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Eye Disease > Vitreous > Flashcards

Vitreous Flashcards

1
Q

how much % of the eye does the vitreous occupy

A

80%

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2
Q

where is the vitreous most strongest

A

at the vitreous base, which is a circumferential band from posterior plans plan to a few mm behind the ora serrata

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3
Q

where is the vitreous loosely attached

A

most loosely attached to the retina

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4
Q

which three things is the vitreous most strongly attached to

A

most strongly attached at the:

  • optic disc/ONH around annulus of zinn
  • macula
  • along retinal blood vessels
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5
Q

what are three symptoms associated with the vitreous

A
  • floaters
  • vision
  • flashes
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6
Q

what is floaters and what symptoms can they cause

A

compressed cells or strands of the vitreous clumped together, so they are less transparent than the rest. some are harmless remnants of the hyaloid artery.

symtoms is may be a bit annoying and rarely interfere with activities

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7
Q

what are the treatments for floaters

A

on the whole there is no treatment, or you can do:

  • victrectomy - take the vitreous out, but is rare as can tear retina as well
  • laser vitreolysis - is risky and rarely justified, this dissolves vitreous floaters
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8
Q

what is floaters and what symptoms can they cause

A

compressed cells or strands of the vitreous clumped together, so they are less transparent than the rest. some are harmless remnants of the hyaloid artery.

symtoms is may be a bit annoying and rarely interfere with activities, only reduces vision is floaters are very numerous i.e. significant amount

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9
Q

what causes flashes

A

photopsia from traction of the vitreous on the retina & not from the vitreous itself
retina has no pain receptors so it flashes light instead

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10
Q

what are the three types of cells that can be found in the vitreous

A
  • leucocytes (white BC)
  • erythrocytes (red BC)
  • pigment cells in anterior vitreous
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11
Q

what are leucocytes in the vitreous indicative of

A

inflammation

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12
Q

what are the four types of cells that can be found in the vitreous

A
  • leucocytes (white BC)
  • erythrocytes (red BC)
  • pigment cells in anterior vitreous
  • tumour cells
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13
Q

what are leucocytes in the vitreous indicative of

A

inflammation

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14
Q

where can tumours in the vitreous come from

A

an intra ocular tumour such as melanoma or retinal blastoma

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15
Q

what are white cells in the vitreous

A

either inflammatory or denatured (old) red blood cells

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16
Q

what are white cells in the vitreous a sign of

A
  • intermediate uveitis (pars planitis) or posterior uveitis
  • inflammatory disease of the posterior segment
  • anterior uveitis which can lead to a ‘spill over’ of cells into the anterior vitreous
17
Q

what can stay in the vitreous for a very long time

A

inflammatory cells so doesn’t mean its active inflammation if you see white cells, it may just mean they had inflammation in the past

18
Q

what is the vitreous very useful for

A

a convenient place for posterior segment drug delivery via the pars plana, the vitreous represents an inert depot location that holds the drug for medium term drug release

19
Q

which three drugs and what are they for, can be injected into the vitreous as an inert depot that holds it

A
  • anti-VEGF: for AMD to treat new blood vessels
  • triamcinolone: steroids, which treats macula oedema or uveitis that doesn’t respond to other drug treatments
  • methotrexate: autoimmune drug to treat macula oedema
20
Q

what do red cells in the vitreous represent

A

vitreous haemorrhage (bleeding somewhere)

21
Q

name 4 potential causes of red cells in the vitreous

A
  • PVD with traction along a retinal blood vessel
  • Retinal tear involving a retinal blood vessel
  • proliferative retinopathy from diabetes or other neovascularising cause of ocular ischaemia (e.g. central retinal vein occlusion), causing new blood vessels
  • breakthrough bleeding from a choroidal neovascular membrane or retinal macro aneurysm
22
Q

what symptoms can a vitreous haemorrhage cause

A

obstruct vision

23
Q

what can vitreous haemorrhage cause

A

can lead to fibrosis within the vitreous and can also cause a vitreous detachment

24
Q

what is the appearance of pigment in the vitreous

A

pigment cells are, larger, darker and more irregularly shaped than red blood cells

25
Q

what are pigment cells in the vitreous also called

A

shafer’s sign

26
Q

what actually are the pigment cells in the vitreous

A

macrophages containing pigment RPE cells that have gained access to the vitreous via a tear in the neuro sensory retina

27
Q

what are pigment cells in the vitreous an indicator of

A

likely retinal tear

Eye Disease (10 decks)

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