Retinal Disorders

Question 1

A RD is the separation of the ___ from the _____

Answer 1

RPE; neurosensory retina

Question 2

Whhich fo the following artery does not branch off of the ophthalmic artery?
A. Superficial temporal artery
B. Muscular artery
C. Supraorbital artery 
D. Lacrimal artery

Answer 2

A

Question 3

The retinal vessels are innervated by sympathetic nerves, T or F?

Answer 3

False

Autoregulation

Question 4

Which of the following has the tight junction between endothelial cells?
A. Choriocapilaris
B. Retinal vessles

Answer 4

Retinal vessles

Question 5

Outer blood retinal barrier

Answer 5

1. Tight junctions between RPE cells

2. Tight connections between RPE and Bruch’s membranes

Question 6

Inner blood retinal barrier

Answer 6

1. Pericytes and tight junctions between endothelial cells

2. Glial cells (astrocytes and muller cells)

Question 7

Macular bloood supply

Answer 7

Choriocapilaris

Does not get blood from the retinal blood vessels

Question 8

Examples Breakdowns of outer blood retinal barrier

Answer 8

ARMD
Drusen builds up and disrupts RPE layer, poor job with transportioan and the outer part of the retina does not get the oxygen and nutrition.
• if not getting nutrients, induces growth of small vessel growth and they leak
• This is wet AMD

CSCR
- water cannot be transported into the choroid and it builds up

Question 9

Example of inner blood retinal barrier

Answer 9

Diabetes and hypertension

Question 10

If CSCR is not better after 3 months then what

Answer 10

Can do any of the following

• photodynamic therapy
• laser treatment
• trimepranol 5mg

Question 11

Most common risk factors for CSCR

Answer 11

Corticosteroids

Question 12

Main causes of CME

Answer 12

Cataracts and DM

Question 13

How to treat CSM

Answer 13

Bromfenac 0.09% QID (NSAID)

Question 14

CRAO

Answer 14

• Whitening of the retina
• Cherry red spot (macula supplied by the choriocapilaris)
• attenuation of the artery
• boxcarring

Prognosis low

Question 15

In CRAO, when can the patient have preserved vision

Answer 15

If they have a cilioretinal artery (short posterior ciliary artery)

Question 16

How do you manage CRAO patients

Answer 16

CBC
ESR, CRP and platelet 
Carotid artery eval
Cardiac eval 
Follow up with eye exam in 2 weeks

Question 17

What do we look for in CRAO patients when they come back for follow up

Answer 17

NVI, NVE, NVD

-20% will develop these in 2-4 weeks

Question 18

How do you manage CRVO pateitns

Answer 18

CBC
Cardiac eval
Amsler grid to take home and follow up in 1 month

Question 19

Difference between CRVO and NPDR

Answer 19

CRVO
• this one is nonischemic
	◦ Mild symptoms 
	◦ Can induce CRAO eventually 
	◦ Tortuous veins 
		‣ In DR, beading of the veins, but they are tortuous here 
	◦ This guys left eye looks totally normal, if it was DR, it would be bilaterall, he is also well controlled, so unlikely this will be DR 
• Ischemic 
	◦ More bleeding in this one 
	◦ Sometimes macular edema

Question 20

Difference between OIS and CRVO

Answer 20

Miderpierhal dot nad blot hemorrhages is typical findgins in OIS
• CRVO will be different because OIS will not have tortuous veins like CRVO
• OIS has anterior seg involved

Question 21

Difference one amsler grid in ON and maculopathy

Answer 21

ON: missing portions or gray spits

Mac: distorted or bent lines