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Posterior Segment > Vitreous > Flashcards

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
Q

What causes a RD more – a horseshoe tear or dialysis?

A

Horseshoe Tear

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26
Q

The vitreous makes up what percentage of the globe?

A

80%

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27
Q

What is the volume of the vitreous?

A

4mL

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28
Q

What percentage of the vitreous is water?

A

98%

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29
Q

What are the 2 main proteins found in the vitreous?

A

Albumin (40%)

Iron-binding protein (30%)

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30
Q

What 6 GAGs give the vitreous a thicker viscosity?

A
  1. Hyaluronic Acid
  2. Chondroitin Sulfate
  3. Heparan Sulfate
  4. Fibrillins
  5. Opticin
  6. Vit 1
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31
Q

What 3 cells are found in the vitreous?

A

Hyalocytes, fibrocytes, macrophages

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32
Q

What 4 collagen types are found in the vitreous?

A

2, 5, 9, 11

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33
Q

What are the 5 functions of vitreous?

A
  1. Storage
  2. Movement of metabolites w/in eye
  3. Shock absorber
  4. Transmits & refracts light/ absorbs UV
  5. Source of ascorbic acid
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34
Q

How thick is the posterior hyaloid?

A

100-200um thick

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35
Q

What is found between collagen strands in the vitreous? What makes these molecules?

A

Hyaluronic Acid is found between strands

- made by hyalocytes

36
Q

Where is the strongest adhesion of the vitreous?

A

Vitreous base

37
Q

The extrabasilar base is found where?

A

In the midperiphery

38
Q

The juxtabasilar base is found where?

A

Closer to ora serrata

39
Q

What secretes ascorbic acid? How much more potent is it in the eye than in blood?

A

Ciliary body

- 40x more potent in eye

40
Q

What is the function of ascorbate/Vitamin C?

A

Neutralizes oxygen released by retina that causes free radicals, cataracts and glaucoma

41
Q

What type of cataract is formed if oxygen reaches the lens?

A

Nuclear Sclerotic

42
Q

Patients with > _____ D of myopia, the vitreous liquifies faster, causing early cataracts

A

> -5.00 D

43
Q

Oxygen can also damage the trabecular meshwork and cause what type of glauocma?

A

POAG

44
Q

Vitrous liquefaction is called what?

A

synchesis

45
Q

Vitreo-retinal dehiscence w/ collapse is called?

A

Syneresis

46
Q

Per Dr. Foo, what percentage of people will have PVD if they’re < 50 yo

A

10%

47
Q

Per Dr. Foo, what percentage of people will have PVD if they’re 60-69yo

A

27%

48
Q

Per Dr. Foo, what percentage of people will have PVD if they’re > 70 yo

A

63%

49
Q

If a partial thickness (vitreoschisis) occurs, what ocular findings may we have?

A
  1. Macular Hole (outward contraction)

2. Macular Pucker (epiretinal membrane) (inward contraction)

50
Q

If a full thickness w/ partial PVD occurs, what ocular findings may we see?

A
  1. VMT (Vitreomacular traction)
  2. Exudative ARMD
  3. Vitreo-Papillopathies
51
Q

What is the 1st stage of a PVD?

A

Pseudo-Macular hole w/ cystic edema

52
Q

What is the 2nd stage of a PVD?

A

True macular hole w/ attachment to one edge only

53
Q

What is the 3rd stage of a PVD?

A

True macular hole (larger than 400um) attached to one edge only

54
Q

What is the 4th stage of a PVD?

A

True macular hole (larger than 400ym) with both edges detached

55
Q

What is this? Vitreous is adherent to retina/macula in an abnormally strong manner

A

Vitreo-Macular Adhesion/Traction (1DD or more of attachment)

56
Q

PVDs are protective against what disease?

A

ARMD

57
Q

VMT promotes what disease?

A

Exudative (Dry) AMD

58
Q

Anomalous PVDs promote what disease?

A

Wet AMD

59
Q

What is the most common cause of blindness after cataract surgery?

A

Retinal Detachments

60
Q

Lattice is found in what percent of the population?

A

8-10%

61
Q

Atrophic holes are found in what percent of lattice lesions?

A

25%

62
Q

Wht’s the risk of RD in a person w/ LD?

A

1%

63
Q

What percentage of cases of LD will have retinal thinning?

A

100%

64
Q

What percent of LD will have pigment?

A

80-90% of cases

65
Q

What is the prevalence of cystic retinal tufts? What’s the risk of RD?

A

5%

less than 1%

66
Q

What is an Anterior Retinal Dialysis? This makes up what percentage of retinal breaks?

A

retinal tear which occurs at ora serrata

53%

67
Q

What is a giant retinal tear? This makes up what percentage of retinal breaks?

A

retinal dialysis more than 3 clock hours

16%

68
Q

Cystoid peripheral degeneration is found in what percentage of people over 8 years old? What happens if they coalesce?

A

100%

form acquired retinoschisis (split in the middle retinal layers)

69
Q

WIT: Disuption of radial pillars and complete separation of inner and outer retinal layers

A

Acquired Retinoschisis

70
Q

What type of visual field is found in an retinoschisis?

A

absolute - no light can get to the photoreceptors

71
Q

What are the 4 complications of a retinoschisis?

A
  1. RD
  2. Progression toward PP
  3. Hemorrhage
  4. Absolute VF defect
72
Q

The majority (76%) of atrophic holes are secondary to what?

A

Lattice Degeneration

73
Q

How does someone seal a retinal detachment?

A

Gas Bubble
Silicone OIl
Penumatic Retinopexy
Scleral Buckle

74
Q

What percentage of patients with RD in one eye will get one in the other eye?

A

5%

75
Q

What’s the leading cause of RDs?

A

Retinal Breaks

76
Q

Jetrea does well to reduce VMT because it does what 2 things to the vitreous?

A

Liquifies and cleaves the vitreo/retinal attachment

77
Q

Jetrea only worked on 37.4% of patients who do not have what?

A

Epiretinal Membrane

78
Q

Is there an increase in cataract formation using jetrea?

A

no

79
Q

This is space is found between the lens and the vitreous; a potential space of non-adhesion between the vitreous and the lens

A

Erggelet’s Space or Berger’s Space

80
Q

This is a slightly enlarged space anterior to the optic disc

A

Area of martegiani

81
Q

This is a small, transparent canal running through the vitreous body to the optic disc from the lens

A

Cloquet’s Canal

82
Q

The attachment of the lens to the anterior hyaloid is done by what ?

A

Anterior ligament of Weiger

83
Q

The gelatinous nature of the vitreous body is the result of _______ .

A

Long, collagen fibrils

84
Q

The presence of what 2 things determine the viscoelastic properties of the vitreous?

A

HA and Collagen

85
Q

What stabilizes the water molecules in the vitreous?

A

HA

Posterior Segment (8 decks)

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