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Ocular Block 7 > RPE > Flashcards

RPE Flashcards

1
Q

What is the outermost layer of the retina

A

RPE

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2
Q

What is the RPE a barrier between

A

Choroid and retina

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3
Q

What needs to be done in order to assess the RPE

A

Eye needs to be dilated

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4
Q

Where is the RPE present in the retina

A

Anywhere the retina is present, the RPE is present

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5
Q

RPE at the optic nerve

A

No retina optic nerve, thus no RPE

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6
Q

Light getting to the retina

A

Light must pass through all of the layers of the retina to reach the RPE

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7
Q

Vitreed

A

Towards the vitreous

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8
Q

Sclerad

A

Towards the sclera

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9
Q

Outer

A

Away from center of the ye

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10
Q

Inner

A

Towards center of eye

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11
Q

What is the RPE rich with

A

Melanocytes

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12
Q

What are the layers of the retina from inner to outer

A 
Inner limiting membrane
Nerve fiber layer 
Ganglion cell layer 
Inner plexiform layer 
Inner nuclear layer 
Outer plexiform layer 
Outer nuclear layer 
Outer limiting membrane 
Layer of rods and cones 
Pigmented epithelium
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13
Q

What is the peripheral retina continuous with

A

RPE continuous with PE of ciliary

Other nine layers are continuous with NPE of ciliary body

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14
Q

How many layers to the RPE

A

One

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15
Q

How many cells in the RPE

A

4-6 million, don’t regenerate

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16
Q

Where is the RPE cell density the greatest

A

In the fovea

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17
Q

How many photoreceptor outer segments does each RPE cell face

A

About 30-40

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18
Q

What does the RPE do to the outer segment of the photoreceptors

A

Engulfs shed discs from photoreceptors on a daily basis

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19
Q

When does the rod shed its discs that get engulfed

A

Morning

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20
Q

When do the cones shed their disc that get engulfed

A

Night

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21
Q

What does the apex of the RPE face

A

Apex of the photoreceptor outer segment

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22
Q

What are the layer of bruchs membranes

A 
RPE BM
Inner collagenous zone 
Elastic zone 
Outer collagenous layer 
BM of choriocapillaris
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23
Q

What are some roles of the RPE

A 
Secretion
Phagocytosis 
Visual cycle
Glia
Epithelial transport 
Light absorption
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24
Q

What are the layers of the RPE

A

Outer zone
Middle zone
Inner zone

25
Q

What is in the outer zone of the RPE

A

Mitochondria

26
Q

What is in the middle layer of the RPE

A

Nucleus
Golgi
ER

27
Q

What is in the inner layer of RPE

A

Melanocytes

28
Q

Where is the degradation of rod outer segment

A

Lysosomal degradation in the RPE. Phagosome and lysosomes come together and form a secondary lysosome and digestions

29
Q

Metabolic waste deposited in inner collagenous zone of Bruch’s membrane

A

Drusen

30
Q

Drusen and age

A

Normal with age

Excess is problem-RPE not functioning, smokers have mroe

31
Q

Familial dominant druses

A

Hereditary
Nothing to do about it
Usually no vision complaints

32
Q

ARMD

A

Build up of hydrophobic stuff in Bruch’s membrane. Waste cant get out, nutrients cant get out. Cracks form in Bruch’s, blood vessels form though cracks. They are fenestrated, so stuff leaks into RPE. Fluid, blood, protein. If in macula, obstrustus vision

33
Q

What is the difference between dry and wet AMD

A

Dry is just drusen

Wet is blood vessels in macula

34
Q

Geographic atrophy

A

Dropout of of RPE, choroidal vessels show through

35
Q

What is treatment for wet AMD

A

Injectable anti vascular endothelial growth factor (anti-VEGF)

36
Q

What are 3 common VEGF inhibitors

A

Avastin
Eylea
Lucentis

37
Q

What is a cheap alternative to anti VEGF treatment

A

Avastin is used for colon cancer, but it is 50$ compared to $2000 and does the same thing

38
Q

Visual distortion causes by AMD

A

Metamorphopsia (blurred)

Scotoma (loss)

39
Q

What do we use to test AMD

A

Master grid

40
Q

How are RPEs and photoreceptors arranged

A

Apex to apex due to embryolongical development

41
Q

What fills the space between the RPE and PRs

A

Interphotoreceptor matrix

42
Q

What is interphotoreceptor matrix

A

Fills the space between RPE and PRs, very strong, but no junctions. Controls trackificing of nutrients

43
Q

Apical membrane specializations

A

Apical Na+/K+ ATPase pumps

44
Q

What do the apical Na+/K+ ATPase pumps do

A

Regulate fluxes to keep the sensory retina adhered to the RPE

45
Q

Lateral membrane specializetions of the RPE

A

Zonula occludens

  • tight junction
  • blood barriers
46
Q

What are all the different types of junctions in the lateral RPE membrane

A 
Zonula occludens 
Zonula adherens 
Macular adherens 
Gap junction 
Focal adhesion 
Bruch's membrane
47
Q

These increase surface area for cell absoprtion and secretion

A

Basal enfoldings

48
Q

Blood retina barrier

A
  • Tight junctions between the RPE cells ( zonula occludens)

- tight junctions between the non fenestrated endothelial cells of the retinal caps

49
Q

Function of the apical microvilli

A

Aids adhesion, phagocytosis, increased surface area for metabolic exchange

50
Q

Function of lysosomes

A

Contain hydrologic enzymes which digest photoreceptors

51
Q

Function of phagosomes

A

Contain phagocytosed photoreceptor segments

52
Q

Function of Golgi

A

Secretion and sulphation of GAGs

53
Q

Function of basal infoldings

A

Increases absorptive surface

54
Q

Retinitis pigmentosa

A
  • Photoreceptors gone
  • RPE too close to second order neurons, so RPE migrate to inner retina and surround the blood vessels
  • occlude the ganglion cell blood vessels
  • rod receptor problem
  • tunnel vision
55
Q

Benign hypertrophy of RPE (bear tracking)

A

Hyper pigmentation of RPE

Normal ish

56
Q

Choroidal Nevis

A

Normal freckle thing

57
Q

Choroidal melanoma

A

Has thickness to it. Can see pigment forming. Immediate referreral

58
Q

Histoplasmosis

A
  • fungal infection
  • peripapillary atrophy
  • central and peripheral

Ocular Block 7 (9 decks)

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