Block 15 Lectures 18, 19, and 21 Flashcards Preview

Posterior Segment > Block 15 Lectures 18, 19, and 21 > Flashcards

Flashcards in Block 15 Lectures 18, 19, and 21 Deck (69):
1

A full thickness defect (tear/hole/split) in sensory retina with may occur with or without detachment of the retina is known as ____?

Retinal break

2

What is a normal age-related process where the vitreous gel liquefies over time?

Vitreal Synchysis

3

What is most likely the reason for vitreal synchysis occurring in all eyes eventually?

Toxic effects of light irradiation and metabolic waste products

4

A normal age-related process where the solid vitreous collapses/contracts forward and liquid fills the retrahyaloid space is known as ____?

Posterior Vitreous Detachment

5

What are 2 features of the vitreous in posterior vitreous detachment?

1. Synchysis
2. Syneresis (shrinkage/contraction)

6

What may occur at a strong vitreous-retina attachment point when the vitreous eventually detaches?

Retinal tear

7

What could cause a vitreous hemorrhage during a posterior vitreous detachment?

Vitreous pulling away from a retinal vessel

8

What is a common symptom that occurs when the retina is being pulled on by the vitreous during a posterior vitreous detachment?

Flashes (photopsia)

9

What are 3 ways floaters may be described by a patient experiencing a posterior vitreous detachment?
What is the cause of each different type of floater described?

1. "Single large floater" - Weiss Ring
2. "Cobwebs" - condensation of collagen fibers
3. "Shower of small dark spots" - RBC's

10

What is important to rule out in a patient experiencing a posterior vitreous detachment?

Retinal detachment

11

The formation of an area of confluent tiny vesicles in peripheral retina causing it to look thickened or less transparent is known as ____?

Microcystoid Degeneration

12

Where does microcystoid degeneration always extend from?

Ora serrata

13

Can microcystoid degeneration be the direct cause of a retinal detachment?

No

14

Microcystoid degeneration is usually benign, but progression to ___ should always be monitored for?

Retinoschisis

15

What condition refers to patches of chorioretinal atrophy aligned in a row parallel to the ora serrata?

Pavingstone Degeneration

16

What do the signs seen in Pavingstone Degeneration represent?

Thinned, intact retina and choroid overlying visible sclera

17

Does Pavingstone Degeneration lead to a retinal detachment?

No

18

Peripheral perivascular pigmentation that may extend posterior to the equator is known as ___?

Reticular Pigmentary Degeneration

19

What age group is Reticular Pigmentary Degeneration commonly seen in?

Older patients

20

What is an example of a pathological condition that looks similar to Reticular Pigmentary Degeneration?

Retinitis Pigmentosa

21

It is important to differentiate benign peripheral drusen from what other condition?

Progressive macular changes in AMD

22

Are patients with benign peripheral drusen at an increased risk for AMD?

No

23

A long area of thinned, atrophic retina that is beneath a pocket of liquefied vitreous and surrounded by strong vitreal attachments at the margins of the lesion is known as ____?

Lattice Degeneration

24

Lattice degeneration is very common, especially in hyperopes or myopes?

Myopes

25

Lattice degeneration is present in up to nearly 50% of eyes with _____?

Retinal detachment

26

What quadrant is lattice degeneration often present in?

Superotemporal

27

What are 4 common appearances often seen within the lesion in lattice degeneration?

White lines, "snowflakes", pigmentation, and/or small holes

28

Most patients with lattice degeneration do or do not develop retinal detachments?

Do not

29

What are 3 events that could take place in lattice degeneration that may lead to a retinal detachment?

1. Flap tear formation during posterior vitreous detachment
2. Tears at posterior margin of lesion
3. Holes within lesion

30

Elongated patches of "frosted" looking peripheral retina with overlying vitreous liquefaction and without strong vitreoretinal attachments is known as ___?

Snailtrack Degeneration

31

Snailtrack degeneration lesions are typically longer or shorter than those seen in lattice degeneration?

longer

32

Opaque appearance of islands of peripheral retina that are attached more strongly to cortical gel than normal only upon scleral indentation is known as ____?

White with pressure

33

Although white without pressure rarely causes problem, what has been known to occur at posterior border?

Giant retinal tears

34

A small, light-colored area of retinal elevation where focal vitreous traction pulls up is known as ____?

Retinal tuft

35

Diffuse chorioretinal atrophy often seen in the equatorial region is most common in hyperopic or myopic eyes?

Highly myopic

36

All chorioretinal atrophy represents what?

Thinning of choroid/retina

37

Holes within the atrophied retina are often difficult to see why?

Lack of contrast between retina and choroid

38

What are 4 retinal degenerations that occur more frequently in myopia?

1. Lattice degeneration
2. Snailtrack degeneration
3. Diffuse chorioretinal atrophy
4. Macular holes

39

What are 3 processes/reasons myopes experience increased risk for retinal detachments?

1. Vitreous degeneration occurs with myopia
2. Posterior vitreous detachment occurs earlier in myopia
3. Cataract surgery causing vitreous loss and laser posterior capsulotomy

40

List 4 peripheral retinal degenerations that may lead to a retinal detachment?

1. Lattice degeneration
2. Snailtrack degeneration
3. White with and without pressure
4. Diffuse chorioretinal atrophy

41

Splitting of retina due to degeneration is called ___?

Degenerative Retinoschisis

42

Degenerative retinoschisis more commonly affects myopic or hyperopic eyes?

Hyperopic

43

Degenerative retinoschisis is often overlooked or mistaken for _____?

Retinal detachment

44

Cystic spaces that coalesce within an area of peripheral cystoid degeneration leads to ______ in degenerative retinoschisis?

Splitting of neurosensory retina into inner and outer layer

45

How does the separation in retinoschisis differ from a retinal detachment?

Retinoschisis involves splitting/separation between different layers within the retina, but the photoreceptors still remain attached to the RPE.

46

A stationary, shallow, smooth dome-shaped elevation of peripheral retina in the inferotemporal quadrant of both eyes of an asymptomatic patient is most likely ____?

Degenerative retinoschisis

47

Are there pigmentary changes on the retina or pigment in the vitreous with degenerative retinoschisis?

No

48

How is retinoschisis most often managed/treated?

Usually monitored without treatment

49

What may be considered for retinoschisis that is very posterior and progressing?

laser therapy

50

What occurs when fluid accumulates between choroid and sclera (suprachoroidal space)?

Choroidal detachment

51

What is the most common association/cause of choroidal detachment?

Recent intraocular history - glaucoma filtering surgery

52

What symptom might be reported for a choroidal detachment?

Shadow in vision (not flashes and floaters)

53

If pain accompanies a choroidal detachment, what may be involved?

Hemorrhagic detachment

54

What is a clinical sign that may obscure posterior pole in choroidal detachments?

Dome-shaped elevation of choroid and retina that is smooth and relatively immobile

55

If choroidal detachment is excessive, how may the anterior chamber be affected?

Shallow AC

56

How might IOP be affected if choroidal detachment is hemorrhagic?
If caused by hypotony?

- Hemorrhagic: high IOP
- Hypotony: low IOP

57

What test can confirm diagnosis of choroidal detachment?

B scan

58

What test can differentiate a serous vs hemorrhagic choroidal detachment?

Ultrasound

59

Hemorrhagic choroidal detachment cases with severe pain or extremely elevated IOP require what kind of treatment?

Prompt surgical drainage

60

Acute angle closure could be caused by what drug?

Topamax

61

How should acute angle closure caused by Topamax be treated? List 4.

1. Discontinue Topamax
2. Lower IOP with anti-glaucoma medications
3. Atropine (strong cycloplegia)
4. Prednisolone Acetate 1% (anti-inflammatory)

62

There is no indication for ____ in acute angle closure caused by Topamax? List 2.

1. Peripheral iridotomy
2. Miotic agent

63

Choroidal effusion due to an unknown cause in association with an exudative retinal detachment is known as _______?

Uveal effusion syndrome

64

Uveal effusion syndrome follows a chronic or acute course?

Chronic

65

Uveal effusion syndrome may lead to what 2 effects?

1. RPE changes
2. Permanently reduced vision

66

Although extremely rare, who does uveal effusion syndrome typically affect?

Hyperopic, middle-aged men

67

A reparative process in which cells migrate to either surface of the retina, form a fibrous cellular sheet, which then contracts causing fixed rigid folds is known as ____?

Proliferative vitreoretinopathy

68

What is the most common cause of failure in retinal detachment surgery?

Proliferative vitreoretinopathy

69

When is the typical occurrence of proliferative vitreoretinopathy?

A few weeks or months following retinal detachment surgery