Vitreous Flashcards

1
Q

The vitreous body makes up approximately ____ of the volume of the eye and thus is the ______ single structure of the eye.

        a. 10%, smallest 
        b. 90 %, largest
        c. 80%, smallest
        d. 80%, largest
        e. 90%, smallest
A

d. 80%, largest

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2
Q

The length of the vitreous body in the newborn eye is approximately _______mm and by the age of 13 years, the actual length of the vitreous increases to ____mm

          a. 16.1 mm, 10.5mm
          b. 12.1 mm, 15,1mm
          c. 10.1 mm, 16.1 mm
          d. 10.5 mm, 16.1 mm
A

d. 10.5 mm, 16.1 mm

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3
Q

The mean adult vitreous is ____ mm.

          a. 12.5 mm
          b. 14.5 mm
          c. 16.5 mm
          d. 18.5 mm
A

c. 16.5 mm

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4
Q

The vitreous is actually ~_____ water.

         a. 75%
         b. 80%
         c. 90%
         d. 98%
A

d. 98%

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5
Q

The major non-aqueous biochemical components: fibrinogen/collagen and Glucosamine/Glycosaminoglycans (GAGs) form the vitreous into a gel that has important viscoelastic/ viscoplastic properties.

A

collagen, Glycosaminoglycans (GAGs), viscoelastic

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6
Q

The gel content increases/decreases with age.

A

decreases

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7
Q

T/F In the human, liquefaction is already at 20% (volume) by around age 18 and progresses to greater than 50% by the 80th decade.

A

True

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8
Q

T/F The existence of a gel in the vitreous does not depend on interactions between GAGs and collagen.

A

False, does depend

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9
Q

Type ____ collagen accounts for ____ of the total vitreal collagen and is the principal “structural” collagen present.

                a. III, 75%
                b. I, 50%
                c. II, 75%
                d. II, 50%
A

c. II, 75%

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10
Q

T/F Type II collagen is essential to gel formation in the vitreous.

A

True

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11
Q

Combined types V/XI collagen represent ~____ of the collagen present.

            a. 10%
            b. 20%
            c. 30%
            d. 40%
A

a. 10%

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12
Q

T/F A difficulty with investigating the vitreous body is that any attempts to define vitreous morphology are in fact attempts to visualize a tissue, which by design is intended to be visible.

A

False, invisible

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13
Q

T/F A difficulty with investigating the vitreous body is the various techniques that have previously been used to define the structure of the vitreous body are combined with artifacts that make interpretations difficult in terms of the true in vivo physiologic situation.

A

True

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14
Q

In the late/early stages of embryology, the optic cup is mainly occupied by the retina/lens vesicle.
As the optic cup grows, the space formed is filled by a system of bony/fibrillar material, presumable secreted by the cells of the embryonic retina/cornea.

A

early, lens, fibrillar, retina

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15
Q

T/F The penetration of the hyaloid artery, more fibrillar material, and other vessels all contributes to filling the space, known as the primary vitreous.

A

True

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16
Q

The size of the vitreous cavity increases and the hyaloid vascular system regresses developing the primary/secondary/tertiary vitreous.

A

secondary

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17
Q

T/F The main hyaloid artery remains for some time, but it eventually disappears and leaves in its place a tube of primary vitreous surrounded by the secondary vitreous, running from the retrolental space to the optic nerve. The tube is called Cloquet’s canal.

A

True

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18
Q

The Cloquet’s canal: a tube of primary/secondary vitreous surrounded by secondary/tertiary vitreous running from the retrolental space to the optic nerve.

A

primary, secondary

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19
Q

T/F The vitreous is the suspensor fibrils that suspend the lens, are developed from the fibrillary material.

A

False, Zonules

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20
Q

Zonules of the lens are termed the primary/secondary/tertiary vitreous.

A

tertiary

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21
Q

The mature vitreous body is a opaque/transparent gel and is spherical except at anterior/posterior end which is concave/convex .

A

transparent, anterior, concave

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22
Q

The innermost/outermost part of the vitreous, called the cortex, is divided into an anterior cortex and a posterior cortex, the latter being approximately 100/200 µm thick.

A

outermost, 100

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23
Q

The vitreous base is a two/three-dimensional zone

A

three

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24
Q

The vitreous base extends approximately from ___mm anterior to the ora serrata to ___mm posterior to the ora serrata, and it is several mm thick.

               a. 3, 2
               b. 2, 2
               c. 2, 3
               d. 3, 3
A

c. 2, 3

The collagen fibrils are especially densely packed in this region

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25
The vitreoretinal interface is the _inner/outer part of the cortex, which includes the internal limiting membrane (ILM) of the _cornea/retina_ and anchoring fibrils of the _conjunctiva/vitreous_ body.
outer, retina, vitreous
26
The ILM is a retinal structure between ___ and ___ µm thick, consisting mainly of type ___ collagen and proteoglycans. It contains several layers and can be considered the basal lamina of the ____ cells. a. 1, 2, IV, Tarsal b. 1, 3, IV, Mueller c. 2, 3, III, Mueller d. 1, 2, III, Tarsal
b. 1, 3, IV, Mueller
27
The vitreous cortex is firmly attached to the ILM at: a. the vitreous base b. Around the optic disc (Weiss ring) c. the vessels d. In the area surrounding the foveola at diameter of 500 µm e. none of the above f. all of the above except e
f. all of the above except e a. the vitreous base b. Around the optic disc (Weiss ring) c. the vessels d. In the area surrounding the foveola Clinically important information; you must know!
28
T/F The aging process of the vitreoretinal interface has been studied with HVF in 209 healthy subjects.
False, OCT not HVF
29
In the OCT studies, preretinal strands, presumably posterior cortex, were found in _50% / 60% / 70% _of these nonsymptomatic cases _with/without_ biomicroscopic evidence of posterior vitreous detachment (PVD).
60%, without
30
Blood vs Vitreous Blood Conc. Vitreous Conc Ascorbate 1.3 mg/100ml 7.6 mg/100ml Bicarbonate 27 mmol/liter 25 mmol/liter GAGs none 25 mg/100ml Protein 7.3 mg/100ml 55 mg/100ml Sodium 150 mmol/liter 137 mmol/liter Potassium 105 mmol/liter 3.8 mmol/liter Glucose 98 mg/100ml 50mg/100 ml
Vitreous lecture Slide 16 Blood Vs Vitreous Comparison
31
T/F The gel structure in the vitreous acts as a barrier against movement of solutes.
True
32
In the vitreous, substances may move by two different processes: a. diffusion or bulk flow. b. diffusion or osmosis
a. diffusion or bulk flow.
33
For diffusion in the vitreous, Fluorescein _can/cannot_ be used as a tracer substance.
can
34
Bulk flow in the vitreous _is/is not_ a result of a pressure gradient from the anterior to posterior pole of the eye.
IS | Large, high molecular weight substances move due to this gradient
35
Large, high molecular weight substances move due to _____ in the vitreous. a. diffusion b. osmosis c. bulk flow
c. bulk flow
36
Bulk flow _does/does not_ play any significant role for distribution of low molecular weight substances in the vitreous.
does NOT
37
T/F The vitreous body does not go through considerable physiological changes during life.
False. DOES go through changes that have great significance for its function.
38
The main aging change in the vitreous is a _disintegration/formation_ of the gel structure, the so-called liquefaction or synchysis, especially notable in the _periphery/center_ of the vitreous, where the collagen concentration is _lowest/highest_.
distengration, center, lowest
39
T/F The structure of the gel is dissolved and replaced with aqueous lacunae, which melt together over time.
True
40
Vitreous collagen molecular weight _increases/decreases_ with age secondary to new covalent cross-links.
increases
41
T/F The aging vitreous collagen process is not equivalent to the aging process in collagen elsewhere in the body.
False, IS equivalent
42
Proteins are cross-linked because of the Maillard reaction, with the formation of a _ionic/covalent_ bond between an amino group and a glucose leading to _insoluble/soluble_ proteins.
covalent, insoluble
43
The vitreous glucose concentration is _the same/doubled/tripled_ in persons with diabetes compared with that of healthy subjects.
doubled
44
The normal physiology of the vitreous body can be divided into _three/four/five_ main groups.
four 1. Support function for the retina and filling-up function of the vitreous body cavity 2. Diffusion barrier between the anterior and the posterior segment of the eye 3. Metabolic buffer function 4. Establishment of an unhindered path of light
45
T/F The intact vitreous body protects the retina
True
46
An intact vitreous body, which fills up the _half/entire_ vitreous cavity, may _retard or prevent/induce or cause_ the development of a larger retinal detachment.
entire, retard or prevent
47
The vitreous body can absorb external forces and _reduce/increase_ mechanical deformation of the eye globe.
reduce
48
T/F The intact vitreous body does not support the lens during trauma to the eye.
False, DOES support the eye
49
The eyes in which the vitreous has been removed during vitrectomy _can/cannot_ have a normal function, and the retina _is not/is_ detached.
can, is not
50
Posterior Vitreous Detachment (PVD) is when the _central/peripheral_ degeneration is _small/large_ and causes a collapse where the cortex sinks to the _center/periphery_ of the vitreous body.
central, large, center
51
PVD is the _least/most_ common pathophysiologic condition of the _vitreous body/lens body_ and is considered a _abnormal/normal_ physiologic aging phenomenon.
most, vitreous body, normal
52
Retinal tear can result if there is a _weak/strong_ attachment between _anterior/posterior_ cortex and the ILM.
strong, posterior
53
Retinal tear caused by a PVD is the _1st/2nd/3rd_ step in a rhegamatogenous retinal detachment.
1st
54
T/F PVD can induce traction on the retina, especially in the foveal region.
True
55
Under normal conditions, the blood-retinal barrier is _tight/loose_ (low passive permeability).
tight
56
An _increase/decrease_ in the passive permeability or a _increase/decrease_ in the outward active transport may lead to edema formation.
increase, decrease
57
T/F In several studies, eyes with otherwise untreatable edema have been shown to have partial PVD and vitrectomy seems to improve visual acuity in these eyes.
True | However, vitrectomy has also been helpful in cases without evidence of vitreomacular traction.
58
Substances liberated from the anterior segment have difficulties reaching _low/high_ concentrations in the _anterior/posterior_ part of the eye
high, posterior
59
T/F The vitreous gel does not prevent topically administered substances from reaching the retina and optic nerve.
False, DOES prevent
60
If the vitreous body is partly removed, exchange between the anterior and posterior part of the eye is much _faster and easier/ slower and more difficult. _.
faster and slower | This is the case when the lens is removed and anterior vitrectomy has been performed
61
The preretinal oxygen tension is _improved/worsened_ in diabetic patients after vitrectomy, indicating oxygen transport _increases/decreases_ with faster fluid currents.
improved, increases This is of clinical relevance because retinal neovascularization and macular edema regress
62
The vitreous can act as a metabolic buffer and a reservoir for metabolism of the ________ and ________. a. ciliary body and cornea b. cornea and retiina c. ciliary body and the retina.
c. ciliary body and the retina.
63
T/F Glucose and glycogen in the vitreous body can supplement the metabolism of the retina, especially during anoxic conditions.
True
64
Vitamin C is also present in the vitreous body in relative _low/high_ concentrations, where it can act as a reservoir of antioxidants in _non-stress/stress_ situations, protecting the retina from metabolic- and light-induced free radicals.
high, stress
65
T/F Because normal function of the retina can be obtained after total vitrectomy, the metabolic buffer functions of the vitreous do seem to play an important role.
False, vitreous DOES NOT play an important role
66
Substances present in or produced in the retina are thus diluted by diffusing into the _____ body. a. ciliary b. corneal c. vitreous d. retinal
c. vitreous
67
The pre-retinal concentration of retinally produced vasoproliferation _depends/independent_ on the condition of the vitreous body.
depends
68
T/F If the vitreous acts as a diffusion barrier to substances, they are retained in high concentrations close to the retina.
True
69
One could assume a vitrectomy _can/cannot_ cure conditions such as diabetic retinopathy.
can
70
A vitrectomy can also _cause/prevent_ the vasoproliferative factors to move from the posterior to the anterior pole leading to neovascularization in the _anterior/posterior_ segment. (neovascular glaucoma)
cause, posterior
71
An important function for the vitreous body is to maintain optimal _opaqueness/transparency_, which is primarily produced by the _low/high_ concentration of structural macromolecules.
transparency, low
72
T/F Degeneration of the vitreous with generation of opacities interferes with the path of light.
True
73
What is/are other names for vitreous opacities? a. floaters b. muches volantes c. none of the above d. a and b
d. a and b a. floaters b. muches volantes
74
``` What is/are pathological conditions that interfere with vitreous transparency? a. Synchysis scintillations b. Asteroid degeneration c, Hemorrhages d. Inflammatory material e. Fibrous tissue f. Lack of regression of the hyaloid artery g. all of the above, except h h. none of the above ```
g. all of the above, except h a. Synchysis scintillations b. Asteroid degeneration c, Hemorrhages d. Inflammatory material e. Fibrous tissue f. Lack of regression of the hyaloid artery
75
T/F Although the vitreous body can be removed and almost normal function of the eye will still be maintained, the vitreous body plays an important role in the physiology and pathophysiology of the eye.
True | KNOW this, he repeated this statement in several slides!!!