The Retina

Question 1

What are 5 important causes of retinal hemorrhage?

Answer 1

HTN, diabetes mellitus, ceontral retinal vein occlusion, bleeding diatheses and trauma

Question 2

What serious condition can retinal vascular occlusion cause?

Answer 2

Blindness

Question 3

What are cotton-wool spots?

Answer 3

White fluffy patches of the retina observed in the ophthalmoscope caused by retinal ischemia

Question 4

What is the cause of the ophthalmic finding of the cherry-red spot?

Answer 4

Prominence of the foveola (which is supplied by the choroid) in the retina when there is arterial occlusion of the central retinal artery.

Question 5

What is amaurosis fugax?

Answer 5

Unilateral blurred vision lasting a few mintues due to small retinal emboli

Question 6

What is a complication of retinal artery occlusion?

Answer 6

Permanent blindness

Question 7

What are some complications of retinal vein occlusion?

Answer 7

Venous hemorrhage, edema, mild ischemia, peripheral anterior synechiae (adhesion betwixt iris and anterior chamber angle)

Question 8

What are the effects of venous occlusion on vision?

Answer 8

Vision is disturbed but may recover well

Question 9

What are features found in hypertensive retinopathy?

Answer 9

Arteriolar narrowing, flame-shaped hemorrhages, exudates, cotton-wool spots, microaneurysms

Question 10

What is arteriovenous nicking?

Answer 10

Site where arterioles cross veins, the latter appear kinked reflecting sclerosis w/i veins

Question 11

What is arterial sheathing?

Answer 11

Abnormal retinal arterioles appear as parallel white lines at sites of vascular crossing

Question 12

Describe the transition between copper and silver wiring in hypertensive retinopathy

Answer 12

Initially, narrowed lumen of retinal vessels decrease visibility of blood column and makes it appear orange. The blood column eventually becomes completely obscured and light reflects from sclerotic vessels

Question 13

Characteristics in malignant hypertension

Answer 13

Necrotizing aeriolitis with fibrinoid necrosis and thrombosis of precapillary retinal arterioles

Question 14

What is the relationship between proliferative diabetic retinopathy and degree of glycemic control?

Answer 14

Better glycemic control, less retinopathy

Question 15

What are the two stages of diabetic retinopathy?

Answer 15

Background (Nonproliferative) and Proliferative

Question 16

Compare the endothelial/pericyte ratio for normal and diabetic microvessels

Answer 16

Normal: 1:1, Diabetic: > 1:1

Question 17

Describe general characteristics of Background Retinopathy

Answer 17

Venous engorgement, small hemorrhages, capillary uaneurysms, and “waxy” fat exudates

Question 18

Describe general characteristics of Proliferative Retinopathy

Answer 18

Delicate BV growth along retina and then into the vitreous cavity

Question 19

What are the three leading causes of irreversible blindness in the US?

Answer 19

Diabetic retinopathy, glaucoma, and age-related macular dengeneration

Question 20

What is diabetic iridopathy? What is hyphema?

Answer 20

Iris neovascularization (rubeosis iridis) in which both anterior and posterior synechiae occur; Hemorrhage of newly friable vessels that can result in blindness

Question 21

What is stored in the epithelium in the iris in diabetic iridopathy?

Answer 21

Glycogen

Question 22

What is a characteristic of diabetic cataracts?

Answer 22

Snowflake cataracts

Question 23

What is Argyll Robertson pupil and what disease is it associated with?

Answer 23

Pupils that react to accommodation but not light; Can be caused by diabetes

Question 24

What space is obliterated in fetal development in the eye?

Answer 24

Space betwixt sensory retina and retinal pigment epithelium

Question 25

What are the three types of retinal detachment?

Answer 25

Rhegmatogenous, Tractional, Exudative

Question 26

Describe Rhegmatogenous retinal detachment

Answer 26

Associated with retinal tear

Question 27

Describe tractional retinal detachment

Answer 27

Retina is pulled toward the center of the eye by adherent vitreoretinal adhesions

Question 28

Describe exudative retinal detachment

Answer 28

Accumulation of fluid in space betwixt the sensory retina and retinal pigment epithelium

Question 29

What is another name for retinitis pigmentosa?

Answer 29

Pigmentary retinopathy

Question 30

What is Retinitis Pigmentosa?

Answer 30

Bilateral, progressive, degenerative retinopathy characterized by night blindness, constriction of peripheral visual fields, loss of photoreceptors (rods and cones) and pigment accumulation in the retina

Question 31

Which type of mutations result in the most severe forms of retinitis pigmentosa?

Answer 31

Autosomal recessive and X-linked disease

Question 32

What causes the retinal pigmentation in retinitis pigmentosa?

Answer 32

Pigmented brown cells derived from retinal pigmented epithelium

Question 33

What is the center of the macula called?

Answer 33

The foveola

Question 34

What is a major cause of macular degeneration?

Answer 34

Old age

Question 35

What is the mutation that is a risk factor for 50% of macular degeneration cases?

Answer 35

Missense mutation of the CFH gene that encodes for complement factor H

Question 36

What are characteristics found in the retina of a patient afflicted with a lysosomal storage disease? What other condition exhibits these characteristics?

Answer 36

Cherry-red macula with pallid retina; Central retinal artery occlusion

Question 37

What are angioid streaks?

Answer 37

Irregular lines that radiate beneath retina from the optic nerve head that occur when the Brunch membrane fractures

Question 38

What is retinopathy of prematurity?

Answer 38

Bilateral iatrogenic, retinal disorder that occurs in premature infants treated with high levels of inspired oxygen after birth

Question 39

Describe the pathology of retinopathy of prematurity

Answer 39

Retinal BVs become obliterated and the peripheral retina which is normally avascular until end of fetal life does not vascularize