retina Flashcards
(100 cards)
1
Q
operculated hole treated if ?
A
associated with persistent vitreous traction, Vit Hg , superior or large
2
Q
symtomatic PVD associated with retinal tear
A
7-18%
if with Vit Hg 75%
3
Q
asymptomatic flap tear progress to RD in
A
5%
4
Q
asymptomatic LD progress to RD in
A
1%
5
Q
risk factors of RRD post phaco
A
male, young, myopia, high AL, PCR, absence of PVD
highst risk in the first year 11x
more risk of RRD than phakic by 1-3 %
6
Q
risk of RRD in the fellow eye
A
10%
7
Q
subclinical RD or asymptomatic RD
A
subretinal fluid that extend more than 1 DD form the break but not more than 2 DD posterior to the equater
30% risk to progress
8
Q
RRD after trauma in young pt
A
12% in immediatly
30% in the first month
50% after 8 months
80% after 24 months
M.C retinal dialysis in inferotemoral or superonasal
vitreous avalsion
macular hole
horseshoe tear (equatorial, post to meridional fold, post margin of vitreous bsae)
often multiple
9
Q
FFA dose
A
2-3 ml of 25% or 5ml of 10% sterile solution in anticubital vien
10
Q
FFA component
A
fluorescein dye ( 80% bound to the plasma protien)
fundus camera
excitation filter (blue green 460-490 nm)
barrier filter (yellow 520-530 nm)
11
Q
phases of FFA
A
choroidal flush 8-12 s from injection
arterial phase 11-18 s from injection
laminar phase 1-3 s later
venous phase 5-10s later
early recirculation 2-4 min
late recirculation 4-5 min
12
Q
hypoflaurescence
A
vascular filling defect
blockage effect
13
Q
drug causing ME
A
docetaxal
niacin
deforxamine
fingolimoid
prostaglandin F2a
glitazone
14
Q
Risk factors for RVO
A
AGE, HTN, DM, dyslipidemia, smoking, glaucoma, hypercoagulable status, hypothyrodism
15
Q
retinitis pigmentosa
A
rod cone dystrophy
tirad of : waxyy pallor of ON, bone specule , attenuated BV
pt complaining of paracentral ring scotoma or restricted peripheral VF and nyctalopia
associated with: vitreous cells, CME, PSC, ERM, ON Drusen
exudative RD and vascular hyperpermabilty (coats like) 2-5%
ERG: reduced both A and B wave
B wave prolonged in duration and diminished in amplitude
16
Q
intraocular FB that cause reaction
A
Zinc and aluminium cause mild inflammation and becoma incapsulated
if lareg can cause severe inflammation and PVR, ERM, TRD , phthisis bulbi
iron and cupper( more) are very toxic to the eye
chalcosis»_space; kayser fleischer ring, sunflower cataract , greenish discoloration of the iris, greenish particle in the aqueous , brownish to reddish opacities and strand in the vitreous, metalic fleck on the retina.
Sidrosis deposits on neuroepithelial cells, most toxic to the PR and RPE , early reduced A wave, later on reduced both A and B wave (electronegative ERG)
SOAG , mydriasis , stromal staining, cataract
symptoms: nyctalopia, restricted VF, DOV
17
Q
pigmentary retinopathy and hearing loss DDx
A
alport syndrome
alstrom syndrome
refsum syndrome
congenital rubella syndrome
mucopolysaccridosis
cockayne syndrome
18
Q
BDUMP
A
- bilateral multiple melanocytic lesions in the choroid
- acute PSCC
- ERD
- iris and CB cysts
19
Q
terson syndrome %
A
1/3 of subdural or subarachnoid Hg
Sun ILM , Subhyaloid, Vit Hg
resolved spontaneously , may need vitrectomy
20
Q
choroidal hemangioma Rx
A
Diffuse: external beam radiation
circumscribed: PDT
if asymptomatic: no treatment
21
Q
choroidal hemangioma types
A
circumscribed: sporadic, usually at the macula, cystoid degenration of the outer retina, exudative retinal detachment.
DDX: amelanotic Choroidal melanoma, choroidal osteoma, choroidal mets, choroidal granuloma
Diffuse CH: SWS, tomato kechup , can cause SACG, ERD
A scan : high amplitude initial echo and high amplitude internal echo
B san: choroidal thickening with high internal reflictivity
FFA: early hyperflauorescnece of large choroidal vessels at choroidal phase followed by stainning of lesion or leakage or pooling of cystoid lesion of overlying retina
ICG: early hyperfluorescence , peak at 3-4 min, wash out at late frame leaving only hyperflourescence rim
infrared imaging
22
Q
electrophysiologic retinal study
A
EOG: RPE
multifocal ERG: Macula cone-red fumction
pattern ERG: (checkerboard , contrast sensetivity) , P50 ( PR in the macule), N95 (GCL)
VEP: afferent visual system
23
Q
types of ocular lymphoma
A
- primary intraocular or vitreoretinal lymphoma (most aggresive)
- primary uveal lymphoma
- primary ocular adnexa lymphoma
- secondary lymphoma
24
Q
PVRL
A
25% of PCNSL will have PVRL
60% PF PVRL will have PCNSL
30% presented unilataral , 85% will affect fellow eye
any pt more than 50 presented with new onset bilateral posterior uveitis consider lymphoma
symptoms: decreased vision and floaters
signs: diffuse vitreous cells and flare, deep sub RPE/ subretina yellow white infiltrate +/- vascultits or vascular occlusion
FFA / ICG : hypofluorescence early and late
Dx: vitrectomy for vitreous +/- subretinal sample for flow cytometry, cytopathology , gene rearrangment study , PCR, IL10: IL6 >1 , MYD88 mutation , Brain imaging and LP
Rx: IV methotrexate +/- IVI methotrexta or rituximab or EB radiotherapy
poor prognosis
25
characteristic signs suggest PVRL
1-incomplete or partial response to steroid
2-atypical large vitreous cells which is white arranged like string of pearls or sheat like (aurora borealis effect)
3- subretinal/ sunRPE white lesion that is may be transient od shift the location with time
26
Uveal lypmphoma
more slow pattern
1/3 associated with systemic lymphoma
bridshot uveitis like retinopathy +/- ERD
thickening of uvea on B san
episcleral involvment>> salmon patch
27
AREDS2 supplements
Vit C 500mg, Vit E 400IU, Lutien 10mg, Zeaxanthin 2mg, zinc 80mg, cupper 2mg
DEC porgression up to **25%**, Dec moderate Vision loss (>3 lines) up to **19%** in 5 years
for**advanced AMD** in one eye: subfoveal GA or CNVM
for**intermediate AMD**:
* extensive intermediate drusen
* single large drusen
* nonfoveal GA
28
focal VMT
50% sponntaneously released
29
refsume disease
AR
elevated plasma phytanic acid
pigmentary retinopathy+ cerebellar ataxia+ hearing loss + icthyosis
nyctalopia early sign of the disease
restricted diatry intake of phytanic acid
30
HTN retinopathy severity
arteriolar narrowing , AV nikking
31
scheie classification of HTN retinopathy
0: no retinopathy
1:mild arterial narrowing
2:marked arterial narrowning
3: 2+ retinal Hgs and Exudate
4: 3+ optic nerve swelling
32
HTN choroidopathy
Young PT + acute increase in BP
ischemia of Choriocapillaris
elsching spot : hyperpigmented lesion surrounded by hypopigmented rim (late)
seigrist streaks: hyperpigmentation along choroidal vessels
FFA: early hypoF , multiple subretinal retinal leakage late +/- PED
SRD bilateral
33
toxo in pregnancy
for 4-6 weeks
spiramycin 400mg TID
intravitreal clindamycin + periocular short acting steroid
azithromycin / clindamycin /atovaquone
sulfonamide can be safely used in the first 2 trimester
34
finding in congenital toxo
bilateral macular chorioretinal scar
35
DX of toxoplasmosis
IgM>> indicate aquired disease
IgG>> if negative rule out the infection
ocular fluid for PCR or goldman whitmer coefficient
36
quadrable therapy
1. sulfadiazine
2. pyrimethamine
3. prednisolone
4. clindamycin
5. +folate (to prevent the anemia)
37
fundus albipunctatus gene
RDH5 in RPE
coding for cis retinol dehydrogenase
38
CMV retinitis
* CMV MC infectious congenital syndrome
* CMV MC oppurtenistic infection in immunosuppressed pt
* manifested as DOC and flaoters
* area of opacitfied necrotic retin along the vessels with Hgs and CWS or frosted branch angiitis
* usually if the CD4< 50 cells/ul
* treated with oral valgancyclovir (**induction 900mg BID for 2-3 weeks then maintainance 900mg once daily until the CD4 > 200 cells/ul)** OR
*systemic gancyclovir (**5mg/kg BID for 2 weeks or foscarnet 90mg/kg BID for 2 weeks)**
+/- IVI gancyclovir** (2mg /0.1 ml)** or foscarnet (**1.2-2.4 mg/0.1 ml)**
* complication 20% recovery inflammation leading to CME , ERM
* 50% can lead to RRD
39
MC cause of ARN or PORN
VZV>> HSV
ARN in both
PORN in immunocompromised Pt (more rapidly progressive)
syphilis work up and PCR for ( VZV,HSV,CMV,TOXO)
treatment systemic +/- IVI (foscarnet or gancyclovir)
1. acyclovir 10mg/kg TID for 10-14 days IV then oral 800mg 5X/day
2. oral valacyclovir 2g TID for 2-3 weels then 1g TID
3. prednisolone (optional) 0.5 mg/kg/day for 3-6 weeks
40
ERM
* avascular ,transparent, fibrocellular membrane adhere to ILM , result from proliferation of Glial cells (astrocyte and muller) , RPE and hyalocytes
* 20% above the age of 75y
* 10-20% bilateral
* PVD is a requisite for ERM development
41
causes of stationary Nyctalopia
1. CSNL
2. Fundus albipuncataus
3. oguchi disease
42
CSNB
* XL (MC), AD (Rare) and AR
* VA range 20/20-20/200
* associated with high myopia, nyctalopia, paradoxical pupillary reflex
* dark adaptometry reduced
* negative ERG (normal A wave and reduced B wave)
* XL CSNL devided into complete ( no Rod responce, NYX mutation) and incomplete (some Rod response , CACNA1F mutation)
43
Fundus albipunctatus
* RDH5>> 11-cis retinol dehyrogenase
* delay in rhodopsin regeneration>> the level normalize after hours in the dark
* yellow white dots in the midperiphery sparing the fovea
* ERG>undetactable rod responce that normalize after time in dark adaptation
* DDx: RP albescense (RLBP1)>>progressive , attenuated BV , ERG does not normalize
44
Oguchi disease
* Rare , MC in japanese
* the fundus normalize in the dark but after exposure to the light , peculiar iridescent sheen appears in the fundus **(mizo nakamura phenomena)**
* rhodopsin kinsae mutation in GRK1 or SAG mutation in arrestin protien
45
dyschromatopisa
congenital: stationary and bilateral (usually red green)
acquired:progressive / bi or uni (usually blue yellow)
deuteranomelous : decrease sensitivty to green
tritanomelous: decrease sensitivity to blue
protanomelous: decrease sensitivity to red
deutera/prota nomelous>> XLR
tritanomelous>>AD
Rod monochromatism (achromatopsia): AR
S cone monochromatism: XLR
monochromatism: associated with infantile nystagmus and poor vision ,photophobia, abnormal ERG ( only normal rod function)
46
CSCR
35-55
M:F 3:1
all from of steroid except ocular steroid
hyperopic shift
20/20 - 20/200
shedding of photoreceptor outer segment in subretinal space (shaggy photoreceptor)
20% associated with CNVM in age >55y
47
PVF
90% unilateral
MC sporadic
isolated
anterior: AS abnormality (cataract , AC shalloe, microcornea, long CB)
posterior: normal AS>> lensectomy + vitrectomy improve the vision by 70%
48
light injury to the eye 3
1- mechanical : yag laser
2-thermal : photocoagulation
3-photochemical: solar retinopathy , photic retinopathy (injury to the outer segment of PR)
49
Vit Hg in children
trauma
XL retinoschesis
Pars planitis
50
incontenintia pigmenti
XL
featal in males
manifested in female
streaky skin line
CNS and teeth abnormality
30-70% have ocular involvment: pigmentary retinopathy , peripheral nonperfusion , NV , TRD
51
shaken baby syndrome
1. retinal Hg and CWS
2. retinal folds
3. hemorrhagic schisis cavity
4. pigmentary maculopathy
52
risk of the fellow eye to have MH if the vitreous still attached to the retina
10%
53
pseudoxanthoma elasticum
AR
ABCC6 gene
angiod streak, peripheral round atrophic scar with comet sign, peau de orange rpe changes , ON drusen
systemic: skin changes (plucked chicken), atheroschlerosis of coronaries, CNS and GIT bleeding
54
FFA and ERG in OIS
delay choroidal filling 60%
prolonged AV transit time 95%
vessels staining 85%
ERG global depression in amplitude
20% bilateral
50% increase the risk of ICVD
40% mortality rate in 5 years
55
XLR
RS1 gene ( retinoschisin) muller cells
XL (male affected and female carrier)
macular retinal schesis (spoke like retinal fold)
recurrent Vit Hg , vitreous viel, metalic sheen
dec VA up to 20/200
negative ERG
peripheral retinoscheisis 50% and peripheral pirmentation
genetic testing is the definitive test
56
CWS Vs Purscher flecken
CWS: occlusion of precapillary arterioles>> indistinct margin whitenning of retina with complete or partially obsecure the retinal vessels
PF: occulsion to the deeper arteriols>> whitening with clear zone arround the arterioles and venules
57
pneumatic retinopexy success rate
usually subretinal fluid absorbtion done within 6-8 hrs
trans scleral cryo at the time of produre or laser retinopexy after retinal apposition
73% in PRP and 82% in scleral buckle, not significant
58
scleral buckle
best in young , phakic pt
PV still attached , complex detachment (multiple breaks)
detachment due to retinal dialysis
59
high IOP after scleral buckle RX
subretinal fluid drainage
AC paracentesis
60
scleral buckle with gas injection +/- darinage
chronic viscous SR fluid
fish mouthing of large retinal breaks
bollous RD
61
complication of Scleral buckle
induced myopia
anterior ocular ischemia
diplopia
ptosis
orbital cellulitis
RM disinsertion
subretinal Hg from drainage site or retinal incarceration
62
complex retinal detachment
PVR
VIT hG
recurrent RRD
GRT
63
temponade in complex RRD
SF6 inferior to C3F8 and silicone
silicone have lower risk of post op hypotony
64
prognosis of RRD Rx
80-90% reattachment
if PVR or previous detachment SX 70%
better prognosis with retinal dialysis , small break , demarcation line
worse prognosis with GRT , PVR, uveitis , choroidal detachment , post break due to trauma ,apahkia or pseudophakia
if macula on>> usually they restore the pro op VA
if macula off>> 1/3 -1/5 will have 20/50 or better
if macula off RRD repair done <1 week (75% will have 20/70 or better)
if macula OFF repair done < 8 weeks but > 10 days>> 50% will have VA of 20/27 or better
65
CNVM in pathological myopia
5-10 %
+/- laquer cracks or chorioretinal scar
usually need fewer IVI than CNVM related AMD
if regressed>>hyperpigmentation and atrophy (fuchs spots)
66
anti VEGF
5 types if VEGF (A-D+ PGF)
pegaptanib (mucagen): aptamer (RNA oligunucleotide ligand) bind to VEGF 165 only
ranibizumab : recombinent humenized antibody fragment bind to VEGF A
aflibercept: VEGF receptor decoy , bind to VEGF A and B and PGF
bavacizumab : full length monoclonal antibody , longer duration of life
brolucizumab : single chain antibody fragment , small molecules, cause more inflammation and retinal vascultitis
67
Sorbsy macula dystrophy
early drusen associated with CNVM in young
TIMP3 gene
68
DDx of young onset drusen
3 types:
1. large colloid drusen
2. malattia leventinese drusen
3. cuticular drusen ( basal laminar drusen)
DDx
familal drusen (extend beyond arcade and nasal to the ON )
malattia leventinese (honycomb macular dystrophy)
sorbsy macular dystrophy
atypical hemolytic uremic syndrome
membranoproliferative glumereolonephritis 2
alport syndrome
does not autofluoresence
69
pattern macular dystrophy
1. adult onset faveomacular vitilifrom D
2. butterfly maculr D
3. reticular macular D
4. multiform pattern macular D
5. fundus pulverulentus
70
CRAO
65% will have vision 20/400 or worse
20% will have vision 20/40 or better (cilioretinal)
1-2 % caused by GCA
referr ro stroke center for neuroimaging and controlling the Risk factors
+/- angio
increase the risk of IM in the first week
Rx
if presented within 4.5 hours and no systemic CI intravenous tpa
if presented within 6 hours and the pt is not candidate for intravenous >> intra arterial tpa through slective ipsilateral ophthalmic artery Cath
NVI 20% in CRAO from 1-12w (mean 4w)
71
FEVR
peripheral exudative leakage and retinal Hg , peripheral retinal avascularization , contraction of FV membrane leads to macular dragging , staightnening of BV ( brush bordr), ERD
mostly bilateral and AD
syndroms associated with FEVR:
* coat plus syndrome
* progressive hemifacial atrophy
* dyskeratosis congenita
* facioscapulohumeral mascular dystrophy
72
Eales Disease
primary occlusive retinopathy with unknown cause
middle age 20-40 , men
bilateral idiopathic peripheral nonperfusion and perivascultitis , NV , recurrent Vit Hg , TRD
associated with tuberculin hypersenstivity
both Aretery and vien affected
RX: PRP to the ischemic retina
73
delayed pattern reversal VEP
P100
Optic neuritits
macular dysfunction
74
types of VEP
flash VEP ( different between population , used to compare the stimulation of each hemisphere)
pattern reversal VEP ( consistent in time and waveform , different in amplitude between the population)
uses:
Optic neuritits
preverbal children
rule out organic VL
macular dysfunction
visual system resolution
crossing of NFL in albinism
75
DM Studies
1. UK prospective DM study :**DM type 2**
* tight glycemic and Bp control by diet/medications
* showed that tight control of BS and BP leads to slowed the progression of DM retinopathy and other microvascular complications
2. diabetic control and complication study : **DM type 1**
* tight control of BS in DM type 1
* effect on prevention of microvascular complications and reduced progression of microvascular complications
* prevent DM retinopathy by 75% , slowed the progression by 55%, reduced the neuropathy by 60%, nephropathy by 50%
3. ETDRS: **DME**
* effect of PRP (focal/ scatter) on ME and DM retinopathy progression
* focal PRP to DME leads to reduced the risk of moderate vision loss (doubling the initial VA) and increase the chance of moderate vision gain )halving the initial VA)
* scatter PRP there is small chance of reducing severe VL(<5/500), but not indicated in mild to moderate NPDR
* aspirin not effective in DM retinopathy but reduced CVS morbidity and mortality
4. DRS: **PDR/Severe NPDR**
* effect of PRP in PDR and severe NPDR
* reduced the risk of severe VL by 50% in 5 years
76
DM protocols
**B**:IV triamcinilone VS PRP (focal/grid) in DME>>laser more effective
**I**:Ranbizumab with initial or deffered focal PRP Vs IV triamcinilone with initial or deffered focal PRP Vs laser alone in DME>> Rani with deffer focal leser is the best
**S**: Rani with deffer PRP Vs Promt PRP in PDR>> Rani is not inferior tp PRP in treating PDR, however Rani after 5 years associated with less peripheral VFL and less DME and less DR requiring vitrectomy
**T**: comparing aflipercept Va RANI VS bevacizumab in DME>> aflipercet has better outcome when the initial VA is 20/50 or worse at 1 year however at 2 years all the IVI anti VEGF are equal
**U**: in resistent DME not responding to anti VEGF, adding intraocular dexa to the anti VEGF reduced the DME but only in the first 6 months
**V**: eye with central involving DME and good VA (20/25 or better)>> Eylea VS laser VS observation have the same VA after 2 years
**W**:pt with moderate to severe NPDR rando,ized to periodic Eylea injection VS sham injection>> the risk of PDR and DME lower in Eylea group in 2 years f/u however there is no Visiual benefit more than starting the aflibercept after having PDR or DME
**AB**: Vit Hg in PDR rando,ised to vitrectomy or Eylea injection>> no significant differance however vitrectomy result in faster visual recovery
**Q**: if pt has Hx of treated DME or noncentral involving DME >> increase the risk of developping central involving DME after cataract sx
77
familial amyloidosis
tranthyretin mutation
AD
ocular: vitreous opacity , glass wool like, CWS, retinal Hgs, peripheral NV, deposit in choroid, TM, retina Vessels
non ocular: upper nad lower peripheral neuropathy , CNS manifestation, deposition in skin , GIT, heart
RX: vitrectomy>> stainning with congo red, birefringies in polar light
DDx: chronic Vit Hg , lymphoma, sarcodiosis , whipple disease
78
choroideremia
XLR code for granylgranyl transferase of REP1
CHM gene
RPE and choriocapillaris atrophy starting in anterior retina and macula and then coelese to form scalloped area of atrophy , normal ON and BV
pt mainatin good central vision until foveal involvment
pt complainning of progressive VF loss and nyctalopia
ERG early subnormal>> extinguishable late
79
FAP
ABC gene
AD
colon polyps + skull osteoma, fibroma , epidermoid cyst, thyroid cancer
atypical or multiple CHRPE
ovoid , multiple , teardrop , halo tail, >4 lesions wildly spaced, bilataral, 4-5mm, midperiphery
bear track are not associated with FAP
80
cryptococcus
yeast infection
cryptococcus neoforman
fungal endopthalmitits in AIDS
yellow- white lesions in the fundus +/- vitirits , vascular sheahthing, SRD and granulomatous Anterior uveitis
+/- meningitits (papilledema, CNP)
indian ink stain from CSF
intravenous amphotericin B or oral flucytosine
81
photic retinopathy
after sx
pt complain from paracentral scotoma , metamorphopsia
fundus:deep irregular yellow white hypopigmented oval - round lesion at fovea
OCT: outer retinal cavitation
usually resolved after 3-6 months to 20/25 - 20/40
with somtimes remaining paracentral scotoma , metamorphopsia
82
BEST disease
AD
Best 1 gene on chromosome 11
yellow vitiliform foveal lesion in childhood
normal ERG but abnormal EOG arden ratio <1.5
30% peripheral vitiliform lesion
20% complicated with CNVM
ARB ( autosomal recessive bestrophinopathy)>> retinal dysfunction on full field ERG , diffuse RPE dysruption, progressive VA loss
83
DDx of vitiliform lesion
1. adult onset foveomacular vitiliform dystrophy
2. vitiliform exudative macular detachemtn ( basal laminar (cuticular) drusen
3. drusenoid RPE detachement ( soft drusen)
84
ciliopathy
**usher syndrome**: RP+ SNHL
**bardet biedl**: pigmentary RP+ bull's eye maculopathy + obesity + polydactly + mental retardation+ renal disease+ hypogonadism (AR)
**joubert syndrome**:retinal dystrophy + renal disease+ cerebellar malformation (molar tooth), hypotonia
**jeune syndrome**: retinal ciliopathy + asphyxating thoracic dystrophy + cystic renal disease
85
Usher syndrome
1. type 1: most severe , infantile onset , RP + profounf SNHL+ vestibular areflexia
2. type 2 : moderate to severe SNHL + normal vestibular system + RP in 2nd decade
3. type 3 : porgressive SNHL + RP of variable severity + sporadic vestibular function
AR in chromosome 16
86
west nile virus
* single stranded RNA virus
* birds ( primary resevior), humen infected by mosquito (culex)
* More severe encephalitis and meningitits in DM and advanced age
* flu like symptoms
* ocular manifestation: bilateral multifocal chorioretinal lesions arranged in curvilinear line along the NFL
* good prognosis unless macular involvment
87
Blood supply in retinal layer
NFL , GCL, Inner 2/3 of INL , IPL by CRA
OPL, ONL, PR, RPE, OUTER 1/3 of INL by choroid circulation
88
Mac Tel
muller cells abnormality
1. type 1 : unilateral , M>F, congenital or aquired, mainly in parafoveal area aneurysmal dilatation, in temporal retina , complicated by ME (exudation) (poorly responding to VEGF)
2. Type 2 : bilataeral parafoveal progressive neurodegenrative D 5th -7th decade, M=F , aquired, greyish discloratiion, loss of foveal reflex, crystaline deposite, right angled retinal vessels, MC type ,Oct showed caviatation in INL complicated by CNVM
3. type 3 : Rare, bilateral parafoveal tlengiectasia with vascular occulsion
89
DDx Of sporadic RP
diffuse uveitis
syphilis
CRAO
trauma
paraneoplastic syndrome
drug toxicity
90
PCV
variant of AMD>> multiple recurrent serosanguineous PED (fibrovascular)
muliple polyps associated with feeder vessels
MC in jabanese and african
female, HTN
+/- soft drusen
peripapillary area
associated more with vitreous Hg, pachychoroid
Rx better with combind therapy anti VEGF+PDT
better prognosis
91
common MC cause of post IVI endophthalimitis
Strept viridans (oral droplet)
92
metabolic disease and retina finding
Tay sachs and niemann Pick>> cherry red spot
hunter and hurler>> pigmentary retinopathy
gaucher>> white preretinal opacity
93
cantrast sensitivity test
pelli robson test
94
color vision tests
anolamoscope
ishihara plates
hardy rand rittler plates
farnsworth panel
95
dark adaptation test
goldman weekers adaptometer
96
scleral rapture in blunt trauma
360 hemorrhagic chemosis+ low IOP+ Hyphema
97
immediate vitrectomy in ROG
1. RD
2. IOFB
3. ENOPHTHALMITIS
should not be delayed more than 2 weeks>> PVR and worse prognosis
98
DUSN
diffuse unilateral subacute neuroretinitis
nematode (roundworm): ancylostoma caninum, balisascaris procyonis , toxocara
Acute: combination of vitiritis , papillitits multiple grey-while lesion of outer retina and choroid , S shape subretinal warm
Chronic: ON atrophy, retinal artery narrowing, RPE disruption, severe VL , resembling RP
Rx: laser to nematode +/- steroid
99
PRP complications
small spot size, high intensity>> perforate BV>>vit HG
short duration, small spot size, high power>> injury to bruch membrane>> CNVM
extensice PRP>> SRD
can leads to RPE tear
100
