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RETINA ANAMOLIES DX/WU/TX > RETINA - RETINOPATHIES ASSOCIATED W/ THIN RETINAS > Flashcards

RETINA - RETINOPATHIES ASSOCIATED W/ THIN RETINAS Flashcards

1
Q

what are 4 conditions associated with thin retinas?

A
  1. lattice degeneration
  2. snail track degeneration
  3. angiod streaks
  4. pathological myopia
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2
Q

what is lattice degeneration?

A

It is peripheral retinal thinning with overlying areas of liquefied vitreous - it has strong adherence between the vitreous and the border of the lesion which leads to traction.

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3
Q

what other condtion can appear similar to lattice degeneration?

A

snail track degeneration

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4
Q

what is snail track degeneration?

A

it is comprised of cystic lesions which lead to the separation of the neurosensory retina, but does NOT have a strong adherence to between the vitreous and the border of the lesion.

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5
Q

what are symptoms of lattice degeneration and snail track degeneration?

A

asymptomatic

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6
Q

signs of lattice degeneration?

A
  • long oval shape crack parallel to the ora serrata that occurs with dark crisscrossing areas.
  • usually located mid-peripheral superior temporal retina
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7
Q

signs of snail track degeneration?

A
  • long oval shape parallel to the ora that occurs with white crisscrossing areas.
  • usually located in the far periphery.
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8
Q

what ocular condition can lattice and snail track degeneration lead to?

A

retinal detachment

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9
Q

tx for lattice and snail track degeneration?

A
  • Edu pt on s/s of retinal detachment.
  • if asymptotic - monitor.
  • if symptomatic - can do cryoprexy or laser photocoagulation to prevent development of retinal holes or tear.
  • if RD - tx with surgery
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10
Q

what is angioid streaks?

A

Large breaks in Bruch’s membrane that results from damage to the elastic layer (maybe collagenous too) of Bruch’s membrane.

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11
Q

what are the systemic Dz associated with angioid streaks?

hint: PEPSI

A
  1. Pseduoxanthoma Elasticum
  2. Ehlers Danlos syndrome
  3. Paget’s Dz
  4. Sickle cell disease
  5. Idiopathic (50%)

Note: not associated with myopia!!

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12
Q

what is the main vision concerning sign of angioid streaks?

A

CNVM

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13
Q

symptoms of angioid streaks?

A
  • Asymptomatic OR
  • Profound vision loss from CNVM
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14
Q

signs of angioid streaks?

A
  • Spoke-like, linear, well-demarcated red/orange or brown lines in Bruch’s that appear around the optic disc.
  • Possible CNVM
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15
Q

tx for angioid streaks?

A
  • No tx, refer to r/o and tx underlying dz.
  • Rec polycarbonate safety glasses for sports due to increased risk of subretinal heme or choroidal rupture.
  • If CNVM - anti-vegf (SOC)
  • F/U – every 6 months (monitor for CNVM).
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16
Q

what is pathological myopia?

A

it is excessive, progressive elongation of the eye that is defined as myopia with a SE > -6.00D or axial length of >26mm

17
Q

pathological myopia is defined by what power and what axial length?

A
  • SE > -6.00D
  • axial length > 26mm
18
Q

does every one with high myopia have pathological myopia?

A

No, only those where myopia continues to progress and who present with pathological myopia signs.

19
Q

what are the risk factors for pathological myopia?

A
  • Genetics - increase risk by x1.5 if one parent is myopic & x3 higher if both.
  • Ethnicity - Asians
  • Gender - 2x F > M
  • Time outdoors - insufficient time outdoors.
  • Myopia onset - developing myopia at younger age.
  • Near work demands - closer WD & longer time periods of continuous near work (>45min).
20
Q

symptoms of pathological myopia?

A

decreased vision

21
Q

signs of pathological myopia?

A

Macular & posterior signs:
* Posterior staphyloma (hallmark).
* Tilted ONH.
* Lacquer cracks (“stretch marks” - fine, yellow irregular lines that represent breaks in Bruch’s membrane (in macula).
* Most serious macula outcome - Fuch’s spot.

Peripheral signs:
* Lattice degeneration
* Snail-tracking degeneration
* Pavingstone degeneration
* Retinal breaks - retinal detachment.

Non-retinal signs:
* Premature cataracts (NSC & PSC)
* PVD
* Axial length >26mm

22
Q

what is a posterior staphyloma?

A

stretching & thinning of the retina & sclera - bulges eye posterior

23
Q

what is pavinstone degeneration?

A

discrete, circular areas of yellow-white chorioretinal atrophy in the retina periphery.

24
Q

what is fuch’s spot?

A

it’s RPE hyperplasia overlying CNVM in the macula.

25
Q

tx for pathological myopia?

A
  • contact lenses preferred b/c it causes less image minification and prismatic effect.
  • if glasses - rec polycarbonate.
  • if CNVM - anti-vegf or laser (for extrafoveal or juxtafoveal)
  • If RT/RH/RD - treat with surgery
  • may benefit from low vision devices
  • F/U – every 6-12 months.
26
Q

What quadrant does lattice degeneration more commonly occur?

A

Temporal or superior retina

RETINA ANAMOLIES DX/WU/TX (11 decks)

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