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UCL Medical Retina > Unit 6 - Retinal pathologies > Flashcards

Unit 6 - Retinal pathologies Flashcards

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USMLE® Step 1 flashcards
1
Q

What 4 symptoms of myopic CNVM do you get?

A
  1. Acute vision reductions
  2. Metamorphopsia
  3. Scotoma
  4. Flashes/floaters
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2
Q

How is myopic CNVM diagnosed?

A
  1. FFA
  2. OCT
  3. Photography
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3
Q

What medical treatments are available for myopic CNVM?

A

Anti-VEGF

PDT but this will only stabilise it Laser photocoagulation

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4
Q

What surgical treatments are available for myopic CNVM?

A

Surgical excision of CNV

Macula/foveal translocation

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5
Q

Who is at risk of developing myopic CNVM?

A
  1. Over -6DS
  2. Axial length >26 mm
  3. Degenerative changes in sclera, choroid and retina e.g. staphyloma, mottled rpe, PPA, etc
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6
Q

What is the incidence of myopic CNVM amongst patients with pathological myopia and in the general population>

A

5-11% of pathological myopia 1-3% of general population

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7
Q

In what % of patients is myopic CNVM bilateral?

A

15%

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8
Q

What risk factors are there in developing RDs?

A
  • Myopia
  • Post-cataract surgery
  • Trauma
  • Retinopathy of prematurity
  • Sticklers syndrome
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9
Q

What symptoms do patients with Stickler’s syndrome have?

A
  • Hearing loss
  • Eye abnormalities
  • Joint problems
  • FLK
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10
Q

What is the incidence of RD amongst the general population?

A

10-15 per 100k

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11
Q

What % of patients with a symptomatic PVD will have a tear?

A

25%

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12
Q

What % of patients with symptomatic breaks will lead to a RD?

A

50%

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13
Q

How do you view the vitreous on the slit lamp?

A

narrow slit and 20degrees between illumination and viewing.

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14
Q

What is the process of RD?

A

Hole Fluid enters hole Rate of fluid under retina is not matched by RPE pumping it out

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15
Q

What are the symptoms of PVD?

A

Temporal flashes of light more noticeable in dark

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16
Q

How are migraine flashes different to PVD?

A
  • Coloured
  • Transient/episodic
  • Seem to sparkle
  • Associated with reduced va
17
Q

What is the definition of retinal dialysis?

A

Circumferential breaks near Ora

18
Q

What is the definition of a giant retinal tear?

A

greater than 3 clock hours in size

19
Q

What symptoms do you get in multiple evanescent white dot syndrome?

A

Constant paracentral photpsia

20
Q

Apart from MEWDS what other condition will give constant paracentral photopsia?

A

AZOOR, acute zonal outer ocult retinopathy

21
Q

What is the referral of an RD?

A

Urgent if macula on If macula on and with pigmented demarcation and no symptoms then routine.

22
Q

What is CSR?

A

Limited detachment of neurosensory retina Photoreceptors outer segments become elongated

23
Q

What increases your risk of getting CSR? (6)

A
  1. Exogenous steroid use
  2. Endogenous steroid use, pregnancy, cushing’s (5%)
  3. Type A personalities
  4. Male: Female 6:1
  5. Age 39-51
  6. Depression odds ratio of 3.5
24
Q

What are the 5 differential diagnoses with CSR?

A
  1. IPCV
  2. CNVM
  3. Optic disc maculopathy
  4. Choroidal haemangioma
  5. Dome-shaped maculopathy
25
Q

What are the symptoms in CSR?

A
  1. Blurred vision
  2. Relative scotoma
  3. Increased hypemetropisation
  4. Reduced CS
26
Q

What is the prognosis in CSR?

A

Resolves spontaneously in 4-6 montsh

May have residual colour perception abnormality

27
Q

What is the difference between chronic and acute CSR?

A

Chronic lasts longer than 6 months with moderate to severe va loss and reduced CS, almost always bilateral.

28
Q

What treatments are available for chronic CSR?

A
  1. Argon laser ( hot laser)
  2. PDT (reduces srf and reduces recurrences)
  3. Eplerenone but can mess with kidneys so watch K+
29
Q

What is the recurrence rate in acute CSR?

A

15-50%

30
Q

What are the treatment indications for chronic CSR?

A

SRF for more than 4/12

Multiple recurrences

CSR in fellow eye with poor visual outcome

Reduced v/a

Rapid recovery required for work

UCL Medical Retina (17 decks)

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