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Ophthalmology > Retina > Flashcards

Retina Flashcards

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1
Q

What can you see on a fundic examination?

A
  • Direct visualization of retinal blood vessels (often in pairs)
  • Optic nerve (CNS)
  • Vitreous (transparent gel-like body between the lens and retina)
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2
Q

Vitreal floaters appearance

A
  • Can’t see the fundus
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3
Q

Clinical relevance of vitreal degeneration or asteroid hyalosis

A
  • Interfere with vision and viewing the fundus

- Otherwise it’s a pretty normal age related change

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4
Q

Another name for vitreal degeneration

A
  • Ateroid hyalosis
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5
Q

Characteristics of dog fundic vessels

A
  • Holangiotic fundus
  • Retinal vessels arcuate over the optic nerve
  • Optic nerve is myelinated and varies in shape
  • Color related to coat color
  • May or may not have tapetum
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6
Q

Is tapetum usually in the superior or inferior fundus?

A
  • Superior
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7
Q

Characteristics of cat fundus?

A
  • Holangiotic fundus
  • Large yellow-green tapetal area
  • Optic nerve in the tapetal area
  • Vessels arise from edge of optic nerve
  • Non-myelinated optic nerve (appears small, round, and dark)
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8
Q

Equine fundus appearance

A
  • Paurangiotic
  • Retinal capillaries extend a few millimeters from the edge of optic nerve
  • Optic nerve is elliptical and in pigmented area
  • Variable colors of tapetum and pigmented areas by coat color
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9
Q

Rabbit fundus appearance

A
  • horizontal optic nerve

- merangiotic (vesels in a certain region)

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10
Q

Bird eyes

A
  • Pectin

- PIgmented vascular supply overlying the optic nerve

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11
Q

Bovine fundus

A
  • Vessels in front of the retina
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12
Q

Do camelids or pigs have a tapetum?

A
  • No
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13
Q

What is the tapetum?

A
  • Reflective layer in choroid
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14
Q

Where is tapetum relative to the retina?

A
  • Deep
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15
Q

Function of tapetum

A
  • Reflects light back to the photoreceptor cells
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16
Q

Pigment in retinal pigmented epithelium over tapetal area

A
  • Does not exist

- Allowing light through

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17
Q

Tapetal area and size of dog

A
  • Smaller dogs have a smaller tapetal area

- Length of coat related to line of demarcation

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18
Q

Where does retinal detachment occur?

A
  • Between the photoreceptors and retinal pigmented epithelium
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19
Q

How many layers of the retina?

A
  • 10 layers

- see diagram in the notes

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20
Q

Which layer of the retina is impacted by glaucoma?

A
  • Nerve fiber layerayer of the retina?
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21
Q

Where is the nerve fiber layer of the retina in relation to the rest of it?

A
  • Innermost layer
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22
Q

What comprises the nerve fiber layer of the retina?

A
  • Ganglion cell axons

- These axons then extend to the optic disc and form the optic nerve

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23
Q

Blood supply to nerve fiber layer of the retina

A
  • Has retinal vessels
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24
Q

How does glaucoma impact the nerve fiber layer of the retina?

A
  • It causes pressure damage
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25
Photoreceptor layer
- Contains the rods and cones
26
Rods - what for?
- Night vision
27
Cones - what for?
- Day vision, color, and acuity
28
Which cell type (rods or cones) is predominant in 1.) domestic animals and 2.) birds/reptiles?
1. ) Domestic animals: rods | 2. ) Birds/reptiles: cones
29
Which diseases will impact the photoreceptor layer
- Anything causing retinal detachment - PRA - SARDS
30
Causes of retinal disorders
- Hereditary or acquired as result of toxin, virus, nutrition, trauma, septicemia, others - Congenital disorders present at birth - Degenerative disorders
31
Which antiparasitic is most commonly implicated for retinal disorders in herding breeds?
- Ivermectin
32
What are some of the more common causes of retinal disease in dogs?
- Infectious diseases | - Not as much trauma
33
Collie eye anomaly 4 parts
- Choroidal hypoplasia - Optic nerve coloboma - Retinal detachment - Hemorrhage
34
Coloboma
- Hole | - E.g. optic nerve coloboma is a hole in the optic nerve
35
Inheritance of collie eye anomaly
- Hereditary
36
Clinical significance of collie eye anomaly
- Might not affect vision, but could - Hereditary - VIRTUALLY ALL COLLIES HAVE THIS
37
When does retinal dysplasia or dystrophy occur?
- At birth | - Occurs during retinal development
38
Who gets retinal dysplasia or dystrophy?
- Springer spaniel | - Likely not clinically significant but does affect if you should breed or not
39
Appearance of retinal dysplasia or dystrophy
- Geographic retinal dysplasia (weird line on the retina) | - Retinal folds (little spots
40
Two categories of diseases causing retinal degeneration
- Hereditary | - Acquired
41
What clinical sign can help you distinguish hereditary vs acquired causes of retinal degeneration?
- Bilateral = hereditary - Asymmetrical/unilateral = acquired (more often) IN GENERAL
42
Major cause of hereditary retinal degeneration
- PRA or progressive retinal atrophy
43
Who gets hereditary retinal degeneration?
- Many breeds and types | - Age of onset varies by breed
44
Acquired causes of retinal degeneration
- Toxins - Trauma - Nutritional - Glaucoma - SARDS (immune mediated)
45
What does SARDS stand for?
- Sudden acquired retinal degeneration syndrome
46
Who gets SARDS?
- Dachshunds and Brittany Spaniels
47
Progressive retinal atrophy - does the retina develop normally?
- Yes, and begins to degenerate after developing normally
48
Clinical signs of PRA
- Lose rods first (night vision) - Dilated pupils as it progresses - Bright and shiny fundus - Blindness as retina thins - Cataracts develop later in the disease
49
Course of disease for PRA?
- Progressive | - Once retina degenerates they develop cataracts --> LIU --> glaucoma or luxation --> enucleation
50
Treatment for PRA
- Not super treatable | - Can supplement with Ocuglow (fatty acids, omega 3s , and high levels of vitamin A)
51
Appearance of fundus in a dog with PRA
- Vascular attenuation - Hyper-reflection - Usually very dilated pupils
52
What is OFA?
- Eye registration certification | - Companion Animal Eye Regsitry
53
What is optigen?
- Genetic testing for inherited eye diseases in dogs
54
Appearance of retinal scarring?
- Can be incidental - Looks like little spots on the retina - Often well delineated - Should make a note - In a horse this is more concerning
55
Can you localize blindness by PLRs?
- No
56
SARDS clinical signs
- Sudden onset blindness or progressive over a few weeks | - Pupils are dilated and slow to respond or non-responsive
57
Signalment of SARDS
- Middle-aged (female more common) - Dachshund, Schnauzer, Birtany Spaniel - History of weight gain, PU/PD/PP 50% of cases - Blood work may suggest adrenal disease
58
Diagnosis of SARDS
- High degree of suspicion based on exam (acutely blind with normal appearing eyes) - ERG - Fundic exam
59
Fundic exam with SARDS: Early vs Late onset
- Early onset it appears normal | - Late you'll see hyperreflectivity
60
ERG with SARDS
- Flat line
61
How can you differentiate optic neuritis from SARDS based on ERG?
- ERG is normal with optic neuritis
62
Treatment for SARDS
- No effective treatment currently | - May give steroids and doxycycline in some cases
63
Major dfdx for a dog with dilated pupils, slow to respond, and sudden onset blindness
- Neoplasia - Optic neuritis - SARDS
64
Optic neuritis clinical signs
- Acute blindness - Dilated pupils - Slow to no response
65
Appearance of optic nerve with optic neuritis
- May appear hyperemic, fuzzy, raised, or it may appear normal if lesion is extraocular
66
How can you distinguish optic neuritis from SARDS?
- ERG
67
Do you need an ERG if the fundus looks abnormal?
- No - Something is wrong at the level of the fundus - Only need an ERG to differentiate SARDS from optic neuritis
68
What causes retinal detachment?
- Fluid or exudate from choroidal vessels accummulates between photoreceptors and RPE and elevates the retina, causing acute blindness
69
Where is the retina attached?
- To the optic nerve | - Also right behind the iris
70
Causes of retinal detachment?
- Hypertension - Trauma - Lens luxation - Systemic disease (chorioretinitis, neoplasia, infectious disease, immune-mediated disease, idiopathic)
71
Appearance of retinal detachment on exam?
- Ribbon of undulation - Retina looks like a tongue coming at you - Retina is floating up
72
Treatment and prognosis of retinal detachment
- If you treat the primary cause immediately, you may restore vision within a few weeks
73
Detached retina example with light source only
- look at the piecture because i found it confusing
74
Diagnostics for retinal detachment
- Normal PE & blood work - Negative titers (tick, fungal, toxo, lepto) - Brucella, Bartonella - Chest films - Respond to prednisone - Can take out the eye and do histopath if it's gone already
75
FIP granuloma appearance
- Look at the nice pictures
76
Retinal detachment appearance on ultrasound
- You can see it
77
Giant retinal tear and disinsertion - who gets?
- Common presentation for young Shi Tzu dogs with acute blindness
78
Treatment for a giant retinal tear
- Surgical reattachment to restore vision - Hole develops so the retina detaches superiorly - You can no longer see the optic nerve because retina has come loose - Make sure you can differentiate from billowing detachment
79
Most common causes of feline hypertensive retinopathy?
- NOT SARDS!!!! | - Infectious diseases and tumors
80
At what BP do cats get retinal detachment?
230 mmHg - MEASURE BP IN ACUTELY BLIND CATS
81
Causes of feline hypertensive retinopathy
- Hyperthyroid - Renal failure - Primary?
82
Treatment of hypertensive retinal detachment
- Amlodipine - Treat underlying disease based on lab work - CBC/Chem/UA - T4 - Chest rads and ultrasound
83
When do you want to recheck BP after starting a hypertensive cat on amlodipine?
- The next day

Ophthalmology (8 decks)

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