Vitreous/Retina Flashcards Preview

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Flashcards in Vitreous/Retina Deck (12):
1

Central serous retinopathy
- most common?

- young male
- pregnancy
- oral steroids
- Cushing's syndrome
- stress
- hypochondriasis
- SLE
- organ transplant
- hypertension

2

Macular Photocoagulation Study Group discovered FOUR risk factors that increase progression to wet AMD. What is it?!

1. multiple soft drusen/confluent
2. focal hyperpigmentation
3. hypertension
4. smoking

3

Histoplasmosis

- caused by Histoplasma capsulatum, fungus grows in soil and contaminated with bat or bird droppings
- common in Ohio, Mississipi River Valley region

Characterized by: choroiditis and TRIAD:
1. peripapillary atrophy 2. multifocal chorioretinal lesion in periphery 3. maculopathy (including neovasc).

NO VITRITIS!

Usually asymptomatic unless macula involved, and if so it is metamorphopsia.

4

Lacquer Cracks

- fine yellow linear irregular lines that represent large breaks in Bruch's membrane
- may be early finding in pathological myopia
- 5% in high myopes


TIP: Angiod streaks usually come from ONH

5

Best's Disease

- diagnosed early childhood (5-10)
- autosomal dominant inherited condition
- bilateral, yellow, round, subfoveal macular lesion ("egg yolk")
- majority of patients are diagnosed with little or no symptoms (75% patients better than 20/40)

6

Stages of Best Disease?

Stage 1: pre-vitelliform: abnormal EOG, normal fundus.

Stage 2: vitelliform: egg-yolk lesion (occur between 3-15)

Stage 3: pseudohypopyon: entire lesion can become absorbed with little to no effect on vision.

Stage 4: vitelliruptive: egg-yolk breaks up and becomes a scrambled apparance; mild visual loss can be expected in this stage.

Stage 5: end-stage: characterized by moderate to severe vision loss as a result of choroidal neovasc, hemorrhage, atrophy and/or macular scarring

7

Adult foveomacular vitelliform dystrophy

- similar to Best's disease
- onset is 30-50
- overall prognosis is better, present with minimal metamorphopsia, mild visual acuity loss, normal EOG/normal ERG
- slight tritan defect

8

Stargardt's macular dystrophy

- most common hereditary macular dystrophy
- autosomal recessive
- onset typically first or second decade of life

Early stage:
- bilateral yellow flecks scattered in fish tail form
- RPE mottling of macula and loss of foveal reflex
- decreased vision often out of proportion with fundus appearance

Late stage:
- classic "beaten bronze" macular appearance/bull's eye
- salt and pepper pigmentary changes in periphery

9

CRVO Management

1. refer to OMD ti discuss anti-VEGF management
2. refer to GP for possible underlying condition

Treatment:
- PRP neovasc

10

Hypoperfusion retinopathy

- occlusion of the internal carotid artery
- chronic iscehmia: dilation, tortuoisity and calibre irregularity

Refer for GP to do carotid doppler

11

Resolution time of cotton wool spots

5-7 weeks

12

Where are hard exudates located?

Outer plexiform.

Macrophages remove lipid within edema to periphery. Long process so it is not a sign of acute.