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Retina > Vascular > Flashcards

Vascular Flashcards

1
Q

Flame-shaped hemorrhages - where

A

track along the nerve fiber layer

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2
Q

dot/blot shaped hemorrhages - where

A

outer plexiform/inner nuclear layers

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3
Q

Central retinal artery - layers

A

intima (single layer of endothelium resting on a collagenous zone), internal elastic lamina, media (smooth muscle), adventitia (loose connective tissue)

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4
Q

Retinal arterioles - characteristic feature

A

internal elastic lamina is discontinuous

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5
Q

Exudates - where in the retina

A

outer plexiform layer

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6
Q

Microaneurysms - where in retina

A

in the inner capillary plexus (inner nuclear layer)

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7
Q

DME - which layers

A

between the outer plexiform and inner nuclear layers; later it may also involve the inner plexiform and nerve fibre layers

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8
Q

Cotton wool spots - where in the retina

A

within the nerve fibre layer. They are clinically evident only in the post-equatorial retina

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9
Q

BRVO - quadrant most commonly affected

A

superotemporal

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10
Q

Neovascularization following BRVO

A

8% of eyes by three years. NVE are more common than NVD

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11
Q

BRVO - FA

A

peripheral and macular ischaemia (capillary non-perfusion, staining of vessel walls, vessel ‘pruning’ – small branches failing to fill), haemorrhage and oedema with collateral vessels commonly forming in established cases. Venous filling is delayed

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12
Q

BRVO - treatment

A

• NVE or NVD - sector photocoagulation. • NVI - urgent sector PRP. •edema - antiVEGF/Intravitreal dexamethasone implant • If visual acuity remains 6/12 or worse after 3–6 months due to macular oedema that is associated with good central macular perfusion on FA, laser may be considered

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13
Q

Impending (partial) CRVO - FAF and FA

A

FAF may reveal a fern-like perivenular appearance, and FA generally demonstrates an impaired retinal circulation

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14
Q

Non-ischaemic CRVO - FAF

A

characteristic fern-like perivenular hypoautofluorescence due to masking of background signal by oedema

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15
Q

Non-ischaemic CRVO - FA

A

delayed arteriovenous transit time, masking by haemorrhage, usually good retinal capillary perfusion and some late leakage

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16
Q

Rubeosis iridis after ischaemic CRVO - %

A

50%

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17
Q

Retinal neovascularization after ischaemic CRVO - %

A

5% of eyes – much less commonly than with BRVO

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18
Q

ischaemic CRVO - FA

A

marked delay in arteriovenous transit time, masking by retinal haemorrhages, extensive areas of capillary non-perfusion and vessel wall staining and leakage

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19
Q

CME following CRVO - treatment

A

Treatment is generally indicated for VA worse than 6/9 and/or with significant central macular thickening (e.g. >250 μm) on OCT, but is unlikely to be of benefit if 6/120 or worse. ○ anti-VEGF ○ Intravitreal dexamethasone implant - (Ozurdex®) ○ Intravitreal triamcinolone ○ Laser photocoagulation. Although macular oedema is anatomically improved, laser is typically not beneficial for visual outcome, except in some younger patients

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20
Q

NVI or angle neovascularization following CRVO - treatment

A

PRP 1500–2000 burns of 0.5–0.1 s duration. ○ anti-VEGF adjunctively every 6 weeks until the eye stabilizes

21
Q

Papillophlebitis

A

under the age of 50 years who may have a higher prevalence of hypertension and diabetes. Disc oedema is the dominant finding, and retinal haemorrhages and other signs such as cotton wool spots are predominantly peripapillary and confined to the posterior pole

22
Q

Supply of outer retina

A

ciliary arteries via the choriocapillaris

23
Q

Supply of inner retina

A

CRA

24
Q

Hollenhorst cholesterol plaques

A

refractile yellow–white cholesterol

25
Q

fibrin-platelet aggregates

A

greyish elongated

26
Q

calcific particles

A

non-scintillating white

27
Q

Susac syndrome

A

CRAO, sensorineural deafness and encephalopathy

28
Q

BRAO - FA

A

delay in arterial filling and hypofluorescence of the involved segment due to blockage of background fluorescence by retinal swelling

29
Q

How often embolus is visible in CRAO?

A

20%

30
Q

Robeosis iridis - how often after CRAO and how fast?

A

1 in 5 eyes, typically earlier than in CRVO (4–5 weeks)

31
Q

Cilioretinal artery is present how often?

A

15–50% of eyes

32
Q

Anterior chamber paracentesis

A

27-gauge needle to withdraw 0.1–0.2 ml of aqueous

33
Q

Ocular ischaemic syndrome

A

uni, Gradual loss, amaurosis fugax, Ocular and periocular pain, persistent after-images, Diffuse episcleral injection and corneal oedema, Aqueous flare with few cells, Iris atrophy, Rubeosis iridis 90%, IOP may remain low, cataract, Venous dilatation, arteriolar narrowing, haemorrhages and occasionally disc oedema, NVD, NVE

34
Q

Ocular ischaemic syndrome - FA

A

Delayed choroidal filling and prolonged arteriovenous transit

35
Q

Hypertensive retinopathy - stages

A

Grade1.mild generalized arteriolar narrowing. 2.Focal narrowing, AV nipping, copper wiring. 3.Hemor, exudates, cotton wool. 4.Malignant, optic disc swelling

36
Q

Hypertensive choroidopathy

A

hypertensive crisis in young, Elschnig spots-focal choroidal infarcts, small black spots surrounded by yellow haloes, Siegrist streaks - flecks linearly along choroidal vessels

37
Q

Most common sickle cell disease to cause retinopathy

A

SC

38
Q

Should be avoided in sickling disorders

A

Carbonic anhydrase inhibitors

39
Q

THALASSAEMIA RETINOPATHY

A

Cataract, a smooth featureless iris, vascular tortuosity, angioid streaks, optic neuropathy and pigmentary retinal mottling

40
Q

Retinal Artery Macroaneurysm

A

older hypertensive women, hyperlipidemia, one eye, macular leakage, exudate, saccular arteriolar dilation at arteriovenous crossing on a temporal vascular arcade, hemor intra, sub, preretinal bleeding

41
Q

Coats disease

A

idiopathic retinal telangiectasia, early childhood, intraretinal and subretinal exudation, exudative RD. Unilateral visual loss, strabismus or leukocoria

42
Q

Coats disease - treatment

A

• Laser ablation of points of leakage • Anti-VEGF • Intravitreal triamcinolone • Cryotherapy • PPV

43
Q

Eales disease

A

idiopathic occlusive peripheral periphlebitis (sheating, superficial retinal hemor, may cotton), mostly indian young males, stage: inflammatory, occlusive, retinal neovasc. prognosis ok. tubercular protein hypersensitivity, recurrent VH, mild AAU, bi asymetrical

44
Q

Purtscher retinopathy

A

chest and head trauma, microvascular damage → occlusion and ischemia

45
Q

Purtscher-like retinopathy

A

fat or amniotic fluid embolism, acute pancreatitis, pre-eclampsia, systemic vasculitis

46
Q

Purtscher retinopathy - biochemical

A

elevated complement 5a

47
Q

Valsalva retinopathy

A

rupture of perifoveal capillaries → premacular hemor, VH may also, YAG laser membranotomy

48
Q

Lipemia retinalis

A

creamy-white discoloration or vessels, hyperTG, chylomycrons, in extreme salmon color, VA ok but not ERG

Retina (8 decks)

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