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Vitreous Flashcards

1
Q

Where do all PVDs stop?

A

At the posterior portion of the vitreous base

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2
Q

When does the base pull off during a PVD?

A

Only during trauma to the eye

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3
Q

When we lose hyaluronic acid, the collagen fibrils collapse on each other. What is this called?

A

Liquefaction

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4
Q

What is the true definition of a PVD?

A

When syneresis (liquefaction) and synchesis (collapse/separation) happen at the same time

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5
Q

Where are some of the other strong adhesions of the vitreous besides the vitreous base?

A

The foveal margin and over the blood vessels (paravascular)

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6
Q

When someone gets a vitrectomy, what percentage of patients will get a cataract or develop glaucoma?

A

100% of patients will get cataracts

20-25% will develop POAG (especially myopes)

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7
Q

What will fill up the optically empty space after syneresis and synchesis take place?

A

Aqueous

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8
Q

What is the medical term when cholesterol leaks into the vitreous during a PVD?

A

Synchesis Scintillans = vitreous opacities

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9
Q

When the PVD has separated from the ON, what will we see floating in the vitreous?

A

Weis’ Ring or Ring of Gartner

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10
Q

What’s one of the reasons patient’s have persistent CSME?

A

i. Anomalous PVD over the retina

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11
Q

What are the 5 substance that make up the glue?

A
  1. fibronectin
  2. laminin
  3. opitcin
  4. chondroitin sulfate
  5. heparan sulfate
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12
Q

What are the 2 complications of a vitrectomy?

A

Nuclear Sclerotic Cataracts and Glaucoma

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13
Q

What is the thickness of the posterior hyaloid?

A

100-200um

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14
Q

What is the full thickness of the vitreous base?

A

4mm

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15
Q

Is a PVD part of the natural process of aging?

A

Yes

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16
Q

What’s the definition of an anomalous PVD?

A

When syneresis or synchesis do not occur at the same time

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17
Q

Anomalous PVD + lattice lesion = ?

A

Horseshoe Tear

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18
Q

What are the two things you are looking for in the periphery?

A

Lattice and Vitreal Tufts

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19
Q

What percentage of patients have lattice?

A

10% of patients

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20
Q

Who get macular holes more? Men or women?

A

Women

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21
Q

Where are the only 2 avascular zone in the retina?

A

About 1mm away from ora serrata and the fovea avscular zone

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22
Q

What is always found associated with lattice?

A

Synchesis (liquefied vitreous) is always found associated with lattice

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23
Q

Why doesn’t blood come in from a retinal hole?

A

Bruch’s membrane overlies the choriocapillaris

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24
Q

What are 3 things to worry about with lattice?

A
  1. Location
  2. PVD
  3. Age
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25
What causes a RD more – a horseshoe tear or dialysis?
Horseshoe Tear
26
The vitreous makes up what percentage of the globe?
80%
27
What is the volume of the vitreous?
4mL
28
What percentage of the vitreous is water?
98%
29
What are the 2 main proteins found in the vitreous?
Albumin (40%) | Iron-binding protein (30%)
30
What 6 GAGs give the vitreous a thicker viscosity?
1. Hyaluronic Acid 2. Chondroitin Sulfate 3. Heparan Sulfate 4. Fibrillins 5. Opticin 6. Vit 1
31
What 3 cells are found in the vitreous?
Hyalocytes, fibrocytes, macrophages
32
What 4 collagen types are found in the vitreous?
2, 5, 9, 11
33
What are the 5 functions of vitreous?
1. Storage 2. Movement of metabolites w/in eye 3. Shock absorber 4. Transmits & refracts light/ absorbs UV 5. Source of ascorbic acid
34
How thick is the posterior hyaloid?
100-200um thick
35
What is found between collagen strands in the vitreous? What makes these molecules?
Hyaluronic Acid is found between strands | - made by hyalocytes
36
Where is the strongest adhesion of the vitreous?
Vitreous base
37
The extrabasilar base is found where?
In the midperiphery
38
The juxtabasilar base is found where?
Closer to ora serrata
39
What secretes ascorbic acid? How much more potent is it in the eye than in blood?
Ciliary body | - 40x more potent in eye
40
What is the function of ascorbate/Vitamin C?
Neutralizes oxygen released by retina that causes free radicals, cataracts and glaucoma
41
What type of cataract is formed if oxygen reaches the lens?
Nuclear Sclerotic
42
Patients with > _____ D of myopia, the vitreous liquifies faster, causing early cataracts
> -5.00 D
43
Oxygen can also damage the trabecular meshwork and cause what type of glauocma?
POAG
44
Vitrous liquefaction is called what?
synchesis
45
Vitreo-retinal dehiscence w/ collapse is called?
Syneresis
46
Per Dr. Foo, what percentage of people will have PVD if they're < 50 yo
10%
47
Per Dr. Foo, what percentage of people will have PVD if they're 60-69yo
27%
48
Per Dr. Foo, what percentage of people will have PVD if they're > 70 yo
63%
49
If a partial thickness (vitreoschisis) occurs, what ocular findings may we have?
1. Macular Hole (outward contraction) | 2. Macular Pucker (epiretinal membrane) (inward contraction)
50
If a full thickness w/ partial PVD occurs, what ocular findings may we see?
1. VMT (Vitreomacular traction) 2. Exudative ARMD 3. Vitreo-Papillopathies
51
What is the 1st stage of a PVD?
Pseudo-Macular hole w/ cystic edema
52
What is the 2nd stage of a PVD?
True macular hole w/ attachment to one edge only
53
What is the 3rd stage of a PVD?
True macular hole (larger than 400um) attached to one edge only
54
What is the 4th stage of a PVD?
True macular hole (larger than 400ym) with both edges detached
55
What is this? Vitreous is adherent to retina/macula in an abnormally strong manner
Vitreo-Macular Adhesion/Traction (1DD or more of attachment)
56
PVDs are protective against what disease?
ARMD
57
VMT promotes what disease?
Exudative (Dry) AMD
58
Anomalous PVDs promote what disease?
Wet AMD
59
What is the most common cause of blindness after cataract surgery?
Retinal Detachments
60
Lattice is found in what percent of the population?
8-10%
61
Atrophic holes are found in what percent of lattice lesions?
25%
62
Wht's the risk of RD in a person w/ LD?
1%
63
What percentage of cases of LD will have retinal thinning?
100%
64
What percent of LD will have pigment?
80-90% of cases
65
What is the prevalence of cystic retinal tufts? What's the risk of RD?
5% | less than 1%
66
What is an Anterior Retinal Dialysis? This makes up what percentage of retinal breaks?
retinal tear which occurs at ora serrata 53%
67
What is a giant retinal tear? This makes up what percentage of retinal breaks?
retinal dialysis more than 3 clock hours 16%
68
Cystoid peripheral degeneration is found in what percentage of people over 8 years old? What happens if they coalesce?
100% | form acquired retinoschisis (split in the middle retinal layers)
69
WIT: Disuption of radial pillars and complete separation of inner and outer retinal layers
Acquired Retinoschisis
70
What type of visual field is found in an retinoschisis?
absolute - no light can get to the photoreceptors
71
What are the 4 complications of a retinoschisis?
1. RD 2. Progression toward PP 3. Hemorrhage 4. Absolute VF defect
72
The majority (76%) of atrophic holes are secondary to what?
Lattice Degeneration
73
How does someone seal a retinal detachment?
Gas Bubble Silicone OIl Penumatic Retinopexy Scleral Buckle
74
What percentage of patients with RD in one eye will get one in the other eye?
5%
75
What's the leading cause of RDs?
Retinal Breaks
76
Jetrea does well to reduce VMT because it does what 2 things to the vitreous?
Liquifies and cleaves the vitreo/retinal attachment
77
Jetrea only worked on 37.4% of patients who do not have what?
Epiretinal Membrane
78
Is there an increase in cataract formation using jetrea?
no
79
This is space is found between the lens and the vitreous; a potential space of non-adhesion between the vitreous and the lens
Erggelet's Space or Berger's Space
80
This is a slightly enlarged space anterior to the optic disc
Area of martegiani
81
This is a small, transparent canal running through the vitreous body to the optic disc from the lens
Cloquet's Canal
82
The attachment of the lens to the anterior hyaloid is done by what ?
Anterior ligament of Weiger
83
The gelatinous nature of the vitreous body is the result of _______ .
Long, collagen fibrils
84
The presence of what 2 things determine the viscoelastic properties of the vitreous?
HA and Collagen
85
What stabilizes the water molecules in the vitreous?
HA

Posterior Segment (8 decks)

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