retinal vascular diseases Flashcards

1
Q

what is the pathology in age related macular degeneration ?

A

yellow spots or drusens left in the bruch membrane

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2
Q

what are the types of AMD ?

A

wet AMD
dry AMD

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3
Q

what are the risk factors associateed with AMD ?

A

aging
smoking
UV light
positive family history

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4
Q

what are the symptoms of AMD ?

A

may be asymptomatic
gradual loss of central vision
visual fluctuations

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5
Q

what are the signs associated with AMD ?

A

early - macular drusens
late - geographic atrophy

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6
Q

what examination is to be done in a case of AMD ?

A

amslet grid
sit-lamp examination

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7
Q

what results are observed with amsler grids in AMD patients ?

A

central scotoma
metamorphasia (distortion)

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8
Q

what is the management for both exudative and non exudative AMD ?

A

education and amsler grid
smokking cessation
sunglasses
HIgh vegetable intakke and vitamins

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9
Q

what is the specific management for exudative AMD ?

A

anti-VEGF
PDT - photodynamic therapy
surgery

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10
Q

what are common signs seen on fundoscopy that indicate retinal vascular disorders ?

A

Av crossings
Cotton wool spots

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11
Q

what are the grades of hypertensive retinopathy ?

A

grade 0: no changes
grade 1: barely detectable arteriolar narrowing
grade 2: obvious arterial narrowing with focal irregularities
grade 3: G2+retinal hges with or without exudate
grade 4: G3 + disc swelling

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12
Q

what are the symptoms of retinal artery occlusion ?

A

sudden painless loss of vision
perceded by amaurosis fugax

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13
Q

what sign is observed if there is central retinal artery occlusion ( CRAO ) ?

A

decreased visual acuity and RAPD
cherry red spot at macula
pale retina
pale disc
attenuated vessels

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14
Q

how is visual acuity tested for ?

A

using a snellen chart

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15
Q

what is the observed sign if there is branch retinal artery occlusion ?

A

field defect

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16
Q

what is the presentation of retinal vein occlusion ?

A

sudden painless loss of vision

17
Q

what are the signs in retinal vein occlusion ?

A

retinal haemorrhages
cotton wool spots and exudate
disc swelling
macula oedema
engorged vessels

18
Q

on appearance of neovascularization what is the best management ?

A

retinal photocoagulationn

19
Q

with macula oedema what is the best management ?

A

consider anti-VEGF

20
Q

what are the stages of diabetic retinopathy ?

A

non-proliferative DR
severe non proliferative DR
proliferative DR
advanced diabetic eye disease

21
Q

what is seen on fundoscopy of non proliferative diabetic retinopathy ?

A

microaneurysms
dot and blot haemorrhages

22
Q

what are the signs observed with severe NPDR ?

A

macular edema
irregular veins
IRMA ( intra-retinal microvascular abnormalities )
venous beading
deep hges

23
Q

why does proliferation occur in proliferative DR ?

A

due to release of VEGF

24
Q

what are the pathologies associated with proliferative diabetic retinopathy ?

A

new vessels on the disc
new vessels elsewhere
vitreous hge
traction retinal detachement

25
Q

what is the management for diabetic retinopathy ?

A

strict control of blood glucose
pan retinal photocoagulation
intravitreal Anti Vegf
Surgery - vitrectomy

26
Q

when is pan retinal photocoagulation used ?

A

in cases of proliferative DR
or
Non proliferative DR but in high risk patients
or
cases of neovascular glaucoma

27
Q

what are the side effects of PRP ?

A

loss of peripheral vision
reduced night vision

28
Q

what is the best next step in management of a DR patient who has macular oedema and is not responding to PRP ?

A

anti-VEGF (intravitreal Lucentis)

29
Q

when should surgery be considered in DR ?

A

vitreous haemorrhages
traction retinal detachment

30
Q

what is retinal deetachement ?

A

Retinal detachment refers to a separation of the retina from the retinal pigment epithelium

31
Q

what are the symptoms of retinal detachement ?

A

floaters and flashes which worsenn on eyee movement
shadow (stationery)
loss of vision

32
Q

what are the signs of retinal detachment ?

A

visual field defects
tobacco dust
retinal tears
subretinal fluid

33
Q

what is the management for retinal detachement ?

A

vitrectomy

34
Q

what is vitreous detachment ?

A

liquification of the vitreous gel
normal deegenrative process

35
Q

what are the symptoms of vitreous detachment

A

floaters
with or without flashers

36
Q

what is the management for vitreous detachment ?

A

no need for intervention

37
Q

what is the leading cause of blindness in the elderly ?

A

ARMD