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CMED 312 Ophtha module > Trans 013 Ocular Manifestation Of Systemic Disease > Flashcards

Trans 013 Ocular Manifestation Of Systemic Disease Flashcards

1
Q

Overall incidence of Hypertensive Retinopathy

A

15%

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2
Q

Keith Wagener Barker Classification

disc edema

A

Stage 4

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3
Q

Keith Wagener Barker Classification

Cotton wool spots hard exudates, Retinal hemorrhage

A

Stage three

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4
Q

Keith Wagener Barker Classification

Moderate to marked arteriolar narrowing, av crossing changes

A

Stage 2

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5
Q

Keith Wagener Barker Classification

Mild to moderate arteriolar narrowing

A

Stage 1

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6
Q

Scheie Classification : Hypertension

No changes

A

Grade zero

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7
Q

, Scheie Classification : Hypertension

Obvious arterial narrowing

A

Grade 2

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8
Q

Scheie Classification : Hypertension

Plus retinal hemorrhage

A

Grade 3

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9
Q

Scheie Classification : Hypertension

Plus puppiledema

A

Grade 4

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10
Q

Scheie Classification: Arteriosclerosis

Obvious increased light reflex changes

A

Grade two

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11
Q

Scheie Classification: Arteriosclerosis

Silver wire arterioles

A

Grade four

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12
Q

Scheie Classification: Arteriosclerosis copper wire arterioles

A

Grade three

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13
Q

In accelerated hypertension (malignant – acute, hypertensive crisis), as in Toxemia of Pregnancy, Essential HPN, Renal Disease, Tumors, Connective Tissue Disorders
• Acute phase: yellow spots at the level of the retinal pigment epithelium
• Pathology: fibrinoid necrosis of choriocapillaris, with damage to RPE / intense plasma leakage can cause exudative retinal detachment / later, lesions scar with pigment or depigmentation.
 This complication only happens on acute accelerated hypertension, toxemia of pregnancy na mag cause ng exudative retinal detachment.

A

HYPERTENSIVE CHOROIDOPATHY

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14
Q

May be a direct ischemic episode of the optic nerve : Ischemic Neuropathy
• Upon resolution, many develop optic atrophy

A

HYPERTENSIVE OPTIC NEUROPATHY

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15
Q

there is intact eye movement but

there is no vision. Normal and MRI, yun pala may stroke sa occipital cortex

A

Cortical blindness

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16
Q

Remember that you will only see the cherry red spot in 2 instances

A

one is in central retinal artery occlusion, second is the tay sachs disease

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17
Q

usually in elderly people with systemic vascular disease : more in men than women (

2:1) : at least 90% carotid stenosis atherosclerosis most common cause 40%
; 20% bilateral : : 5 yr. mortality rate is

A

Ocular Ischemic Syndrome

18
Q

vegetations from valves become emboli and cause retinal vascular occlusion

A

Subacute Infectious Endocarditis

19
Q

from distant sites : operative sites, cardiac valves, cholesterol plaques

A

Embolic phenomena

20
Q

Risk factors in having diabetic retinopathy

A 
Duration of Diabetes
• Glycaemic Control
• Age
• Type of Diabetes
• Family Hx of DM
• Blood Pressure
• Serum Lipids
• Nutritional Factors/Obesity
• Clotting Factors
• Renal Disease
21
Q

Funds changes in

Non proliferative -Diabetic Retinopathy)

A
  • Microaneurysms
  • Retinal hemorrhages
  • Hard exudates
  • Cottonwool spots or soft exudates
  • Venous beading
  • Intraretinal microvascular abnormalities
22
Q

Fundus Changes in Proliferative Diabetic Retinopathy (PDR)

A
  • Neovascularization of the disc and retina
  • Vitreous and preretinal hemorrhages
  • Fibrovascular membranes
  • Vitreoretinal traction
23
Q

Causes of visual loss in

Diabetic retinopathy

A 
Macular Edema
• Macular / Premacular Hemorrhage
• Massive Vitreous Hemorrhage
• Traction Retinal Detachment
• Rhegmatogenous Retinal Detachment
• Neovascular Glaucoma
 Visual loss and retinal changes are irreversible.
 Early detection of Diabetic Retinopathy is crucial in blindness
prevention.
24
Q

It there is diabetes at zero to 29 years old when is the recommended time of first exam? Follow up?

A

5 years after onse t;

yearly

25
Q

Dm at 30 years and older when is the first exam? Follow up?

A

At time of diagnosis

Yearly

26
Q

Prior to frequency dm when is the first exam? Follow up?

A

Prior to conception or early in first trimester

No retinopathy to non server: every 3-12 months; other stages 1-3 months

27
Q

Management

Diabetic retinopathy

A

• Strict blood sugar control
• Management of other systemic problems
• Dilated fundus examinations
• Pan retinal Photocoagulation (PRP) for High Risk PDR /
Early PDR / Severe-Very Severe NPDR
• Macular Grid and Focal Photocoagulation for macular edema
• Anti VEGF intravitreal injections / intravitreal steroid injections

or implants for Macular edema
• Vitreoretinal surgery for advanced cases

28
Q
  • Most common cause of unilateral or bilateral proptosis in adults and children
  • usually bilateral (pwede din na unilateral)
  • immune-mediated process
  • 4-5x more in females, usually middle age
A

dysthyroid ophthalmopathy, Graves’ ophthalmopathy ” May our in euthyroid state

29
Q

What disease? Pathophysiology
• Chronic inflammation and scarring
• infiltration of EOMs & orbital fat by inflammatory cells first
then mucopolysaccharide and collagen
• disease process is marked by early inflammation & long term
fibrosis and scarring

A

dysthyroid ophthalmopathy, Graves’ ophthalmopathy ”

30
Q

What disease! • Non-specific redness, irritation, chemosis, lid swelling  Chemosis is the swelling of the conjunctiva and the lids
• Lid retraction, lid lag
• Eyelid retraction, proptosis, motility restriction
 Kasi diba naka prop outward yung eyes kaya pwedeng prone
sa keratitis ang patient
• Corneal exposure
• Optic nerve compression
 In very severe cases you will see this.
*** entire process: 6-24 mo. active disease, ff by stability and scarring in the orbit

A

dysthyroid ophthalmopathy, Graves’ ophthalmopathy ”

31
Q

Management of

Dysthyroid ophthalmopathiy

A

• Patient education
• Evaluation and monitoring of thyroid problem
• Monitoring of vision, color vision, pupillary reflexes
• Careful evaluation for optic nerve compression, corneal
exposure • Ocular surface lubricants
• Active: ocular lubricants, orbital irradiation, systemic steroids,
orbital decompression
• Chronic: observation, ocular lubricants, surgery for muscles,
orbital decompression, lid surgery

32
Q

Opportunistic Infections: in AIDS

A

Cytomegalovirus, Candida, Herpes Zoster, Toxoplasmosis, Pneumocystis Carinii

33
Q

most common finding in 100% of

HIV infected patients

A

Cotton wool spots

34
Q

most frequent is posterior granulomatous choroiditis
• retinal vasculitis with sheathing is common vitritis
• chronic iridocyclitis
• endophthalmitis

A

Ocular tuberculosis

35
Q

are found in pork meat, and other tapeworms like D. latum. The larvae get into the system and then get into the eye.

A

Cysticercosis

36
Q

drying of conjunctiva and cornea, Bitot’s Spots, keratomalacia, night blindness.

A

xerophtalmia

37
Q

Corrugated sa eyes?

Melt down of Correa?

A

Bitot’S spot

Keratomalacia

38
Q

crushing injuries of head or chest
• complement-activated coagulation of leukocytes, plus other
microemboli

A

Purstcher’s Retinopathy

39
Q

Some medicine that cause retinopathy

A

Chloroquine tamoxifen thioridazine

40
Q

IMMUNOLOGIC / COLLAGEN DISEASE that cause Retinal vas colitis

A

Juvenile Rheumatoid Arthritis

41
Q

IMMUNOLOGIC / COLLAGEN DISEASE that cause uveitis

A

Hashimoto Thyroiditis

CMED 312 Ophtha module (19 decks)

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