3. Acquired Maculopathies

Question 1

What is a maculopathy?

Answer 1

Disease of the macular

Question 2

Symptoms vs sign difference?

Answer 2

Symptom= px reports
Sign= Seen by the optom

Question 3

What is Central Serous Retinopathy (CSR)?

Answer 3

Central defect in the retina, retinal detachment with fluid under the retina.

Question 4

Cause of Central Serous Retinopathy (CSR)?

Answer 4

Unknown

Question 5

Central Serous Retinopathy (CSR) is unilateral or bilateral?

Answer 5

Unilateral

Question 6

Why does Central Serous Retinopathy (CSR) have a hyperopic shift?

Answer 6

Elevated cystic area, that shortens the axial length

Question 7

Symptoms of Central Serous Retinopathy (CSR)?

Answer 7

Blurred vision, distortion, micropsia, positive scotoma- blob.

Question 8

Central Serous Retinopathy (CSR) OCT and fluorescein angiography results?

Answer 8

OCT: Subretinal fluid, elevated areas, Fluorescein angiography: Leakage of blood vessels (focal leakage), in early stages hyperfluorescent spot, late pooling with dye in subretinal spaces.

Question 9

What is idiopathic macular hole?

Answer 9

Hole in the macular, the RPE has lipofuscin dye. Usually unilateral, then becomes bilateral.

Question 10

Cause of idiopathic macular hole?

Answer 10

Unknown. Can arise due to ageing or trauma, myopia, chronic CMO.

Question 11

Symptoms of idiopathic macular hole?

Answer 11

Variable vision loss, metamorphopsia, jumbling of letters when reading.

Question 12

OCT of idiopathic macular hole?

Answer 12

Splitting of photoreceptors

Question 13

Pathogenies of of idiopathic macular hole?

Answer 13

1. Early localized perifoveal vitreous detachment.
2. Static and dynamic traction
3. Open up a hole.

Question 14

Treatment of idiopathic macular hole?

Answer 14

First stage is to wait, when VA is <6/18 and its been 1 year- vitrectomy

Question 15

What is epiretinal membrane?

Answer 15

Scar infront of the macular (idiopathic paramacular fibrosis), caused due to posterior vitreous detachment.

Question 16

Symptoms of epiretinal membrane?

Answer 16

1. Reduced VA
2. Distortion
3. Binocular diplopia
4. Macropsia

Question 17

Signs of epiretinal membrane?

Answer 17

1. Glistening
2. Crinkled sheen
3. Contracture

Question 18

Treatment of epiretinal membrane?

Answer 18

None if asymptomatic, or else pars plana vitrectomy

Question 19

Pathogenesis of epiretinal membrane?

Answer 19

Idiopathic, after posterior vitreous detachment. Can be associated with: retinal vascular disease, venous occlusion, diabetic retinopathy, uveitis, trauma, retinal detachment.

Question 20

What is cystoid macular oedema?

Answer 20

Cystic spaces filled with fluid or oedema at the macular.

Question 21

Cause of cystoid macular oedema?

Answer 21

1. Retinal vein occlusion
2. Diabetic retinopathy
3. Post cataract surgery
4. Chronic uveitis
5. Retinitis pigmentosa

Question 22

Pathogenesis of cystoid macular oedema?

Answer 22

Accumulation of fluid on outer plexiform later, disrupting blood-retinal barrier. Vitreous traction may be involved.

Question 23

Cystoid macular oedema on FFA & OCT?

Answer 23

FFA: Petaloid appearance
OCT: Lacuna, fluid filled microcysts, bubbles on OCT.

Question 24

Signs and symptoms of cystoid macular oedema?

Answer 24

Blur or distortion, hyperopic shift, on fundus CL: Honeycomb pattern of retinal thickness, loss of normal foveal reflex.

Question 25

Treatment of cystoid macular oedema?

Answer 25

Prevention, tropical NSAIDS and steroids to treat underlying uveitis.

Question 26

Signs & symptoms of myopic