Flashcards in Block 15 Lectures 18 and 20 - Retinal Detachments Deck (48):
Separation of photoreceptors from the underlying RPE is known as _____?
What are the 3 types of RD?
A retinal break that allows liquefied vitreous to seep into potential space between neurosensory retina and RPE is known as _____?
Rhegmatogenous retinal detachment
Formation of rhegmatogenous RD requires what 3 elements?
1. Full-thickness retinal break
2. Traction to hold the break open
3. Liquefied vitreous
What accumulates between the photoreceptors and RPE in a rhegmatogenous RD?
What can be a signal of the initial location of a primary retinal break in rhegmatogenous retinal detachments?
The initial location of a curtain/shadow seen in vision
The majority of spontaneous rhegmatogenous RD notice what symptoms?
Flashes and floaters
Where are retinal breaks most often found in rhegmatogenous RD?
What does Shafer's sign refer to in rhegmatogenous RD?
Pigment cells in anterior vitreous ("tobacco dust")
How might IOP be affected in rhegmatogenous RD?
Slightly lower in eye w/ RD
RAPD may be present if what type of RD is extensive?
What type of RD may show "Shafer's sign"?
An operculated tear may be a sign of what type of RD?
Describe 3 features about the clinical appearance of a fresh/recent rhegmatogenous RD.
1. Translucent elevated retina
3. Moves with eye movements
Describe 3 features about clinical appearance of long-standing rhegmatogenous RD
1. Detached retina becomes thinned and atrophied
2. Intraretinal cysts
3. Demarcation lines
Successful reattachment of retina in rhegmatogenous RD depends on what?
Permanent closure of the retinal breaks that caused the RD in a timely manner
What are 4 reattachment techniques?
1. Laser or cryotherapy (prophylactic)
2. Pneumatic retinopexy (gas tamponade)
3. Scleral buckling (with or without fluid drainage)
4. Vitrectomy (combined with scleral buckle)
Contraction of fibrous tissue on the retinal surface, pulling the retina away from the RPE below it is known as _____?
Tractional retinal detachment
Does tractional RD require retinal break?
What is a common cause of tractional retinopathy?
Proliferative diabetic retinopathy
What type of RD is usually a complication observed in a patient known to have diabetic retinopathy?
Why are symptoms limited in tractional RD?
Contraction of fibrous tissue occurs slowly
How does the detached retina appear in a tractional RD?
Smooth and concave to surface of retina; relatively stationary and initially shallow
What can often be seen at the site of vitreoretinal traction in an tractional RD?
Proliferative fibrous membrane - elevation of retina
What cause of a tractional RD could lead to a combined tractional-rhegmatogenous RD?
Blood within vitreous gel may cause what kind of RD?
What are 2 treatment strategies for Tractional RD?
1. Release of traction by vitrectomy
2. Membrane dissection
What is an optometrist's role in managing tractional RD?
Detect and refer for surgical intervention
Is there an effective medical treatment for tractional RD?
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
Separation of neurosensory retina from RPE by fluid accumulation from a breakdown of inner/outer blood-retinal barriers is known as _____?
Does an exudative RD require a retinal break?
Which RD requires a retinal break?
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
What is a possible vascular cause of an exudative RD?
What is a possible inflammatory cause of an exudative RD?
What is a possible neoplastic cause of an exudative RD?
What is a possible idiopathic cause of an exudative RD?
Bullous central serous chorioretinopathy
Which RD is commonly associated with fluctuating visual changes?
What causes these changes?
- Exudative RD
- Shifting subretinal fluid
If an exudative RD was associated with pain, what could be the underlying cause?
Why is photopsia not a common symptom of exudative RD?
No traction pulling on retina
What does an exudative RD look like on the retina?
Smooth, dome-shaped elevation of retina with shifting subretinal fluid
Which RD is associated with "leopard spots"?
What are "leopard spots" seen in Exudative RD?
Scattered subretinal pigment clumping caused by resorption of fluid
What test can determine source/cause of subretinal fluid in exudative RD?
Diagnosis of exudative RD is mostly based on ____?
Clinical exam - fundus appearance and signs/symptoms of underlying cause
If a choroidal melanoma is found to be underlying cause for exudative RD, how does an optometrist manage?
Referral to ophthalmic oncology