Retina 1

Question 1

hyaloideocapsular ligament of (weiger)

Answer 1

attaches anterior vitreous to posterior lens

Question 2

patellar fossa

Answer 2

this is the groove that the vitreous has for the lens to sit in.

Question 3

retrolental space of berger

Answer 3

space where lens and vitreous are not attached

Question 4

Where is the vitreous based attached to?

Answer 4

2mm anterior and 3mm posterior to ora serata

Question 5

area martegiani

Answer 5

posterior end of the canal, where the hyaloid artery once emerged from the optic disc

Question 6

Precortical vitreous pocket

Answer 6

Vitreous space formed by macular attachments

Question 7

What are the different areas of the macula and the anatomic descriptions?

Answer 7

1. Macula: Area between peripheral arcades2. Fovea: Central macula about 1 DD (1.5mm) in diameter)3. Foveola: 0.35mm of central macula (inner nuclear and ganglion cell layers are laterally displace)4. Umbo: Depression at center of fovea5. Parafovea: 0.5 mm in width surrounding fovea6. Perifovea: 15.mm in width surrounding the parafovea

Question 8

Meridional fold

Answer 8

pleats of redudant retina extending radially into pars plana

Question 9

What cells make the internal limiting membrane? What about the external limiting mebrane (XTL)

Answer 9

Made by footplates of Muller’s cells. XTL is not actual membrane but junctional complex between Muller cells and photoreceptors.

Question 10

What are some of the functions of RPE cells?

Answer 10

• absorbs light * phagocytoses rod and cones outer segments * participates in retinal and polyunsaturated fatty acid metabolism * forms the out blood-ocular barrier * maintains the subretinal space * heals and forms scar tissue

Question 11

What are physical properties that make fluoroscein different from ICG? What is ICG good for evaluating?

Answer 11

ICG is 98% protein bound and fluoresceine is 80% protein bound. ICG is good for looking at choroidal vasculature

Question 12

What is the doasage thought to start toxicity for chloroquine? Hydroxychloquine?

Answer 12

300g cumulative; 400mg/day over months to years with cumulative dose of > 1000g although highly weight dependent

Question 13

What are the two topographic areas of the vitreous?

Answer 13

Core and cortical

Question 14

Aside from water, what is vitreous composed of?

Answer 14

Collagen, hyaluronan

Question 15

What is the definition of a giant retinal tear?

Answer 15

An rt extending more than 3 clock hours circumferentially

Question 16

What is the most common cause for a dialysis tear?

Answer 16

Trauma

Question 17

When there is avulsion of the vitreous base, what must have assuredly happened?

Answer 17

Trauma of some sort

Question 18

Do traumatic retinal breaks in young patients generally occur/manifest early on or late?

Answer 18

Late

Question 19

What is the incidence of PVd over age of 70?

Answer 19

Over 60 percent

Question 20

What is the incidence of retinal tear in patients with hemorrhagic vs non-hemorrhagic tears? Total combined incidence?

Answer 20

70 percent10 percent15 percent

Question 21

How common is lattice in the general population?

Answer 21

About 10%, more common in myopes

Question 22

What are the 3 types of retinal tufts?

Answer 22

Cystic, non-cystic, and zonular (extends over the pars plana)

Question 23

Lattice degeneration, vitreoretinal tufts, and meridional folds all increase the risk of….

Answer 23

Retinal tears and detachments

Question 24

How common is cobblestoning or paving stone degeneration in the general population?

Answer 24

20%

Question 25

Cobblestoning, rpe hyperplasia, peripheral cystoid degeneration all ______ the risk of retinal detachment?

Answer 25

Have no affect on

Question 26

Approximately what percentage of eyes in the general population have a retinal break?

Answer 26

5%, most are sub clinical and undetected and rarely go on to retinal detachment

Question 27

What is highly characteristic of a exudative detachment vs RRD or TRD?

Answer 27

Shifting sub retinal fluid and smooth areas of detachment

Question 28

Peripheral cystoid degeneration does not predispose to retinal detachment but is associated with what?

Answer 28

Retinoschisis

Question 29

What retinal findings can be seen in Gardners syndrome (familial adenomatous polyposis)?

Answer 29

Ovoid CHRPE like lesions that are multiple and bilateral

Question 30

What are some exam findings seen in birdshot retinochoroidopathy? Symptoms?

Answer 30

Vitritis 100% of timeDisc edemaCmeNasal choroidal/retinal vitelliform lesions (spares temporal retina often), vasulitis, bilateral diseaseNyctalopia, loss of color vision, vision loss

Question 31

What is the Hla associated with birdshot retinochoroiditis?

Answer 31

HLA-A29 in >90%

Question 32

What is the treatment for Birdshot retinochoroidopathy?

Answer 32

Intravitreal steroid/systemic steroid that often requires chronic steroid sparing immunomodulatory agents

Question 33

What is the typical clinical presentation of APMPPE (acute posterior multifocal placoid pigment epitheliopathy)?

Answer 33

Acute onset vision loss in one eye followed days later by involvement in the other eye.

Question 34

What is the treatment for APMPPE?

Answer 34

Observation

Question 35

What is usually the treatment for active serpiginous choroidopathy?

Answer 35

Corticosteroids and immunomodulatory medications combined

Question 36

What is the size classification for intermediate druse?

Answer 36

64-124 microns; remember this number and you can remember the large and small druse size

Question 37

What is the purpose of following patients with angioid streaks?

Answer 37

Monitor for development of cnv which can be treated.

Question 38

What preventative measure should patients with angioid streaks take?

Answer 38

Protective eye wear as their blood vessels are more prone to break

Question 39

What are the specific micro vascular findings that happen with diabetic retinopathy?

Answer 39

Pericyte damage/lossBasement membrane thickening

Question 40

What are the three criteria for CSME?

Answer 40

1. Macula edema within 500 microns of foveal center2. Exudates within 500 microns of foveal center if associated with edema3. 1 disc diameter of edema within 1 disc diameter of foveal center

Question 41

What is the definition (4 criteria) of high risk PDR?

Answer 41

1. NV within 1 DD of disc greater than 1/4 DD2. NVD associated with vitreous hem3. NVE associated with vitreous hem4. NVI/NVA

Question 42

What are FIPTs in regards to hypertensive retinopathy?

Answer 42

Focal intraretinal prearteriolar transudates that are similar to cotton wool spots but deeper, smaller, and less white

Question 43

What is the mutational change in sickle cell (Hb S) disease?

Answer 43

Glutamate to valine in the sixth position of the beta polypeptide

Question 44

What is the mutational change in hemoglobin C (Hb C) disease?

Answer 44

Glutamate to lysine in the sixth position of beta polypeptide

Question 45

What is a basic ddx for disc edema associated with flame hemorrhages and macular star Exudates?

Answer 45

Neuroretinitis, diabetic papillopathy, hypertensive retinopathy, CRVO, AION, and radiation papillopathy

Question 46

What are some characteristics of PSR (sickle cell retinopathy) compared to PDR?

Answer 46

PSR is usually more peripheral and associated with "sea fan" neovascularization that is white in appearance

Question 47

What is the most common quadrant for BRVO?

Answer 47

Superotemporal

Question 48

What are the two categories of CRVO?

Answer 48

Ischemic and non ischemic

Question 49

What is an exam technique to distinguish CRVO from OIS

Answer 49

Placing pressure on the globe while examining the central retinal artery to see if it collapses or not. A collapsible artery is consistent with ocular ischemic syndrome.

Question 50

What are the three major categories of retinal emboli?

Answer 50

1. Cholesterol (holenhorst plaques)2. Platelet-fibrin ( associated with large arteriosclerotic disease)3. Calcific emboli (from diseases cardiac valves)