Malginant astrocytoma aka?

A

Adult ON glioma - males (NOT a/w NF)

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18
Q

Which chiasm lesion has normal vision?

A

Posterior chiasm

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19
Q

Which chiasm lesion has normal vision?

A

Posterior chiasm

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20
Q

Retrochiasm lesion affect this vision how?

A

Do not decrease VA unless the lesions are bilateral, then VA will be equal.

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21
Q

LGN defects look like what and are caused by what?

A

Sectoranopia; Posterior choroidal (hilum) or anterior choroidal artery.

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22
Q

What happens to the ventricular system and CSF in pseudo tumor?

A

Normal brain on CT scan; increased CSF

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23
Q

Bilateral optic neuritis occurs in whom?

A

Children

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24
Q

Morning Glory syndrome is a/w what 4 d/o?

A
  1. Basal encepholocele
  2. Pituitary dwarfism
  3. Moyamoya dz
  4. NF2!!!
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25
Q

On a molecular level, what is the problem in MG?

A

Presence of antibodies to ACH receptors in the moter endplate of striated muscle.

26
Q

What percentage of pts with ocular MG have detectable ACH receptor Ab?

27
Q

What is not affected in CPEO?

A

Pupils spared

28
Q

In myotonic dystrophy, what happens to the pupils?

A

Mitoic pupils to light AND near!!

29
Q

Other than muscles and fat, what else enlarges in Graves dz?

A

Lacrimal Gland

30
Q

Which LGN cells have small receptive fields tuned to fine spatial resolution?

A

P cells - color (red/green)

31
Q

Which LGN cells have large receptive fields and low spatial resolution?

A

M cells - motion; K cells - blue/yellow color (SWAP tests this)

32
Q

What is denial of blindness which usually occurs following b/l damage to straie cortex?

A

Anton’s syndrome

33
Q

What is preservatio of perception of motion in blind hemifield?

A

Riddoch phenomenon - Following occipital stroke

34
Q

What is a visuospatial d/o in which patients are unable to attend to stimuli presented into the left hemifield, despite full VF?

A

Hemispatial neglect - caused by damage to a network in the right hemisphere that controls visuospatial attention to both hemispheres. Areas include PPC, FEF, cingulate gyrus.

35
Q

What is the perception in time of a previously viewed image?

A

Palinopsia

36
Q

What is failure to integrate multiple elements of a visual scene into 1 global image; and where is the lesion?

A

Simultanagnosia (“cookie theft picture”); posterior parietal cortex - Balint’s syndrome

37
Q

What ON d/o must have optic disc edema by definition?

38
Q

Which PO medication is used for IIH?

A

Carbonic anhydrase inhibitors

39
Q

Which phakomatosis is a/w ON meningoma?

40
Q

What is the treatment of choice for ON meningioma?

A

Radiation tx (for

41
Q

What is the treatment of choice for a sphenoid wing meningoma?

42
Q

What 2 toxic optic neuropathies present with rapid VA loss with disc edema?

A

1.Ethylene glycol
2. Methanol
Usually toxic is slow developing with no disc edema WITH A WEDGE SHAPED NFL DEFECT!!
ETHAMBUTOL IS MOST COMMON - low renal clearance

43
Q

In LHON what do you see in the contralteral eye that presents before onset of disc edema?

A

Peripapillary telencetasias

44
Q

What disease has the OPA-1 mutation?

A

Kjer’s AD Optic Atrophy

45
Q

Platlet/fibrin plaques orginate from where?

A

Heart valves (calcium also from heart valves)

46
Q

What is the main cause for junctional scotoma?

A

Sphenoid wing menigoma or asymmtric pitutary ademona

47
Q

Post-fixation blindness or hemifield slide is caused from a lesion where?

48
Q

The RAPD and bow-tiet are on which side of a optic tract lesion?

A

Contralateral (or IPSIlateral to the VF defect)

49
Q

What is Gerstmann sydrome and where is the lesion.

A

Dominant parietal lobe

  1. Acalculia
  2. Agraphia
  3. Finger agnosia
  4. Left-right confusion
50
Q

What is the tract of the nasocililary nerve?

A

It enters within the annulus of sinn –> the “runs through” the ciliary ganglion to innervate the globe –> branches run through the ethmoidal foramen to innervate the ethmoid and the skin of the nasal tip

51
Q

The Middle Cerebral artery supplies what?

A

The very posterior tip of the primary visual cortex of the occipital lobe responsible for the CONTRALATERAL macular portion of the hemifield.
(The PCA supplies the contralateral PVC responsbile for the hemifeild except for the macula)

52
Q

What dx has bilateral stenosis or occlusion of arteries around the circle of Willis that causes TIAs, stroke, epilepsy?

A

Moyamoya dx

53
Q

What is the most common VF defect with ODD?

A

Enlargement of blind spot (VF defect present 75-90%)

54
Q

What is the 5 year risk % of contralateral NAION?

55
Q

Amsler grid test how many degrees of the central VF?

A

20 degrees (10 degrees on either side of fixation)

56
Q

What is the Pulfrich phenomenon and when does it happen?

A

An illusion that an object moving perpendicular to them is looking like it is moving to and away from them. Occurs after a bout of optic neuritis.

57
Q

Is a photopsia an illusion or hallucination?

A

Hallucination

58
Q

Is a photopsia an illusion or hallucination?

A

Hallucination

59
Q

What lesion causes rebound and gaze evoked nystagmus?

A

Cerebellar lesion - contains integrators

60
Q

Dural venous sinus thromosis has what on finding?

61
Q

In optic tract syndrome, which side is the VF defect, the APD, and the tract lesion?

A

APD and VF defect is CONTRAlateral to tract lesion. Also bowtie atrophy is contralateral!!

Neuro (7 decks)

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