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Ophthalmology > Retina > Flashcards

Retina Flashcards

1
Q

What can you see on a fundic examination?

A
  • Direct visualization of retinal blood vessels (often in pairs)
  • Optic nerve (CNS)
  • Vitreous (transparent gel-like body between the lens and retina)
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2
Q

Vitreal floaters appearance

A
  • Can’t see the fundus
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3
Q

Clinical relevance of vitreal degeneration or asteroid hyalosis

A
  • Interfere with vision and viewing the fundus

- Otherwise it’s a pretty normal age related change

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4
Q

Another name for vitreal degeneration

A
  • Ateroid hyalosis
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5
Q

Characteristics of dog fundic vessels

A
  • Holangiotic fundus
  • Retinal vessels arcuate over the optic nerve
  • Optic nerve is myelinated and varies in shape
  • Color related to coat color
  • May or may not have tapetum
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6
Q

Is tapetum usually in the superior or inferior fundus?

A
  • Superior
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7
Q

Characteristics of cat fundus?

A
  • Holangiotic fundus
  • Large yellow-green tapetal area
  • Optic nerve in the tapetal area
  • Vessels arise from edge of optic nerve
  • Non-myelinated optic nerve (appears small, round, and dark)
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8
Q

Equine fundus appearance

A
  • Paurangiotic
  • Retinal capillaries extend a few millimeters from the edge of optic nerve
  • Optic nerve is elliptical and in pigmented area
  • Variable colors of tapetum and pigmented areas by coat color
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9
Q

Rabbit fundus appearance

A
  • horizontal optic nerve

- merangiotic (vesels in a certain region)

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10
Q

Bird eyes

A
  • Pectin

- PIgmented vascular supply overlying the optic nerve

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11
Q

Bovine fundus

A
  • Vessels in front of the retina
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12
Q

Do camelids or pigs have a tapetum?

A
  • No
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13
Q

What is the tapetum?

A
  • Reflective layer in choroid
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14
Q

Where is tapetum relative to the retina?

A
  • Deep
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15
Q

Function of tapetum

A
  • Reflects light back to the photoreceptor cells
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16
Q

Pigment in retinal pigmented epithelium over tapetal area

A
  • Does not exist

- Allowing light through

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17
Q

Tapetal area and size of dog

A
  • Smaller dogs have a smaller tapetal area

- Length of coat related to line of demarcation

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18
Q

Where does retinal detachment occur?

A
  • Between the photoreceptors and retinal pigmented epithelium
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19
Q

How many layers of the retina?

A
  • 10 layers

- see diagram in the notes

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20
Q

Which layer of the retina is impacted by glaucoma?

A
  • Nerve fiber layerayer of the retina?
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21
Q

Where is the nerve fiber layer of the retina in relation to the rest of it?

A
  • Innermost layer
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22
Q

What comprises the nerve fiber layer of the retina?

A
  • Ganglion cell axons

- These axons then extend to the optic disc and form the optic nerve

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23
Q

Blood supply to nerve fiber layer of the retina

A
  • Has retinal vessels
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24
Q

How does glaucoma impact the nerve fiber layer of the retina?

A
  • It causes pressure damage
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25
Q

Photoreceptor layer

A
  • Contains the rods and cones
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26
Q

Rods - what for?

A
  • Night vision
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27
Q

Cones - what for?

A
  • Day vision, color, and acuity
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28
Q

Which cell type (rods or cones) is predominant in 1.) domestic animals and 2.) birds/reptiles?

A
  1. ) Domestic animals: rods

2. ) Birds/reptiles: cones

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29
Q

Which diseases will impact the photoreceptor layer

A
  • Anything causing retinal detachment
  • PRA
  • SARDS
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30
Q

Causes of retinal disorders

A
  • Hereditary or acquired as result of toxin, virus, nutrition, trauma, septicemia, others
  • Congenital disorders present at birth
  • Degenerative disorders
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31
Q

Which antiparasitic is most commonly implicated for retinal disorders in herding breeds?

A
  • Ivermectin
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32
Q

What are some of the more common causes of retinal disease in dogs?

A
  • Infectious diseases

- Not as much trauma

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33
Q

Collie eye anomaly 4 parts

A
  • Choroidal hypoplasia
  • Optic nerve coloboma
  • Retinal detachment
  • Hemorrhage
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34
Q

Coloboma

A
  • Hole

- E.g. optic nerve coloboma is a hole in the optic nerve

35
Q

Inheritance of collie eye anomaly

A
  • Hereditary
36
Q

Clinical significance of collie eye anomaly

A
  • Might not affect vision, but could
  • Hereditary
  • VIRTUALLY ALL COLLIES HAVE THIS
37
Q

When does retinal dysplasia or dystrophy occur?

A
  • At birth

- Occurs during retinal development

38
Q

Who gets retinal dysplasia or dystrophy?

A
  • Springer spaniel

- Likely not clinically significant but does affect if you should breed or not

39
Q

Appearance of retinal dysplasia or dystrophy

A
  • Geographic retinal dysplasia (weird line on the retina)

- Retinal folds (little spots

40
Q

Two categories of diseases causing retinal degeneration

A
  • Hereditary

- Acquired

41
Q

What clinical sign can help you distinguish hereditary vs acquired causes of retinal degeneration?

A
  • Bilateral = hereditary
  • Asymmetrical/unilateral = acquired (more often)

IN GENERAL

42
Q

Major cause of hereditary retinal degeneration

A
  • PRA or progressive retinal atrophy
43
Q

Who gets hereditary retinal degeneration?

A
  • Many breeds and types

- Age of onset varies by breed

44
Q

Acquired causes of retinal degeneration

A
  • Toxins
  • Trauma
  • Nutritional
  • Glaucoma
  • SARDS (immune mediated)
45
Q

What does SARDS stand for?

A
  • Sudden acquired retinal degeneration syndrome
46
Q

Who gets SARDS?

A
  • Dachshunds and Brittany Spaniels
47
Q

Progressive retinal atrophy - does the retina develop normally?

A
  • Yes, and begins to degenerate after developing normally
48
Q

Clinical signs of PRA

A
  • Lose rods first (night vision)
  • Dilated pupils as it progresses
  • Bright and shiny fundus
  • Blindness as retina thins
  • Cataracts develop later in the disease
49
Q

Course of disease for PRA?

A
  • Progressive

- Once retina degenerates they develop cataracts –> LIU –> glaucoma or luxation –> enucleation

50
Q

Treatment for PRA

A
  • Not super treatable

- Can supplement with Ocuglow (fatty acids, omega 3s , and high levels of vitamin A)

51
Q

Appearance of fundus in a dog with PRA

A
  • Vascular attenuation
  • Hyper-reflection
  • Usually very dilated pupils
52
Q

What is OFA?

A
  • Eye registration certification

- Companion Animal Eye Regsitry

53
Q

What is optigen?

A
  • Genetic testing for inherited eye diseases in dogs
54
Q

Appearance of retinal scarring?

A
  • Can be incidental
  • Looks like little spots on the retina
  • Often well delineated
  • Should make a note
  • In a horse this is more concerning
55
Q

Can you localize blindness by PLRs?

A
  • No
56
Q

SARDS clinical signs

A
  • Sudden onset blindness or progressive over a few weeks

- Pupils are dilated and slow to respond or non-responsive

57
Q

Signalment of SARDS

A
  • Middle-aged (female more common)
  • Dachshund, Schnauzer, Birtany Spaniel
  • History of weight gain, PU/PD/PP 50% of cases
  • Blood work may suggest adrenal disease
58
Q

Diagnosis of SARDS

A
  • High degree of suspicion based on exam (acutely blind with normal appearing eyes)
  • ERG
  • Fundic exam
59
Q

Fundic exam with SARDS: Early vs Late onset

A
  • Early onset it appears normal

- Late you’ll see hyperreflectivity

60
Q

ERG with SARDS

A
  • Flat line
61
Q

How can you differentiate optic neuritis from SARDS based on ERG?

A
  • ERG is normal with optic neuritis
62
Q

Treatment for SARDS

A
  • No effective treatment currently

- May give steroids and doxycycline in some cases

63
Q

Major dfdx for a dog with dilated pupils, slow to respond, and sudden onset blindness

A
  • Neoplasia
  • Optic neuritis
  • SARDS
64
Q

Optic neuritis clinical signs

A
  • Acute blindness
  • Dilated pupils
  • Slow to no response
65
Q

Appearance of optic nerve with optic neuritis

A
  • May appear hyperemic, fuzzy, raised, or it may appear normal if lesion is extraocular
66
Q

How can you distinguish optic neuritis from SARDS?

A
  • ERG
67
Q

Do you need an ERG if the fundus looks abnormal?

A
  • No
  • Something is wrong at the level of the fundus
  • Only need an ERG to differentiate SARDS from optic neuritis
68
Q

What causes retinal detachment?

A
  • Fluid or exudate from choroidal vessels accummulates between photoreceptors and RPE and elevates the retina, causing acute blindness
69
Q

Where is the retina attached?

A
  • To the optic nerve

- Also right behind the iris

70
Q

Causes of retinal detachment?

A
  • Hypertension
  • Trauma
  • Lens luxation
  • Systemic disease (chorioretinitis, neoplasia, infectious disease, immune-mediated disease, idiopathic)
71
Q

Appearance of retinal detachment on exam?

A
  • Ribbon of undulation
  • Retina looks like a tongue coming at you
  • Retina is floating up
72
Q

Treatment and prognosis of retinal detachment

A
  • If you treat the primary cause immediately, you may restore vision within a few weeks
73
Q

Detached retina example with light source only

A
  • look at the piecture because i found it confusing
74
Q

Diagnostics for retinal detachment

A
  • Normal PE & blood work
  • Negative titers (tick, fungal, toxo, lepto)
  • Brucella, Bartonella
  • Chest films
  • Respond to prednisone
  • Can take out the eye and do histopath if it’s gone already
75
Q

FIP granuloma appearance

A
  • Look at the nice pictures
76
Q

Retinal detachment appearance on ultrasound

A
  • You can see it
77
Q

Giant retinal tear and disinsertion - who gets?

A
  • Common presentation for young Shi Tzu dogs with acute blindness
78
Q

Treatment for a giant retinal tear

A
  • Surgical reattachment to restore vision
  • Hole develops so the retina detaches superiorly
  • You can no longer see the optic nerve because retina has come loose
  • Make sure you can differentiate from billowing detachment
79
Q

Most common causes of feline hypertensive retinopathy?

A
  • NOT SARDS!!!!

- Infectious diseases and tumors

80
Q

At what BP do cats get retinal detachment?

A

230 mmHg

  • MEASURE BP IN ACUTELY BLIND CATS
81
Q

Causes of feline hypertensive retinopathy

A
  • Hyperthyroid
  • Renal failure
  • Primary?
82
Q

Treatment of hypertensive retinal detachment

A
  • Amlodipine
  • Treat underlying disease based on lab work
  • CBC/Chem/UA
  • T4
  • Chest rads and ultrasound
83
Q

When do you want to recheck BP after starting a hypertensive cat on amlodipine?

A
  • The next day

Ophthalmology (8 decks)

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