Block 15 Lectures 18 and 20 - Retinal Detachments Flashcards Preview

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Flashcards in Block 15 Lectures 18 and 20 - Retinal Detachments Deck (48):
1

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

Retinal detachment

2

What are the 3 types of RD?

1. Rhegmatogenous
2. Tractional
3. Exudative

3

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

Rhegmatogenous retinal detachment

4

Formation of rhegmatogenous RD requires what 3 elements?

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

5

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

Liquefied vitreous

6

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

7

The majority of spontaneous rhegmatogenous RD notice what symptoms?

Flashes and floaters

8

Where are retinal breaks most often found in rhegmatogenous RD?

Superotemporal quadrant

9

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

Pigment cells in anterior vitreous ("tobacco dust")

10

How might IOP be affected in rhegmatogenous RD?

Slightly lower in eye w/ RD

11

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

Rhegmatogenous RD

12

What type of RD may show "Shafer's sign"?

Rhegmatogenous

13

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

Rhegmatogenous

14

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

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

15

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

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

16

Successful reattachment of retina in rhegmatogenous RD depends on what?

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

17

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)

18

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

Tractional retinal detachment

19

Does tractional RD require retinal break?
Liquefied vitreous?

Neither

20

What is a common cause of tractional retinopathy?

Proliferative diabetic retinopathy

21

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

Tractional RD

22

Why are symptoms limited in tractional RD?

Contraction of fibrous tissue occurs slowly

23

How does the detached retina appear in a tractional RD?

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

24

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

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