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3F: Neuro Final > Retinal Disorders II > Flashcards

Retinal Disorders II Flashcards

1
Q

Paraneoplastic retinopathy

A

Cancer associated retinopathy
Melanoma assocaited retinopathy
Diffuse uveal melanocytic proliferation
Paraneoplastic cell neuronopathy

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2
Q

Big blind spot syndrome

A
  • acute idiopathic blind spot enlargement

- multiple evanescence’s white dot syndrome (MEWDS)

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3
Q

Paraneoplastic retinopathy

A

Refers to a syndrome of subacute deterioration of vision and retinal function resulting from a non metastatic, remote effect of a malignancy

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4
Q

Signs and symptoms of paraneoplastic retinopathy

A
  • acute onset of photopsia
  • abnormal color vision
  • scotomas usually begins in the midperiphery (paracentral scotoma)
  • ERG shows evidence of diffuse retinal dysfunction, suggesting the diagnosis of PR
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5
Q

Why does paraneoplastic retinopathy scotoma not respect the horizontal meridian

A

Because the damage is in the outer retina, not the NFL like glaucoma is

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6
Q

Cancer related retinopathy

A

Autoimmune (recoverin)

Diffuse loss of ERG (abnormal scotopic ERG)
Rods are primarily affected

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7
Q

Melanoma associated retinopathy (MAR)

A

Autoimmune pathogensis

ERG shows rod dysfunction (scotopic b wave) and normal cone function

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8
Q

Paraneoplastic ganglion cell neuronopathy

A

Autoimmune pathogenesis
Progressive loss of vision
May have optic disc swelling

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9
Q

Bilateral diffuse uveal melanocytic proliferation

A

Develops in women with reproductive tract cancers and men with cancers in retroperitoneal area

Retinal findings are very typical of multiple choroidal nevi and yellowish orange lesions of RPE

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10
Q

Cancer associated cone dysfunction

A

Autoimmune
Abnormal cone ERG
Flash of light and light srnzsitrivity
Color vision deficiency

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11
Q

Lab findings for paraneoplastic retinopathy

A

Identification of serum antiretinal antibodies is an important diagnostic aid (commercial)

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12
Q

Differential diagnosis for paraneoplastic retinopathy

A

An abnormal ERG will distinguish it from optic neruopathy

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13
Q

Paraneoplastic retinopathy treatment and management

A

Systemic corticosteroids is the main therapy

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14
Q

RP vs PR

A

RP is peripheral and gradual

PR is very rapid progression

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15
Q

Big blind spot syndrome

A

Acute onset of VF defect around the physiological blind spot accompanied by photopsia

  • all likely affect the outer retina
  • more common in women
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16
Q

Acute idiopathic blind spot enlargement (AIBSE)

A

A big blind spot syndrome

  • not sure of pathophysiology
  • photopsia
  • VF defect
  • ERG: focal and multifocal directed at the peripapillary retina
  • peripapillary pgientary changes
  • mild ONH swelling
17
Q

MEWDS

A

Big blind spot syndrome

  • Multiple evanescent white lesions at the level of the RPE
  • full field ERG abnormalities
18
Q

Differences between AIBSE and MEWDS

A

AIDBSE will have a normal full field ERG and problems on focal ERG

MEWDS will have a problem on full field ERG

19
Q

Differences between paraneoplastic retinopathy and big blind spot syndromes

A 
PR
• assocaited with cancer (Malignant) 
• More severe 
Big blind spot syndrome 
• idiopathic inflamamtion of the peripapillary area or on the whole retina
20
Q

Cone or cone-rod dystrophies

A
  • hereditary retinal dystrophy
  • presents with progressive and heritable central vision loss who do not have an ophthlamocscopic appearance suggesting an alternative dystrophy
  • dyschromatopsia (May be first sign)
21
Q

Best diseases DiffDx from cone or cone rod dystrophies

A 
Egg yolk appearance 
RPE disturbance 
May develop NVC
DXed when younger 
20/80 to 20/200
22
Q

Stargardts diffdx from cone or cone rod dystrophy

A
  • yellow flecks
  • beaten bronze
  • RPE disturbance
  • dark silent choroid on FA
  • Dx when younger
  • stable after teen years
  • when 40, they have second deterioration from this disease
  • bilateral
  • 20/80-2/200
23
Q

Familial drusen as dffdx from con dystrophy

A 
Numerous drusen 
Choroidal neovascularization 
Vision can depend 
-macula involvement affects vision 
-increases chance to develop AMD
24
Q

Myopic degeneration as diffdx from cone dystrophy

A
  • peripapillary atrophy
  • staphyloma
  • lacquer cracks (break of bruchs membrane)
25
Q

Juvenile retinoschisis diffdx from cone rod hereditary

A
  • X linked retinoschisis. Caused by gene on X chromosome
  • fovea retinoschisis
  • happens on the fovea
  • stellate spoke like appearance with microcysts
26
Q

Retinoschisis

A

Break of inner and outer retina

27
Q

Digoxin

A

Xanthopsia (yellow vision)
Positive visual phenomenon (photopsia)
Decreased color vision
Abnormal ERG

28
Q

Tamoxifen

A

Crystalline deposits in the macula

Macular edema

29
Q

Canthazanthine

A

Crystalline deposits in the macula

30
Q

Thioridazine

A

Pigmentary deposits on cornea and anteiror lens capsule

Pigmentary retinopathy

31
Q

Diagnosis of cryslaiine depotis from drugs

A

If drusen it would be in the outer plexiform layer on the RP layer
Crystalline deposits are on the inner limiting membrane.
• OCT needed got determine

32
Q

Isotrtinoin

A

Acne

Decreased night vision

33
Q

Choloruine and hydroxychloroquine

A

Corneal whirl

Bulls eye maculopathy

34
Q

Nicotinic acid

Quinine

A

Cystoid macualr edema

Retinal photoreceptor and ganglion cell toxicity

35
Q

Vigabatrin

A

ERG abnormalities

Visual field constriction

36
Q

Safe doses of chloroquine or hydroxychloroquine

A

Less than 6.5 ug per day. Only needs screened if taking mroe tha nthis or if they are taking it for mroe than 5 years

37
Q

Sildenafil

A

Halos and blue vision
Visual field contributions
ERG abnormalities

38
Q

Two things seen on OCT in bulls eye maculopathy in plaquenil toxicity

A

OCT: PR or outer nuclear layer is thinner. Can see a break in the RPE

3F: Neuro Final (8 decks)

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