Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Posterior Seg > Retinal Hemorrhages and Exudates > Flashcards

Retinal Hemorrhages and Exudates Flashcards

1
Q

The superficial capillary network is mostly impacted by ___ disease

A

Artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The deep capillary network is mostly impacted by __ disease

A

vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is a pre-retinal hemorrhage located

Associated with the ___ capillary network of the ___ zone

A

Between the internal limiting membrane and nerve fiber layer.

Associated with the superficial capillary network or the radial/circumpapillary zone (posterior pole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does gravity affect a pre-retinal hemorrhage?

A

Affects it’s appearance- demonstrating a well demarcated superior horizontal line.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Predicted visual outcome of pre-retinal hemorrhage

A

Decreased VA, VF defect or scotoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiology of pre-retinal hemorrhages

A

PVD
Valsalva (most common- forceful attempt to exhale)
DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Appearance of pre-retinal hemorrhage

A

Well demarcated superior horizontal line
Elevated bubble
Can have flayed edges with a dark center when acute (this is blood spreading in between the ILM and NFL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Color of pre-retinal hemorrhage from recent to older

A

Red - yellow - white. Then reabsorbed by the retina.
Change in color because blood is becoming deoxygenated.
This process can take months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Outcomes of pre-retinal hemorrhage

A

Want to determine cause

Will resolve on own in couple of months. Just monitor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where are flame shaped hemorrhages located? What capillary bed are they associated with?

A

NFL, associated with the superficial /innercapillary network/radial network of the cicumpapillary zone.
Artery based disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Appearance of a flame shaped hemorrhage

A

Flayed or flame appearance. Associated with counter of NFL.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Do flame shape hemorrhages leak into deeper tissue or the vitreous?

A

NO. The hemorrhage is located within the NFL. Can spread within that layer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Flame shape hemorrhages represent an area of localized retinal _____

A

Hypoxia. and artery based disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Predicted visual outcomes of flame shape hemorrhages

A

Watch for neo due to ischemia
Usually no effect on VA- since there are no capillaries located in the fovea.

Possible scotoma if large enough. But usually asymptomatic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How fast should a flame shape hemorrhage resolve? How do we treat?

A

Usually due to an artery based disease- determine etiology and treat systemically. Should resolve in weeks to months if systemic treatment is successful.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common etiology of flame shape hemorrhages

A

Hypertension- artery based

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Roth spot

A

Flame shape hemorrhage surrounding a white middle (roth spot)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The white center in roth spots are due to which 4 things

A
  1. WBC from inflammatory disease.
  2. CWS surrounded by the hemorrhage.
  3. Leukemic cells/WBC surrounded by hemorrhage
  4. Fibrin surrounded by hemorrhage.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Intraretinal hemorrhages are located in which layers? What capillary network is it associated with?

A

In the INL, OPL, and may extend to the ONL.

Associated with the deep capillary network.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do intra retinal hemorrhages appear as?

A

Spot or blot of blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is different about intra retinal hemorrhages compared to flame shape and pre retinal?

A

Intra retinal can be in multiple layers- INL, OPL, and ONL.

Flame shape and pre-retinal can only be in one layer.
Flame shape in NFL
Pre retinal in between ILM and NFL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Shape of intra retinal hemorrhages? Does this affect surrounding tissues?

A

The hemorrhages follow vertical lines of retinal tissues- INL, OPL and ONL.

Can push other structures aside.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

intra retinal hemorrhages are signs of??

A

Venous based diseases- venous stasis. Need to do OCT! Difficult to see with 78 or 90

Retinal edema. back up of blood due to poor capillary flow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

If you see an isolated intra retinal hemorrhage, suspect

A

Micro aneurysm. Especially in posterior pole. Associated with diabetic retinopathy, a venous based disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
If you see a sector of intra-retinal hemorrhages, suspect?
Branch retinal vein occlusion
26
If you see all four quadrants of intra retinal hemorrhages, suspect?
Central retinal vein occlusion
27
If you see bilateral intra-retinal hemorrhages, suspect?
Prob systematic, venous based disease. Suspect significant ischemia.
28
If you see unilateral intra-retinal hemorrhages, suspect?
Something is wrong w one eye- prob not systemic. | BRVO, CRVO? Ischemia. Carotid blockage?
29
Intra retinal hemorrhages predicted visual outcomes?
Usually no effect on VA, unless there is surrounding edema that involves the macula. Scotoma is unlikely. **must determine etiology or underlying cause to create effective treatment plan.
30
Sub retinal hemorrhages. Where are they located? (2 places)
Both locations in the outer retinal. | Between RPE and photoreceptors OR between RPE and Bruch's.
31
Sub retinal hemorrhages usually results from
Bleeding of a choroidal neovascular membrane (CNV)
32
What do sub retinal hemorrhages look like?
Lobulated boarders Color appearance changes when acute vs chronic ``` Sub retinal (between PR and RPE) is red Sub RPE (between RPE and Bruch's) is grey-green ```
33
Sub retinal hemorrhage visual outcomes?
Scar tissue will eventually develop which will be devastating to the visual outcome. **Determining the etiology is critical to establishing an effective treatment plan. Outcomes are typically poor.
34
CNV- what is it and what type of hemorrhage does it usually cause?
Choroidal neovascular membrane. | Main cause of sub retinal hemorrhages
35
Vitreous hemorrhage location
Hemorrhage located between the detached vitreous hyaloid membrane and internal limiting membrane, or within the vitreous. Retro-vitreous or Intra-vitreous
36
How does a vitreous hemorrhage occur?
Occurs from a break in the internal limiting membrane- usually associated with retinal beaks or neovascularization. ILM is hard to break- maybe due to inflammation.
37
A vitreous hemorrhage is likely due to?
DM Retinal break/tear/detachment with associated damage to vasculature PVD
38
Vitreous hemorrhage appearance acute vs chronic
The retina may not be visible in the acute phase- tomato soup appearance. Chronic appearance- Yellow hue, feathery white clumps of debris.
39
Vitreous hemorrhage predicted visual outcomes
Significant vision loss in acute phase. Scotoma Floaters
40
Vitreous hemorrhage management
Surgical procedures and intervention might be necessary to manage
41
What test to do if you can't see the retina?
B scan
42
CWS are located where?
Within the NFL (Same as flame shaped hemorrhages) | Associated with the superficial capillary network or radial network of the posterior pole.
43
CWS are due to what kind of based disease?
Artery based | Due to ischemia of the NFL --> edema in NFL
44
CWS appearance
Blurred retinal vessels in acute stages with fuzzy boarders. Similar to a flame shaped hemorrhage. Swollen NFL, looks elevated
45
CWS are immediate precursors of
Neovascularization Because they represent an area of localized hypoxia and artery based disease.
46
Predicted visual outcomes of CWS
Usually no effect on VA- as long as it doesn't involve the macula. Possible scotoma if NFL degeneration.
47
CWS could be due to which systemic diseases?
HTN, diabetes
48
Where is retinal exudate located? What capillary network?
OPL, but can extend from the ONL to the INL. Similar to dot blot hemorrhages (intra retinal hemorrhage) in that it spans many layers of the retina. ^^Both are space occupying. Pushes other retinal tissue aside. Deep capillary network involved. Venous based disease such as DM.
49
What does retinal exudate appear as at the macula in henle's layer?
Macular star.
50
What does retinal exudate appear as when acute? | What does it look like after some time?
When acute- melted wax. White candle that dribbled wax onto paper. Raised and shimmery. After time, appears pale or dirty yellow in color.
51
retinal exudate always presents with ____
Edema.
52
What comes first? Exudate or edema?
Edema first. Exudate comes later. See exudate? know that edema has been there a while.
53
Patterns of retinal exudate
Migrates away from edema/location of insult. Can develop different patterns- localized, ring/circinate, or arc.
54
What is retinal exudate composed of?
Lipoprotein and macrophages leaking out of deep capillary network.
55
Location of retinal exudate
Can occur in posterior pole, equator, or retinal periphery.
56
Predicted visual outcomes from retinal exudate
Decreased VA Metamorphopsia **Always determine etiology
57
Does retinal exudate every resolve? What about the associated edema?
Edema may resolve. Exudate may not. Similar to salt water- water evaporates. Salt remains.
58
Retinal exudate is commonly due to which systemic condition or 2 ocular conditions?
DM- venous based. Deep capillary network. CRVO, BRVO Macro or micro aneurysms
59
Retinal and macular edema - Layers involved - Location of local/acute edema. Which capillary beds and layers. - Location of diffuse/chronic edema. Which capillary beds and layers.
INL and OPL Local/acute edema- Outer capillary network. Deep. Between INL and OPL. Contained. (May contain exudate in OPL) Diffuse/chronic edema- Associated with both inner and outer capillary networks. can span ILM to RPE (involving the PR)
60
Cotton wool spots should NEVER be located __
In the FAZ. Because no capillaries in the FAZ
61
Hemorrhages should not be located in the FAZ, but
They can be due to disease radiation from other parts of the retina like pre-retinal hemorrhages, exudate, or edema.
62
Blood or exudate in the FAZ is an indication of edema or leakage ___
Elsewhere. It traveled.
63
Local edema (contained in 1 layer of retina, between INL and OPL) Can be difficult to observe alone, but usually associated with ___
Dot blot hem (intra retinal) and exudate
64
Why is diffuse edema poorly defined and hard to observe?
Because it can span many levels- ILM to RPE. May appear as retinal thickening. Can see this with 78 or 90D
65
RBC- high or low levels indicate
High- Hyperviscosity. | Low- Anemic
66
WBC- high or low levels indicate
Low- immune compromised | high- Active infection
67
Platelets- high or low levels indicate?
low- Helps us determine if pt is at risk for bleeding (hemorrhage) high- hypercoagability. Clots.
68
Hematocrit percentages for male and female
Male: 39-49 | Female- 33-43
69
These 3 measurements can help us determine types of anemia MCV MCHC MCH
Mean cell volume- average volume of RBCs. 76-100fL Mean cell hemoglobin concentration- average concentration of Hb per 100mL of packed RBCs. 33-37 g/dL Mean cell hemoglobin- average weight of Hb per individual RBC. 27-33pg
70
Lymphocyte levels are high. May indicate?
Viral infection
71
monocyte levels are high may indicate?
Phagocytosis and immune regulation.

Posterior Seg (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions