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Y. Post Seg 2 > White Dot Syndrome 2 > Flashcards

White Dot Syndrome 2 Flashcards

(63 cards)

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1
Q

PIS BAMA

A

Punctate Inner Chorioretinopathy
Idiopathic Multifocal Choroiditis
Serpiginous Chorioretinopathy
Birdshot Chorioretinopathy
Acute Zonular Occult Outer Retinopathy
Multiple Evanescent WDS
Acute Posterior Multifocal Placoid Pigment Epitheliopathy

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2
Q

Which WDS has the acronym PIC?

A

Punctate Inner Chorioretinopathy

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3
Q

Which WDS has the acronym IMFC?

A

Idiopathic Mulifocal Choroiditis

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4
Q

Which WDS has the acronym AZOOR?

A

Acute Zonular Occult Outer Retinopathy

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5
Q

Which WDS has the acronym MEWDS?

A

Multiple Evanescent White Dot Syndrome

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6
Q

Which WDS has the acronym APMPPE?

A

Acute Posterior Multifocal Placoid Pigment Epitheliopathy

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7
Q

Which two WDSs appear similar to POHS?

A

MCP (aka IMFC) and PIC

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8
Q

Which two WDSs are most prevalent in older (middle-aged) patients?

A

Birdshot and Serpiginous

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9
Q

Birdshot lesions are predominantly located ______ (superior, inferior, nasal, or temporal) to the ONH

A

Nasal

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10
Q

Serpiginous lesions normally appear in the ________ region of the retina with _______ spread.

A

Peripapillary region of the retina with centrifugal spread

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11
Q

Which two WDSs present unilaterally?

A

MEWDS and AZOOR (remember: both contain the “U” sound for unilateral)

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12
Q

Unilateral WDSs can result in what clinical finding?

A

RAPD

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13
Q

Which of the two WDSs that typically present as unilateral eventually end up bilateral?

A

AZOOR

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14
Q

MEWDS is most easily visualized during which diagnostic test?

A

FA

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15
Q

AZOOR is most easily visualized during which diagnostic test?

A

FAF

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16
Q

MEWDS is most often found in which part of the retina?

A

Perifoveal

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17
Q

A lesion in MEWDS is shaped like ______

A

A wreath

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18
Q

Which WDS is likely to be “unrevealing” under DFE?

A

AZOOR

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19
Q

AZOOR is most often found in which part of the retina?

A

Peripapillary

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20
Q

What does “serpiginous” mean and how does it relate to the clinical signs of Serpiginous Choroidopathy?

A

“Snake-like”; refers to the centrifugal spread that appear like a slithering snake

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21
Q

Which two WDSs have the largest lesions?

A

APMPPE and Serpiginous

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22
Q

Which WDSs affect males and females equally?

A

APMPPE, Serpiginous,and Relentless Placoid Chorioretinitis

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23
Q

Most WDSs predominantly affect _______ (females/males)?

A

Females

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24
Q

Which two WDSs specifically affect young myopic females?

A

PIC and AZOOR

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25
Which three WDSs have the worst prognoses?
Serpiginous, Birdshot, and MCP (aka IMFC)
26
What is an appropriate treatment for the WDSs with the least amount of risk for vision loss?
Steroids
27
What is an appropriate treatment for the WDSs with higher risk of vision loss?
Steroids + Immunomodulatory Therapy (IMT)
28
What is the "ultimate/long-term management goal for all forms of uveitis?"
No inflammation on no steroids
29
Which two WDSs always presents with vitreous cells?
Birdshot and MCP (aka IMFC)
30
Which WDS has a strong association with a specific Human Leukocyte Antigen (HLA) and which one is it?
Birdshot; associated with HLA—A29
31
True/False: it is possible to test positive for the HLA protein (that has a strong association with a particular WDS) and not have the WDS
TRUE; 7% of the general population are (+) HLA-A29 and will not develop birdshot
32
Which WDS is associated with cerebral vasculitis?
APMPPE
33
True/False: due to the nature of APMPPE, headaches may indicate a sight-threatening complication and requires an urgent MRI.
FALSE; headaches are common in APMPPE due to its viral prodrome nature and does not require urgent medical attention
34
What APMPPE finding requires urgent medical attention and what intervention is indicated?
A peripheral neuro deficit; requires urgent MRI of brain and treatment with systemic steroids
35
Which two WDSs are associated with viral prodrome?
APMPPE and MEWDS
36
Which 4 WDSs are recurrent?
Birdshot, Serpiginous, IMFC, and Relentless Placoid Chorioretinitis
37
What is the classic FA pattern of APMPPE?
Blocks early, stains late (initially hypofluorescent behind the lesions, and in later stages, absorb the fluorescein and become hyperfluorescent)
38
What other WDSs show similar FA patterns to APMPPE?
MCP (aka IMFC) and Serpiginous
39
What infectious pathology shows a similar FA pattern to APMPPE?
Syphilis, Tuberculosis, and Sarcoidosis (should always be DDx for uveitis)
40
When syphilis causes uveitic lesions, it is referred to as…
Acute Syphilitic Posterior Placoid Chorioretinopathy (ASPPC)
41
What is one way to differentiate APMPPE and ASPPC?
ASPPC patients will typically be immunocompromised (APMPPE patients will not)
42
Patients with Birdshot are at particular risk for what vision-threatening complication? What does the presence of this complication indicate?
Cystoid Macular Edema, which indicates an active lesion
43
3 Signs of Active Birdshot
Cystoid Macular Edema, ONH inflammation, and retinal vasculitis (usually phlebitis)
44
True/False: If a Birdshot patient presents with none of the signs of active lesion, it is not likely to progress and the management plan is to monitor.
FALSE; Birdshot can be insidious (even if seemingly dormant)
45
What diagnostic tests should be routinely performed for Birdshot patients?
Full-field ERG and HVF 30-2
46
What is the most classic symptom of AZOOR?
Photopsia
47
What visual field defect would you expect in an AZOOR patient?
It's highly variable but typically connected to blind spot
48
What is the classic VF defect with MEWDS?
Enlarged blind spot
49
What sign is pathognomonic for MEWDS?
Granular pigment changes after resolution of white dots
50
Most common cause of vision loss in MCP (IMFC) patients?
Choroidal neovascularization
51
What infectious pathology has a similar appearance to Serpiginous? This is referred to as…
Tuberculosis; referred to as Serpiginous-like Choroiditis (SLC)
52
What population is particular vulnerable to SLC?
Asians :/
53
In what ways is Relentless Placoid Choroiditis similar to APMPPE?
Multifocal/numeros lesions located throughout posterior pole and near periphery
54
In what ways is Relentless Placoid Choroiditis similar to Serpiginous?
Recurrent nature and leaves pigmented areas of chorioretinal scarring/atrophy
55
In what ways is Relentless Placoid Choroiditis NOT like Serpiginous?
Even though they are both recurrent, with RPC, the lesions recur in new areas, whereas Serpiginous recurs at the edge of previous lesions
56
When suspecting WDS, what 4 infectious etiologies should always be considered?
Syphilis, Tuberculosis, Sarcoidosis, and Diffuse Unilateral Subacute Neuroretinitis (DUSN)
57
What pathogen is responsible for DUSN? What are the most common types?
Nematode (aka Roundworm); Baylisacaris (most common of all), Anclyostoma, and Toxocara
58
True/False: a single pathogen can illicit a DUSN response
TRUE; infectious load is 1 single roundworm
59
Who is most likely affected by DUSN?
Healthy adolescent/young adult
60
How will the patient present in the Acute Stage of DUSN?
Decreased VA and pain with vitritis, disc edema, and multiple lesions (but the signs/symptoms come and go)
61
How will the patient present in the Late Stage of DUSN?
Poor VA, Depigmented RPE, disc pallor/atrophy, and attenuated retinal vessels
62
True/False: once DUSN reaches late stage, it's untreatable
TRUE; this highlights the importance of properly diagnosing at the acute stage
63
How do you treat DUSN?
Locate the worm and laser it

Y. Post Seg 2 (13 decks)

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