Unit 6 - other retinopathies Flashcards

1
Q

Which is more common type 1 or type mac tel?

A

Type 2

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2
Q

What is the pathogenesis of mac tel?

A

Postmortem histopathology show Muller cell loss.

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3
Q

What is the disease progression in foveo-macula vitelliform degeneration?

A

yellow material fades and GA develops

CNVM may develop (rarely)

photoreceptor loss may predispose patient to a macula hole

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4
Q

Is type 2 mac tel bilateral or unilateral?

A

Bilateral

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5
Q

What percentage of the over 40 population is affected by mac tel?

A

0.1%

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6
Q

What is the differential diagnosis in foveo-macula vitelliform degeneration?

A

Best’s disease - lesions appear earlier in life and are smaller

AMD - lesions appear later and are less discrete that in AFMVD

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7
Q

What are the clinical signs of foveo-macula vitelliform degeneration?

A

Pigment

Round, yellow discrete lesions in or near macula

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8
Q

In autosomal dominant dystrophies what % of children will be affected?

A

50% but with difference in severity

Male = female

Does not skip a generation

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9
Q

What ocular investigations should be conducted in foveo-macula vitelliform degeneration?

A

Photography

OCT

FFA, may show hyper-fluorescent staining with a corona sign possible present.

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10
Q

What is the pathogenesis of foveo-macula vitelliform degeneration?

A

Don’t know

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11
Q

What are the symptoms of foveo-macula vitelliform degeneration?

A

None or mild reading difficulties

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12
Q

In autosomal recessive what % of children will be affected?

A

25% if both parents carriers

Male = female

e.g. Stargardt’s

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13
Q

What % chance does a female carrier of an X-linked disease have an having affected children?

A

50% risk of a son be affected

50% risk of daughter being a carrier

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14
Q

What is the prognosis in foveo-macula vitelliform degeneration?

A

Generally good but can cause significant visual loss

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15
Q

What are the clinical signs of type 1 mac tel?

A

Copious hard exudates

V/a approximately 6/12

1-2 disc diameter of telangiectasis temporal to fovea

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16
Q

When does adult onset foveo-macula vitelliform degeneration become apparent?

A

4th and 5th decade

17
Q

What does mac tel look like?

A

Looks like a macula hole with DMO although retinal thickness not as bad as DMO

Retinal crystals

Normal or subtle grey appearance to central mac

18
Q

What is mac tel?

A

An ectasia of retinal capillaries where there is irregular capillary dilatation.

19
Q

Who does adult onset foveo-macula vitelliform degeneration affect more men or women?

A

Women more than men

20
Q

What treatment is there for mac tel?

A

Focal laser to individual telangiectasia

Macula grid laser (PDT and conventional laser are ineffective)

Anti-VEGF if SRF CNVM develops

Nerve fibre growth factors may delay progression

21
Q

Are men or women more affected by mac tel type 1?

22
Q

if cones are affected in a dystropy more than rods how would it be described?

A

Cone-rod dystrophy

23
Q

What is the inidence of RP?

24
Q

Where do the bony spicules of RP come from?

A

Pigment in RPE liberated from degenerated retina.

25
What is a monogenic retinal dystrophy?
Dystrophy caused by one gene mutation.
26
What is a molecular diagnosis?
A diagnosis confirmed with DNA testing.
27
How is mitchondrial disease passed on?
Through the mother Children of affected males are unaffected Children of affected females will have mutation E.g. Maternally inherited deafness and diabetes
28
If the disorder has extraocula manifestations what is it called?
Syndromic
29
What is the most common syndromic RP and what is it associated with?
Usher's syndrome Associated with deafness
30
What part of the cell is affected in Usher's sydrome?
The cilium that connects outer segments to inner segments. Also present in auditory hair hence deafness.
31
Which genes are responsible for the manufacturer of the following protein? * RHO * USH2A * RPGR * RP2
* Rhodopsin * Usherin * RPGR * RP2
32
What is the most common cone-rod dystrophy and what gene does it affect?
Stargardt's, ABCA4
33
How common are cone-rod dystrophies?
1 in 40,000
34
What are the initial symptoms of a cone-rod dystrophy?
Poor v/a Sensitive to bright lights Colour vision defects.
35
What ocular tests should be conducted on a patient with suspected Stargadt's?
Electrophysiology
36
What ocular signs would you expect with AD Drusen?
Drusen orientating radially away from macula and next to optic disc.
37
Which gene is responsible for Best's disease?
BEST1
38
In AD Best's disease what are the signs and symptoms?
* Hyperautofluorescence at macula * Hyperopia * EOG light rise absent * Scars/fluid * Very variable
39
What are the signs and symptoms in AR Best's disease?
* 6/36 v/a * Longstanding poor vision * Chronic irf/srf,