Unit 6 - Retinal pathologies Flashcards
What 4 symptoms of myopic CNVM do you get?
- Acute vision reductions
- Metamorphopsia
- Scotoma
- Flashes/floaters
How is myopic CNVM diagnosed?
- FFA
- OCT
- Photography
What medical treatments are available for myopic CNVM?
Anti-VEGF
PDT but this will only stabilise it Laser photocoagulation
What surgical treatments are available for myopic CNVM?
Surgical excision of CNV
Macula/foveal translocation
Who is at risk of developing myopic CNVM?
- Over -6DS
- Axial length >26 mm
- Degenerative changes in sclera, choroid and retina e.g. staphyloma, mottled rpe, PPA, etc
What is the incidence of myopic CNVM amongst patients with pathological myopia and in the general population>
5-11% of pathological myopia 1-3% of general population
In what % of patients is myopic CNVM bilateral?
15%
What risk factors are there in developing RDs?
- Myopia
- Post-cataract surgery
- Trauma
- Retinopathy of prematurity
- Sticklers syndrome
What symptoms do patients with Stickler’s syndrome have?
- Hearing loss
- Eye abnormalities
- Joint problems
- FLK
What is the incidence of RD amongst the general population?
10-15 per 100k
What % of patients with a symptomatic PVD will have a tear?
25%
What % of patients with symptomatic breaks will lead to a RD?
50%
How do you view the vitreous on the slit lamp?
narrow slit and 20degrees between illumination and viewing.
What is the process of RD?
Hole Fluid enters hole Rate of fluid under retina is not matched by RPE pumping it out
What are the symptoms of PVD?
Temporal flashes of light more noticeable in dark
How are migraine flashes different to PVD?
- Coloured
- Transient/episodic
- Seem to sparkle
- Associated with reduced va
What is the definition of retinal dialysis?
Circumferential breaks near Ora
What is the definition of a giant retinal tear?
greater than 3 clock hours in size
What symptoms do you get in multiple evanescent white dot syndrome?
Constant paracentral photpsia
Apart from MEWDS what other condition will give constant paracentral photopsia?
AZOOR, acute zonal outer ocult retinopathy
What is the referral of an RD?
Urgent if macula on If macula on and with pigmented demarcation and no symptoms then routine.
What is CSR?
Limited detachment of neurosensory retina Photoreceptors outer segments become elongated
What increases your risk of getting CSR? (6)
- Exogenous steroid use
- Endogenous steroid use, pregnancy, cushing’s (5%)
- Type A personalities
- Male: Female 6:1
- Age 39-51
- Depression odds ratio of 3.5
What are the 5 differential diagnoses with CSR?
- IPCV
- CNVM
- Optic disc maculopathy
- Choroidal haemangioma
- Dome-shaped maculopathy
What are the symptoms in CSR?
- Blurred vision
- Relative scotoma
- Increased hypemetropisation
- Reduced CS
What is the prognosis in CSR?
Resolves spontaneously in 4-6 montsh
May have residual colour perception abnormality
What is the difference between chronic and acute CSR?
Chronic lasts longer than 6 months with moderate to severe va loss and reduced CS, almost always bilateral.
What treatments are available for chronic CSR?
- Argon laser ( hot laser)
- PDT (reduces srf and reduces recurrences)
- Eplerenone but can mess with kidneys so watch K+
What is the recurrence rate in acute CSR?
15-50%
What are the treatment indications for chronic CSR?
SRF for more than 4/12
Multiple recurrences
CSR in fellow eye with poor visual outcome
Reduced v/a
Rapid recovery required for work
