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VM773 SA Med & Sx > Ophtho > Flashcards

Ophtho Flashcards

(92 cards)

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1
Q

causes of a hyperreflective tapetum

A

retina atrophy or degeneration

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2
Q

dogs, cats, ruminants, camelids and humans have what retina blood vessel pattern

A

holangiotic (304 major venules)

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3
Q

horses and guinea pigs have what retina blood vessel pattern

A

paurangiotic (small retinal vessels)

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4
Q

rabbits have what retina blood vessel pattern

A

merangiotic (vessels in focal region)

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5
Q

birds have what retina blood vessel pattern

A

anagiotic (no retinal vessels)

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6
Q

optic n is myelinated in which species

A

canine and ruminants

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7
Q

optic n is not myelinated in which species

A

cats, horses, camelids

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8
Q

what are the 3 parts of the dog optic n head

A

neurorim
physiologic cup
venous anastomosis

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9
Q

where does a dog optic disc lay

A

tapetal and non tapetal junction

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10
Q

where does a cats optic disc lay

A

tapeal fundus

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11
Q

where does a horses optic disc lay

A

non-tapetal fundus

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12
Q

progressive retinal atrophy
cause?

A

inherited autosomal recessive but also autosomal dominant and X linked

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13
Q

progressive retinal atrophy symptoms

A

loss of night vision then day
increase tapetal reflectivity
retinal vascular attenuation
optic n atrophy

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14
Q

how can you diagnose progressive retinal atrophy?

A

minimal retinal function on ERG or fundic exam

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15
Q

cats predisposed to progressive retinal atrophy? cause?

A

abyssinian and persian
autosomal recessive

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16
Q

signs of an active inflammatory retinal lesions

A

chorioretinitis or retinal detachment causes hyporeflective lesions due to accumulation of cells/fluid

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17
Q

signs of post-inflammatory retinal lesions

A

hyperreflective scar - retinal degeneration

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18
Q

what are the most common lesions associated with blindness

A

retinal disease
optic n disease
cortical disease

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19
Q

retinal disease resulting in blindness is usually due to what?

A

retinal detachment = decreased tapetal reflectivity and hazy appearance

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20
Q

PLR response due to retinal disease?

A

dilated pupil
sluggish PLR

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21
Q

PLR response due to optic n disease (optic neuritis)?

A

dilated pupil (mydriasis)
sluggish PLR

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22
Q

most common cause of optic neuritis? what must you rule out?

A

idiopathic
must rule out infectious (toxo, crypto, borreliosis)

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23
Q

how to diagnose optic neuritis?

A

fundic exam - swelling, hemorrhage, peripapillary edema
ERG normal
MRI or CT helpful
CSF analysis

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24
Q

what are two systemic causes of non-infectious blindness?

A

hypertensive retinopathy
uveodermatologic syndrome

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25
what is termed hypertensive retinopathy?
>160mmHg
26
what will you see in a cat with hypertensive retinopathy?
older cat, bilateral mydriasis, blindness +/- renal disease, cardiomyopathy or hyperthyroidism
27
what is the prognosis for hypertensive retinopathy?
50% will regain vision w/ treatment of systemic hypertension and underlying systemic disease
28
what is uveodermatologic syndrome in dogs?
immune mediated disease - targets dermal and uveal melanocytes usually arctic breeds, akitas ocular signs first then derm signs
29
what's the cause of sudden acquired retinal degeneration syndrome (SARDS)
unknown - thought to be immune mediated
30
signs of SARDS
blind in both eyes normal fundus early in the disease course abnormal PLR signs similar to cushings (PUPD, polyphagia, weight gain)
31
diagnosis of SARDS
ERG flat line
32
treatment for SARDS
none, permanent blindness
33
neomycin, polymyxinB, bacitracin (neopolybac) does it penetrate the corneal epithelium? when is it used? caution in?
NO penetration used for simple corneal ulcer (no active infection) cats - anaphylaxis
34
what is neomycin polymyxinB gramicidin?
a solution instead of ointment
35
what drug should be used for an actively infected corneal ulceration? why?
olfoxacin or ciprofloxacin good penetration through intact epithelium
36
when should you use tobramycin? does it penetrate the intact epithelium?
simple ulcers in high risk patients (brachycephalics) yes
37
what topical antibiotic is epithelial toxic?
gentamicin - don't use unless culture says to
38
which two antibiotics are effective against Chlamydophilia and Mycoplasma?
erythromycin terramycin
39
what antibiotic is useful for cats with conjunctivitis and uncomplicated corneal ulcerations?
erythromycin
40
what antibiotic is shown to reduce healing time in dogs with SCEED (indolent ulcers)
terramycin (oxytet + polymyxinB)
41
why is there a caution of terramycin use in cats?
polymyxin anaphylaxis
42
what antibiotic has the risk of aplastic anemia?
chloramphenicol
43
what are the 4 options for anti-collagenase medications?
acetylcysteine EDTA doxycycline PO BID serum
44
what is the best choice for stabilizing the cornea with keratomalacia?
acetylcysteine
45
dendritic ulcerations are pathognomonic for what?
FHV
46
if a cat has unilateral hyperemia, top ddx?
FHV
47
if a cat has bilateral chemosis, ddx?
chlamydophilia
48
mainstay treatment for FHV
famciclovir L-lysine
49
how does L-lysine help prevent FHV? how often must it be given?
L-lysine competes with arginine which is required by the virus to replicate = stops viral replication must be given 2x a day bc the body will eliminate Lysine
50
what drug should be used for long term uveitis prevention (e.g. lens induced uveitis) or mature cataracts?
NSAIDs - flurbiprofen, diclofenac, ketorolac
51
which steroid is a good choice for uveitis and immune mediated keratitis? why?
Prednisolone Acetate penetrates the cornea
52
which steroid is a good choice for superficial disease like conjunctivitis? why?
dexamethasone sodium phosphate does not penetrate the cornea well
53
with what steroid should you watch out for fungal keratitis and stromal abscesses in horses?
dexamethasone sodium phosphate
54
NSAIDs penetration of the cornea? when do they become epithelial toxic?
yes when used more than 4x/day
55
what is the most effective drug for allergic conjunctivitis (inflammatory) in the dog?
neopolydex
56
NeoPolyDex caution in which species? why?
cats - they get infectious conjunctivitis not inflammatory horses - stromal abscess and fungal keratitis
57
what are some options for topical glaucoma medications?
beta blockers - timolol Carbonic anhydrase inhibitors - dorzolamide or methazolamide prostaglandin analog - latanoprost
58
timolol MOA
decreases aqueous humor by blockage of beta receptors in ciliary body = mild decrease in IOP
59
dorzolamide - MOA - what can you combine it with? - effective in who?
carbonic anhydrase inhibitor - decreases aqueous humor production in ciliary body epithelium can combine with timolol = cosopt dogs/cats
60
methazolamide is also a carbonic anhydrase inhibitor but has a higher risk of what?
systemic effects - metabolic acidosis (clients watch for panting)
61
what is Latanoprost used for?
emergency situation in dogs to decrease IOP excellent if posterior lens luxation
62
Latanoprost MOA
increase aqueous outflow
63
why is latanoprost not used in cats? when do you not want to use it?
cats don't have PGA receptors thus has minimal affect NOT if there's sig uveitis OR anterior lens luxation
64
what mydriatic agent has the longest onset and duration?
atropine
65
when is tropicamide useful?
fundic exams
66
when should you NOT dilate the eyes?
if IOP is elevated
67
when is phenylephrine used?
reduce conjunctival hemorrhage during ocular surgery = drain to mouth and blanch gums
68
what drugs do you use for dry eye (KCS)?
calcineurin inhibitors - cyclosporine (mild) - tacrolimus (if sensitive to cyclo or can be combined with cyclo if severe)
69
what are the two risks of using calcineurin inhibitors for dry eye?
1. risk of SCC 2. immunosuppression
70
orbital neoplasia clinical signs: ddx: best diagnostic:
exophthalmos + third eyelid elevation tumor vs abscess vs cellulitis vs salivary gland mucocele CT/MRI
71
what is the most common primary eyelid tumors in dogs
meibomian gland adenoma
72
Meibomian Gland Adenoma benign or malignant? treatment?
benign, locally invasive debulk w/ cryo or wedge resection
73
how is a fibropapilloma different than a meibomian gland adenoma
less friable generally not on the eyelid margin treatment same
74
Melanoma location: predispositions: diagnostics: treatment:
eyelid margin - dark/pigmented vizlas, weimaraners histopath cryo +/- debulk or wedge resection
75
what is the most common primary eyelid tumor in cats
SCC
76
SCC location: diagnostics: treatment:
lower lid or 3rd eyelid biopsy w/ histopath complete sx ecision +/- RT, chemo or immunotherapy
77
what 3 neoplasms can occur on the third eyelid
SCC hemangioma/hemangiosarcoma adenoma/adenocarcinoma
78
treatment for hemangioma/HSA on the 3rd eyelid?
excise (1mm margins) w/ adjunctive cryotherapy or radiofreq electocautery
79
treatment for adenoma/adenosarcoma on the gland of the 3rd eyelid
surgical excision of 3rd eyelid often curative
79
corneal SCC are more common in what species
equine (UV exposure) dogs (brachycephalics)
80
what are the underlying causes of corneal SCC
KCS immune mediated/chronic keratitis (increased risk w/ chronic use of cyclo or tacro)
81
treatment for corneal SCC
keratectomy adjunct cryo, RT or chemo
82
how to differentiate a limbal melanoma/melanocytoma limbal origin from uveal origin
ultrasound
83
treatment for a limbal melanoma/melanocytoma
excision w/ cryo cryo alone +/- graft
84
what are the two types of primary anterior uveal neoplasias?
ciliary body adenoma/adenocarcinoma uveal melanoma
85
ciliary body adenoma/adenocarcinoma behavior? diagnosis? treatment?
benign, slow growing, locally aggressive intraocular mass, elevated IOP, uveitis enucleate once uveitis or glaucoma develop
86
uveal melanoma location: behavior in dogs vs cats:
on iris or ciliary body dogs: slow growing, unilateral, middle age/older animals cats: starts small, can grow fast and met, but majority are slow growing
87
treatment of uveal melanoma in dogs
laser enucleation
88
treatment of uveal melanoma in cats; what are the criteria for enucleation
depends on age (4 vs 12) monitor enucleation 1. iris abnormal 2. uveitis and/or glaucoma 3. rapid progression
89
what neoplasia is the secondary anterior uveal neoplasia
lymphoma
90
lymphoma in the eye behavior: diagnostics: treatment:
bilateral, stage V LN asp, chest/abd imaging, aqueocentesis systemic + treat uveitis and glaucoma
91
choroidal melanoma diagnostics: treatment:
fundic exam (dark raised lesion, retinal detachment) enucleation

VM773 SA Med & Sx (15 decks)

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