RPE

Question 1

What is the outermost layer of the retina

Answer 1

RPE

Question 2

What is the RPE a barrier between

Answer 2

Choroid and retina

Question 3

What needs to be done in order to assess the RPE

Answer 3

Eye needs to be dilated

Question 4

Where is the RPE present in the retina

Answer 4

Anywhere the retina is present, the RPE is present

Question 5

RPE at the optic nerve

Answer 5

No retina optic nerve, thus no RPE

Question 6

Light getting to the retina

Answer 6

Light must pass through all of the layers of the retina to reach the RPE

Question 7

Vitreed

Answer 7

Towards the vitreous

Question 8

Sclerad

Answer 8

Towards the sclera

Question 9

Outer

Answer 9

Away from center of the ye

Question 10

Inner

Answer 10

Towards center of eye

Question 11

What is the RPE rich with

Answer 11

Melanocytes

Question 12

What are the layers of the retina from inner to outer

Answer 12

Inner limiting membrane
Nerve fiber layer 
Ganglion cell layer 
Inner plexiform layer 
Inner nuclear layer 
Outer plexiform layer 
Outer nuclear layer 
Outer limiting membrane 
Layer of rods and cones 
Pigmented epithelium

Question 13

What is the peripheral retina continuous with

Answer 13

RPE continuous with PE of ciliary

Other nine layers are continuous with NPE of ciliary body

Question 14

How many layers to the RPE

Answer 14

One

Question 15

How many cells in the RPE

Answer 15

4-6 million, don’t regenerate

Question 16

Where is the RPE cell density the greatest

Answer 16

In the fovea

Question 17

How many photoreceptor outer segments does each RPE cell face

Answer 17

About 30-40

Question 18

What does the RPE do to the outer segment of the photoreceptors

Answer 18

Engulfs shed discs from photoreceptors on a daily basis

Question 19

When does the rod shed its discs that get engulfed

Answer 19

Morning

Question 20

When do the cones shed their disc that get engulfed

Answer 20

Night

Question 21

What does the apex of the RPE face

Answer 21

Apex of the photoreceptor outer segment

Question 22

What are the layer of bruchs membranes

Answer 22

RPE BM
Inner collagenous zone 
Elastic zone 
Outer collagenous layer 
BM of choriocapillaris

Question 23

What are some roles of the RPE

Answer 23

Secretion
Phagocytosis 
Visual cycle
Glia
Epithelial transport 
Light absorption

Question 24

What are the layers of the RPE

Answer 24

Outer zone
Middle zone
Inner zone

Question 25

What is in the outer zone of the RPE

Answer 25

Mitochondria

Question 26

What is in the middle layer of the RPE

Answer 26

Nucleus Golgi ER

Question 27

What is in the inner layer of RPE

Answer 27

Melanocytes

Question 28

Where is the degradation of rod outer segment

Answer 28

Lysosomal degradation in the RPE. Phagosome and lysosomes come together and form a secondary lysosome and digestions

Question 29

Metabolic waste deposited in inner collagenous zone of Bruch's membrane

Answer 29

Drusen

Question 30

Drusen and age

Answer 30

Normal with age | Excess is problem-RPE not functioning, smokers have mroe

Question 31

Familial dominant druses

Answer 31

Hereditary Nothing to do about it Usually no vision complaints

Question 32

ARMD

Answer 32

Build up of hydrophobic stuff in Bruch's membrane. Waste cant get out, nutrients cant get out. Cracks form in Bruch's, blood vessels form though cracks. They are fenestrated, so stuff leaks into RPE. Fluid, blood, protein. If in macula, obstrustus vision

Question 33

What is the difference between dry and wet AMD

Answer 33

Dry is just drusen Wet is blood vessels in macula

Question 34

Geographic atrophy

Answer 34

Dropout of of RPE, choroidal vessels show through

Question 35

What is treatment for wet AMD

Answer 35

Injectable anti vascular endothelial growth factor (anti-VEGF)

Question 36

What are 3 common VEGF inhibitors

Answer 36

Avastin Eylea Lucentis

Question 37

What is a cheap alternative to anti VEGF treatment

Answer 37

Avastin is used for colon cancer, but it is 50$ compared to $2000 and does the same thing

Question 38

Visual distortion causes by AMD

Answer 38

Metamorphopsia (blurred) | Scotoma (loss)

Question 39

What do we use to test AMD

Answer 39

Master grid

Question 40

How are RPEs and photoreceptors arranged

Answer 40

Apex to apex due to embryolongical development

Question 41

What fills the space between the RPE and PRs

Answer 41

Interphotoreceptor matrix

Question 42

What is interphotoreceptor matrix

Answer 42

Fills the space between RPE and PRs, very strong, but no junctions. Controls trackificing of nutrients

Question 43

Apical membrane specializations

Answer 43

Apical Na+/K+ ATPase pumps

Question 44

What do the apical Na+/K+ ATPase pumps do

Answer 44

Regulate fluxes to keep the sensory retina adhered to the RPE

Question 45

Lateral membrane specializetions of the RPE

Answer 45

Zonula occludens - tight junction - blood barriers

Question 46

What are all the different types of junctions in the lateral RPE membrane

Answer 46

``` Zonula occludens Zonula adherens Macular adherens Gap junction Focal adhesion Bruch's membrane ```

Question 47

These increase surface area for cell absoprtion and secretion

Answer 47

Basal enfoldings

Question 48

Blood retina barrier

Answer 48

- Tight junctions between the RPE cells ( zonula occludens) | - tight junctions between the non fenestrated endothelial cells of the retinal caps

Question 49

Function of the apical microvilli

Answer 49

Aids adhesion, phagocytosis, increased surface area for metabolic exchange

Question 50

Function of lysosomes

Answer 50

Contain hydrologic enzymes which digest photoreceptors

Question 51

Function of phagosomes

Answer 51

Contain phagocytosed photoreceptor segments

Question 52

Function of Golgi

Answer 52

Secretion and sulphation of GAGs

Question 53

Function of basal infoldings

Answer 53

Increases absorptive surface

Question 54

Retinitis pigmentosa

Answer 54

- Photoreceptors gone - RPE too close to second order neurons, so RPE migrate to inner retina and surround the blood vessels - occlude the ganglion cell blood vessels - rod receptor problem - tunnel vision

Question 55

Benign hypertrophy of RPE (bear tracking)

Answer 55

Hyper pigmentation of RPE | Normal ish

Question 56

Choroidal Nevis

Answer 56

Normal freckle thing

Question 57

Choroidal melanoma

Answer 57

Has thickness to it. Can see pigment forming. Immediate referreral

Question 58

Histoplasmosis

Answer 58

- fungal infection - peripapillary atrophy - central and peripheral