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Posterior Segment > Block 15 Lectures 18 and 20 - Retinal Detachments > Flashcards

Block 15 Lectures 18 and 20 - Retinal Detachments Flashcards

(48 cards)

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1
Q

Separation of photoreceptors from the underlying RPE is known as _____?

A

Retinal detachment

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2
Q

What are the 3 types of RD?

A
  1. Rhegmatogenous
  2. Tractional
  3. Exudative
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3
Q

A retinal break that allows liquefied vitreous to seep into potential space between neurosensory retina and RPE is known as _____?

A

Rhegmatogenous retinal detachment

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4
Q

Formation of rhegmatogenous RD requires what 3 elements?

A
  1. Full-thickness retinal break
  2. Traction to hold the break open
  3. Liquefied vitreous
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5
Q

What accumulates between the photoreceptors and RPE in a rhegmatogenous RD?

A

Liquefied vitreous

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6
Q

What can be a signal of the initial location of a primary retinal break in rhegmatogenous retinal detachments?

A

The initial location of a curtain/shadow seen in vision

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7
Q

The majority of spontaneous rhegmatogenous RD notice what symptoms?

A

Flashes and floaters

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8
Q

Where are retinal breaks most often found in rhegmatogenous RD?

A

Superotemporal quadrant

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9
Q

What does Shafer’s sign refer to in rhegmatogenous RD?

A

Pigment cells in anterior vitreous (“tobacco dust”)

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10
Q

How might IOP be affected in rhegmatogenous RD?

A

Slightly lower in eye w/ RD

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11
Q

RAPD may be present if what type of RD is extensive?

A

Rhegmatogenous RD

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12
Q

What type of RD may show “Shafer’s sign”?

A

Rhegmatogenous

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13
Q

An operculated tear may be a sign of what type of RD?

A

Rhegmatogenous

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14
Q

Describe 3 features about the clinical appearance of a fresh/recent rhegmatogenous RD.

A
  1. Translucent elevated retina
  2. Wrinkled
  3. Moves with eye movements
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15
Q

Describe 3 features about clinical appearance of long-standing rhegmatogenous RD

A
  1. Detached retina becomes thinned and atrophied
  2. Intraretinal cysts
  3. Demarcation lines
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16
Q

Successful reattachment of retina in rhegmatogenous RD depends on what?

A

Permanent closure of the retinal breaks that caused the RD in a timely manner

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17
Q

What are 4 reattachment techniques?

A
  1. Laser or cryotherapy (prophylactic)
  2. Pneumatic retinopexy (gas tamponade)
  3. Scleral buckling (with or without fluid drainage)
  4. Vitrectomy (combined with scleral buckle)
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18
Q

Contraction of fibrous tissue on the retinal surface, pulling the retina away from the RPE below it is known as _____?

A

Tractional retinal detachment

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19
Q

Does tractional RD require retinal break?

Liquefied vitreous?

A

Neither

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20
Q

What is a common cause of tractional retinopathy?

Study These Flashcards
A

Proliferative diabetic retinopathy

21
Q

What type of RD is usually a complication observed in a patient known to have diabetic retinopathy?

Study These Flashcards
A

Tractional RD

22
Q

Why are symptoms limited in tractional RD?

Study These Flashcards
A

Contraction of fibrous tissue occurs slowly

23
Q

How does the detached retina appear in a tractional RD?

Study These Flashcards
A

Smooth and concave to surface of retina; relatively stationary and initially shallow

24
Q

What can often be seen at the site of vitreoretinal traction in an tractional RD?

Study These Flashcards
A

Proliferative fibrous membrane - elevation of retina

25
What cause of a tractional RD could lead to a combined tractional-rhegmatogenous RD?
Penetrating trauma
26
Blood within vitreous gel may cause what kind of RD?
Tractional
27
What are 2 treatment strategies for Tractional RD?
1. Release of traction by vitrectomy | 2. Membrane dissection
28
What is an optometrist's role in managing tractional RD?
Detect and refer for surgical intervention
29
Is there an effective medical treatment for tractional RD?
No
30
Early detection and treatment of what condition is key for an optometrist to help prevent tractional RD? How is this condition typically treated?
- Proliferative diabetic retinopathy | - Panretinal photocoagulation of neovascularization
31
Separation of neurosensory retina from RPE by fluid accumulation from a breakdown of inner/outer blood-retinal barriers is known as _____?
Exudative RD
32
Does an exudative RD require a retinal break?
No
33
Which RD requires a retinal break?
Rhegmatogenous
34
What are 2 ways the blood-retinal barrier could be defective in exudative RD?
1. Increased vascular permeability | 2. Dysfunction of pumping mechanisms of RPE
35
What is a possible vascular cause of an exudative RD?
Coat's disease
36
What is a possible inflammatory cause of an exudative RD?
Posterior scleritis
37
What is a possible neoplastic cause of an exudative RD?
Choroidal melanoma
38
What is a possible idiopathic cause of an exudative RD?
Bullous central serous chorioretinopathy
39
Which RD is commonly associated with fluctuating visual changes? What causes these changes?
- Exudative RD | - Shifting subretinal fluid
40
If an exudative RD was associated with pain, what could be the underlying cause?
Posterior scleritis
41
Why is photopsia not a common symptom of exudative RD?
No traction pulling on retina
42
What does an exudative RD look like on the retina?
Smooth, dome-shaped elevation of retina with shifting subretinal fluid
43
Which RD is associated with "leopard spots"?
Exudative RD
44
What are "leopard spots" seen in Exudative RD?
Scattered subretinal pigment clumping caused by resorption of fluid
45
What test can determine source/cause of subretinal fluid in exudative RD?
Angiography
46
Diagnosis of exudative RD is mostly based on ____?
Clinical exam - fundus appearance and signs/symptoms of underlying cause
47
If a choroidal melanoma is found to be underlying cause for exudative RD, how does an optometrist manage?
Referral to ophthalmic oncology
48
If posterior scleritis is found to be underlying cause for exudative RD, how does optometrist manage?
Urgent referral to rheumatologist

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