Vitreous/Retina Flashcards
Central serous retinopathy
- most common?
- young male
- pregnancy
- oral steroids
- Cushing’s syndrome
- stress
- hypochondriasis
- SLE
- organ transplant
- hypertension
Macular Photocoagulation Study Group discovered FOUR risk factors that increase progression to wet AMD. What is it?!
- multiple soft drusen/confluent
- focal hyperpigmentation
- hypertension
- smoking
Histoplasmosis
- caused by Histoplasma capsulatum, fungus grows in soil and contaminated with bat or bird droppings
- common in Ohio, Mississipi River Valley region
Characterized by: choroiditis and TRIAD:
1. peripapillary atrophy 2. multifocal chorioretinal lesion in periphery 3. maculopathy (including neovasc).
NO VITRITIS!
Usually asymptomatic unless macula involved, and if so it is metamorphopsia.
Lacquer Cracks
- fine yellow linear irregular lines that represent large breaks in Bruch’s membrane
- may be early finding in pathological myopia
- 5% in high myopes
TIP: Angiod streaks usually come from ONH
Best’s Disease
- diagnosed early childhood (5-10)
- autosomal dominant inherited condition
- bilateral, yellow, round, subfoveal macular lesion (“egg yolk”)
- majority of patients are diagnosed with little or no symptoms (75% patients better than 20/40)
Stages of Best Disease?
Stage 1: pre-vitelliform: abnormal EOG, normal fundus.
Stage 2: vitelliform: egg-yolk lesion (occur between 3-15)
Stage 3: pseudohypopyon: entire lesion can become absorbed with little to no effect on vision.
Stage 4: vitelliruptive: egg-yolk breaks up and becomes a scrambled apparance; mild visual loss can be expected in this stage.
Stage 5: end-stage: characterized by moderate to severe vision loss as a result of choroidal neovasc, hemorrhage, atrophy and/or macular scarring
Adult foveomacular vitelliform dystrophy
- similar to Best’s disease
- onset is 30-50
- overall prognosis is better, present with minimal metamorphopsia, mild visual acuity loss, normal EOG/normal ERG
- slight tritan defect
Stargardt’s macular dystrophy
- most common hereditary macular dystrophy
- autosomal recessive
- onset typically first or second decade of life
Early stage:
- bilateral yellow flecks scattered in fish tail form
- RPE mottling of macula and loss of foveal reflex
- decreased vision often out of proportion with fundus appearance
Late stage:
- classic “beaten bronze” macular appearance/bull’s eye
- salt and pepper pigmentary changes in periphery
CRVO Management
- refer to OMD ti discuss anti-VEGF management
- refer to GP for possible underlying condition
Treatment:
- PRP neovasc
Hypoperfusion retinopathy
- occlusion of the internal carotid artery
- chronic iscehmia: dilation, tortuoisity and calibre irregularity
Refer for GP to do carotid doppler
Resolution time of cotton wool spots
5-7 weeks
Where are hard exudates located?
Outer plexiform.
Macrophages remove lipid within edema to periphery. Long process so it is not a sign of acute.
