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Y2 Ophthalmology > Retina and Choroid > Flashcards

Retina and Choroid Flashcards

1
Q

What is retinal detachment

A

Detachment of the inner layer of the retina from retinal pigment epithelium

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2
Q

Types of causes of retinal detachment

A

Rhegmatogenous
Non-rhegmatogenous

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3
Q

What is the rhegmatogenous cause of retinal detachment

A

Caused by Retinal tear
Retinal tear -> vitreous humour pass through the tear to behind the retina and cause it to detach

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4
Q

What is the non-rhegmatogenous cause of retinal detachment

A

Detachment without any retinal tears

Tractional / exudative causes

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5
Q

What is tractional retinal detachment

A

Extensive growth of abnormal blood vessels in proliferative diabetic retinopathy
The blood vessels eventually becomes scar tissue
When the scar tissue contracts, it can pull the retina and cause it to detach

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6
Q

Tractional retinal detachment is most commonly seen in

A

Diabetic patients with proliferative diabetic retinopathy

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7
Q

What is the exudative cause of retinal detachment

A

Subretinal fluid accumulation without retinal tears

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8
Q

Which type of retinal detachment is more common

A

Rhegmatogenous

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9
Q

Risk factors of retinal detachment

A

Diabetes
Myopia
Increasing age
Previous surgery for cataracts
Eye trauma

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10
Q

Symptoms of retinal detachment

A

New onset floaters or flashes
Painless progressive visual loss
“curtain descending”
Central visual acuity can be reduced if macula is affected
RAPD

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11
Q

What are the fundoscope findings for retinal detachment

A

Retinal tear may be visible in rhegmatogenous
No retinal tear in non-rhegmatogenosu
Retinal folds may be pale / wrinkled/ opaque

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12
Q

management of retinal detachment

A

Urgent referral to ophthalmologist if new onset of floaters
Surgery to reattach retina

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13
Q

What is posterior vitreous detachment

A

Separation of vitreous membrane from the retina

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14
Q

Cause of posterior vitreous detachment

A

Increasing age -> degeneration of vitreous body
Highly myopic
Eye trauma

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15
Q

Why do myopic patients have higher risk of posterior vitreous detachment

A

Because myopic eye has longer axial length

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16
Q

What are the degenerative changes of vitreous fluid that causes posterior vitreous detachment

A

Vitreous fluid becomes less viscous hence does not hold its shape well
So pulls the membrane away from the retina

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17
Q

Symptoms of posterior vitreous detachment

A

New onset of floaters
Flashes of light in vision
Blurred vision

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18
Q

New onset of floaters + flashes are most commonly caused by

A

posterior vitreous detachment

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19
Q

If a patient with suspected posterior vitreous detachment describes a “curtain descending” what can this mean

A

This can mean that there is also retinal detachment

20
Q

Sign of posterior vitreous detachment

A

Weiss ring on ophthalmoscopy - due to detachment of vitreous membrane around optic nerve to form a ring shaped floater

21
Q

Management for posterior vitreous detachment

A

Urgent referral to ophthalmologist to examine
Most do not need treatment - resolves in 6 months

22
Q

Complication of posterior vitreous detachment

A

Retinal detachment

23
Q

What is vitreomacular traction

A

Incomplete posterior vitreous detachment with the persistent tractional pull on the macula

24
Q

Symptom of vitreomacular traction

A

Metamorphopsia - dysfunction that causes straight lines to appear warped, distorted or bent
Visual loss

25
Q

What is central serous chorioretinopathy

A

Dysfunction of retinal pigment epithelium causing fluid from choroid to leak into subretinal space

26
Q

Central serous chorioretinopathy most commonly affect

A

Men 30-50 years old

27
Q

Symptoms of central serous chorioretinopathy

A

Hyperopia
Metamorphopsia

28
Q

Investigations for central serous chorioretinopathy

A

Fundoscopy
Fluorescein angiography

29
Q

Fundoscope findings of central serous chorioretinopathy

A

Roundish detachment of central retina

30
Q

What is the most common cause of blindness

A

Age related macular degeneration

31
Q

Risk factors of age related macular degeneration

A

Females
Increasing age
Smoking
Family history
Hypertension
Diabetes
Dyslipidaemia

32
Q

Age related macular degeneration more commonly affects females / males

A

Females

33
Q

Types of ARMD

A

Dry macular degeneration
Wet macular degeneration

34
Q

Which type of ARMD is the most common

A

Dry macular degeneration

35
Q

What is dry ARMD

A

Deposition of drusen in Bruch’s membrane causing slow progressive atrophy of the RPE

36
Q

What is drusen

A

accumulation of proteins, lipids, and inflammatory mediators - yellow round spots

37
Q

Where is Bruch’s membrane

A

Between the RPE and choriocapillaries of choroid

38
Q

What is wet macular degeneration

A

Neovascularisation in choroid due to VEGF causing leakage of fluid and blood -> vision loss

39
Q

Symptom of wet ARMD

A

Rapid central visual loss
Metamorphopsis
Photopsia - Flashing lights
Deterioration in vision at night
fluctuations in visual disturbance vary from day to day

40
Q

Symptoms of dry ARMD

A

Progressive central visual loss
Central vision missing - scotoma
Photopsia
fluctuations in visual disturbance vary from day to day
Deterioration in vision at night

41
Q

Investigations for ARMD

A

Amsler grid testing
Fundoscopy
Slit lamp
Ocular coherence tomography (OCT)

42
Q

What is amsler grid testing used to

A

To check for distortion of line perception

43
Q

Fundoscope findings for dry ARMD

A

Drusen - yellow round spots
Areas of atrophy

44
Q

Fundoscope findings for wet ARMD

A

well demarcated red patches - intraretinal/subretinal fluid leakage or haemorrhage

45
Q

Why is OCT used for ARMD

A

visualise the retina in three dimensions because it can reveal areas of disease which aren’t visible using slit lamp microscopy

46
Q

Management of wet ARMD

A

Anti-VEGF

47
Q

Management of dry ARMD

A

No cure
Zinc with anti-oxidant vitamins A,C and E (for moderate and above dry ARMD)
Magnifier vision aids

Y2 Ophthalmology (8 decks)

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