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Mnemonics in Ophthalmology > Vascular retinopathies > Flashcards

Vascular retinopathies Flashcards

1
Q

Inner Blood Retinal Barrier is made up of _____, and its pathology is seen in _____ on FA.

A

Retinal capillaries tight-junctions, DM.

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2
Q

Outer Blood Retinal Barrier is made up of _____, and its pathology is seen in _____ on FA.

A

RPE Zonula occludens, AMD.

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3
Q

___% of DM patients have sight-threatening pathology, and ____% of all DM have some sort of pathology.

A

8%, 42&

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4
Q

___% of DM patients that lost sight in one eye will lose it in the other in a year, and ____% in 5 years

A

60%, 90%

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5
Q

Duration of DM increases the risk of DM retinopathy - ___% of DM patients under 10 years, and ____% in DM patients over 20 years

A

7%, 75%

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6
Q

PDR has vessels crossing the____.

A

ILM

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7
Q

Mild-Moderate NPDR findings:

A

MEH…

M - Micro-aneurysms.
E - Exudates (hard).
H - hemorrhage (dot, blot, flame).

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8
Q

Circinate is ____, and its clinical significance is ______.

A

a ring of hard exudates, significant central leak.

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9
Q

Severe NPDR findings:

A

BIC’S:

B - beading & looping of veins.
I - IRMA, intraretinal microangiopathy (new vessels don’t cross the ILM).
C - Cotton wool spots/ vessel closure.
S - Sclerosis of vessels.

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10
Q

Cotton wool spots are_____, and their significance is____.

A

focal ischemia and damage to NFL (axoplasmic flow damage), axons swelling.

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11
Q

Hard exudates are_____, and their clinical significance is____.

A

fat and protein precipitants, edema due to damage of the inner RBB.

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12
Q

On FA of NPDR patient, white spots are____.

A

Micro-aneurysms.

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13
Q

On FA of NPDR patient, black areas are____.

A

hemorrhage.

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14
Q

On FA of NPDR patient, it’s impossible to see____.

A

active bleeding.

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15
Q

NPDR patients are usually _____.

A

asymptomatic

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16
Q

NPDR patients will begin to experience symptoms with ______, and it is _____ to treat.

A

macular edema, possible.

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17
Q

Macular edema is _____ to treat.

A

possible

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18
Q

Ischemic maculopathy is _____ to treat.

A

not possible

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19
Q

NVD stand for______, and has ______ prognosis.

A

disc neo-vascularization, poor

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20
Q

NVE stand for______.

A

neo-vascularization elsewhere.

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21
Q

Immediate complication of PDR is ______.

A

tearing of pathologic vessels (due to movement of Vitreous body) -> bleeding-> “black screen”.

22
Q

Later complication of PDR is ______.

A

Traction retinal detachment.

23
Q

Traction retinal detachment in PDR’s pathophysiology:

A

Growth of pathologic vessels and fibrovascular membrane -> vessels gradually get absorbed -> fibrotic membrane remains that is attached to the retina in several locations ->Traction retinal detachment.

24
Q

Rubeosis iridis is ______, and can lead to ______, and eventually _____.

A

Growth of pathologic vessels over the Iris, Vascular Glaucoma, impossible to rehabilitate.

25
Q

Severe NPDR has the ____ rule.

A

4-2-1 rule - the patient is at increased risk for PDR:

4: 4 quadrants with aneurysms (4nurisms) or hemorrhages.
2: 2 quadrants with Venous beading (V sign for veins and 2 for 2 quadrants).
1: 1 quadrant of IRMA (1RMA)

26
Q

Treatment of DM retinopathy?

A

Prevention: He PLANS to prevent!
He - HTN treatment

P - Pregnancy
L - Lipideamia (HDL, LDL)
A - Anemia
N - Nephropathy and Proteinuria 
S - Suger (blood suger managment - most important!)
27
Q

What is the DCCT, and its significance?

A

DM retinopathy study for DM1 patients. Found that strict adherence and treatment halted occurrence and progression of DM retinopathy by 5 times over.

28
Q

What are the AR of the DCCT

A

Hypoglycemia and Fat gains

29
Q

Unbalanced patients starting strict Blood sugar control will experience ___________.

A

progression of DM retinopathy for a year and a half before improvement.

30
Q

What is the UKPDS, and its significance?

A

DM retinopathy study for DM2 patients. Found that HTN control (below 150\85). halted progression of DM retinopathy by a third, and moderate sight loss by 50%.

31
Q

What is the ETDRS, and its significance?

A

DM retinopathy study - high cholesterol increases hard exudates occurrence X2 over.

32
Q

What is the ACCORD, and its significance?

A

DM retinopathy study - balancing all factors. HbA1C control had the most significant effect. No effect in HTN control below 140 SBP (120 vs. 140).
HIghest mortality in the strictest control group.

33
Q

PDR treatment?

A

Go away PeR-VerT!
PeR - PRP
VerT - Vitrectomy

34
Q

VEGF in normal concentration causes ____ and in high concentrations causes _____.

A

healthy blood vessels, pathologic blood vessels

35
Q

Anti VEGF is injected at ______, every ______, preceding an ______

A

Pars plan (6 mm from the limbus), every 4-6 weeks, OCT

36
Q

Treatment with Anti VEGF can lead to _______

A

improvement of 10 letters.

37
Q

AR of PRP are?

A

Not a FAN!
F - Field (visual feid decrese)
A - Acuity (blurness due to macular edema)
N - Near-sight decrease (damage to long ciliary nervs)

38
Q

AR of PRP are?

A

Not a FAN!
F - Field (visual feid decrese)
A - Acuity (blurness due to macular edema)
N - Near-sight decrease (damage to long ciliary nerves)

39
Q

Mild hypertensive retinopathy results in____.

A

arteriovenous nicking, narrowing of vessels, and opacification of the arteriolar walls.

40
Q

Moderate hypertensive retinopathy results in____.

A

Flam, Blot, Cotton wool spots.

41
Q

Severe hypertensive retinopathy results in____.

A

Optic disc swelling -> AION/CRAO

EMERGENCY!

42
Q

____(3)____ are more common in hypertensive retinopathy

A

Hypertensive retinopathy - Flam, Blot, Cotton wool spots.

May also present with hard exudates

43
Q

____2____ are more common in DM retinopathy.

A

DM retinopathy - hard exudates, microaneurysms.

May also present with: Flam, Blot, Cotton wool spots.

44
Q

CRAO etiologies:

A 
SHIT-E (shitty)
S - spasm
H - Hypertension of the EYE (Glaucoma/Hypertensive retinopathy)
I - Inflammation (temporal arteritis)
T - Thrombus
E - Emboli
45
Q

CRAO signs:

A

CMV:
C - Cherry red spot/Cow trucks
M - Marcus gun pupil
V - visual acuity

46
Q

CRVO etiologies:

A

Best Sweet Glue PATHS and CLuMMPSS the veins!

Best - Bechet
Sweet - DM
Glue - Glaucoma

P - Protines S, C deficiency
A - APLA
T - Trauma
H - HTN
S - SOL
C - Cryoglobineamia
L - Leukemia
u
M - MM
M - Macroglobineamia
P - Polyciteamia Vera
S - Sickle cell
S - SLE
47
Q

CRVO complications:

A

ENTRaP

E -Edema of the macula
N -Neovascular glaucoma
T - Traction RD
R - Rubeosis iridis
a
P - Pigmentary changes
48
Q

CRVO treatment:

A

Anti-vegetarian Perps! NO Laser!
Anti-vegetarian = Anti-VEGF
Perps = PRP
NO Laser! - Laser not effective

49
Q

CRVO types:

A

Ischemic vs non-ischemic

50
Q

Ischemic CRVO findings.

A

aCHiEVE

a
C - CWS
H - Hemorrhages
i
E - Engorged vessels
V - Vision decreased 
E - Edematous nerve
51
Q

Non-ischemic CRVO types:

A

Good prognosis and visions - much less aCHiEVE

52
Q

BRVO treatment:

A

Anti-vegetarian Laser!

Anti-vegetarian = Anti-VEGF
Laser! - Laser effective (Unlike in CRVO)

Mnemonics in Ophthalmology (16 decks)

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