633 -14 Assessment Of Peripheral Retina Abnormalities

Front 1

short ciliary nerves are found in the vertical meridian. How many could you expect to find in an eye?

Back 1

5-8

Front 2

what meridian do find long ciliary nerves in

Back 2

3 and 9

Front 3

retinal holes are always what color

Back 3

red

Front 4

you must DDx cystoid degeneration from what

Back 4

white w/o pressure

Front 5

what is the most common peripheral abnormality

Back 5

cystoid degeneration

Front 6

what is described as a tiny bubble next to the ora, beneath the vitreous base, thickened retinal tissue and is slightly opaque.

Back 6

cystoid degeneration.

Front 7

what quadrant of the retina is most commonly involved with cystoid degeneration

Back 7

superior temporal

Front 8

cystoid degeneration, is it bilateral or unilateral?

Back 8

bilateral and usually symmetrical

Front 9

cystoid degeneration is common at what age and is wide spread over the age of what?

Back 9

common at 8 yo
widespread over 40 yo

Front 10

what peripheral abnormality consists of cystoid spaces b/t retinal layers. (at the outer plexiform layer)

Back 10

cystoid degeneration

Front 11

cystiod degeneration is associated with RD or retinoschisis?

Back 11

retinoschisis
cystoid=schisis
cystiod=schisis
cystoid=schisis

Front 12

what is the difference b/t a RD and a retinoschisis

Back 12

RD is at the level of the RPE/receptors and is usually caused by fluid leaking in through a hole
retinoschisis - is at the level of the INL and is usually caused from an anatomical problem like a cyst.

Front 13

what is the treatment for cystoid degeneration?

Back 13

no Tx.
if there is a hole you should follow up in 3 months but there is very little chance that there will be a problem b/c there is a sticky substance in the hole that prevents the vitreous from getting in.

Front 14

true or false, white with pressure is the same thing as white w/o pressure and you do not need to distinguish b/t them

Back 14

true

Front 15

white with pressure and white w/o pressure are usually perpendicular to the ora or parallel?

Back 15

parallel

Front 16

is white with pressure and white w/o pressure elevated or not

Back 16

no

Front 17

you see an area of white/opalescent coloring parallel to the ora that is not raised and has irregular yet sharp edges. what is it?

Back 17

white with pressure or white w/o pressure

Front 18

white with pressure and white w/o pressure are commonly mis diagnosed as what?

Back 18

a RD

Front 19

white with pressure and white w/o pressure are seen in 32% of eyes. Is it more common to see them in light colored eyes or dark?

Back 19

dark

Front 20

true or false, white with pressure and white w/o pressure can extend form the ora to the posterior pole.

Back 20

true - but remember it typically runs parallel to the ora

Front 21

what is the reason that white with pressure and white w/o pressure is thought to be transient?

Back 21

it is thought that it changes b/c of the change in the orientation that the vitreous pulls on the retina

Front 22

white with pressure and white w/o pressure is likely due to what?

Back 22

traction on the retina from the vitreous

Front 23

clinically there is no management for white with pressure and white w/o pressure unless what is pressent?

Back 23

vitreous degeneration, rearby lattice degeneration, or hx of large retinal tear in the other eye

Front 24

what portion of the eye are you really seeing in a paving stone

Back 24

the sclera, so it looks yellow/white in appearance

Front 25

you see some yellow/white, round lesions that have distinct margins b/t the ora and the equator in the inferotemporal quadrant what is it

Back 25

paving stone degeneration

Front 26

what layers are affected in paving stone degeneration

Back 26

the outer retina. really the choriocapilaris is lost first the RPE and then finally the outer layers of the retina are thinned out.

Front 27

how do you DDx paving stone degeneration from histo

Back 27

the edges are different. histo looks like and eraser edge and paving stone looks like a cookie cutter

Front 28

what is it called when you see pigment clumping on the blood vessels

Back 28

reticular senile pigmentary degeneration

Front 29

reticular senile pigmentary degeneration is usually bilateral or unilateral

Back 29

bilateral

Front 30

you see a net like appearance of pigment clumping near the equator. how do you DDx b/t RP and reticular senile pigmentary degeneration

Back 30

if you have previous pics - RP would expand from the equator towards the posterior pole and reticular senile pigmentary degeneration expands form equator towards the ora. You could also ask about night blindness

Front 31

vitreoretinal tufts could possibly be surrounded by what degeneration

Back 31

cystoid degeneration

Front 32

you see discrete white to gray irregular clumps on the nasal retinal surface that are elevated and granular appearing. what could it be

Back 32

vitreoretinal tufts. (granular tags)

Front 33

what makes vitreoretinal tufts a significant concern

Back 33

the fact that there is traction on the retina from the vitreous. this increases the chance for a retinal break

Front 34

if a hole is present with a vitreoretinal tuft when should the pt RTC

Back 34

q3 months and then q6 months if stable

Front 35

what is a vitreoretinal tuft

Back 35

small masses of cells of degenerated retina or proliferated glial cells. although they are elevated there is still traction on them from the vitreous

Front 36

what are the three risks that you should look for in a vitreoretinal tuft

Back 36

flashes/floaters
pigment in vitreous
RD in fellow eye

Front 37

in general how large in DD can a meridional fold get?

Back 37

up to 4DD

Front 38

are meridional folds more commonly aligned with processes or perpendicular

Back 38

aligned

Front 39

how common is it to see a meridional fold?

Back 39

20 to 26% of people will have it

Front 40

in general there is a 20 to 26% chance of having a meridional fold. who has a greater chance of having it men or women

Back 40

men

Front 41

if you spot a meridional fold (usually in the superior temporal retina) that is covering both the process and the bay what is it called?

Back 41

meridional complex

Front 42

you spot a white lesion in the superior temporal retina that is 4DD long and aligned with a process in a male. what could it be?

Back 42

meridional folds ( I suppose you could argue others)

Front 43

what is a meridional fold?

Back 43

radially oriented folds of redundant retinal tissue

Front 44

true or false meridional folds are congenital

Back 44

true

Front 45

holes are common in meridional folds and even more common in meridional complexes. this said is it more common to see the hole anterior or posterior to the fold?

Back 45

posterior

Front 46

what procedure could you do to help you see if there is a hole associated with a meridional fold

Back 46

scleral depression

Front 47

if you see a meridional fold (probably in the sup. nas. quad) with a hole and a tag when should you follow up and what are you looking for

Back 47

q 3 months and you need to watch for a RD

Front 48

what three risks should increase your willingness to treat a meridional fold and what is the preferred treatment?

Back 48

flashes/floaters
pigment in vitreous
previous RD in the other eye
cryoplexy is preferred tx

Front 49

true or false the classic presentation of lattice degeneration is most commonly seen? (as opposed to a form that is not lattice looking)

Back 49

false the classic appearance of criss cross pattern of white lines is only seen in 6-9% of cases

Front 50

what as occurred on a meridional fold if you see hyperplasia on the lesion

Back 50

this means that there has been traction on it before

Front 51

what is the max size of lattice degeneration? LxW

Back 51

length up to one quadrant
width up to 2/3DD

Front 52

what significant finding could you see on the boarder of lattice degeneration?

Back 52

a pigmented boarder

Front 53

what type of lattice degeneration is more concerning the ones located b/t 5 and 7 or the ones that are near the equator following a blood vessel and why?

Back 53

the ones following a blood vessel b/c there is a better chance that it could cause a RD

Front 54

what are the lines created from in lattice degeneration

Back 54

they are thickened walls of blood vessels from inflammation - blood is still flowing

Front 55

what degeneration is associated with a vitreous tent that consists of strong vitreal adhesion's on the edges, liquefied vitreous in the middle and degenerated inner retina?

Back 55

lattice degeneration - you may also see some hyper pigmentation

Front 56

what form of lattice degeneration is is more concerning for a RD. Radial or a lesion that is running parallel to the ora/equator

Back 56

radial

Front 57

overlying vitreous liquefaction, fine white specks in the lesion, RD, and a partial thickness or full thickness hole are all significant findings/risks for what degeneration

Back 57

lattice - remember the vitreal tent

Front 58

true or false an atrophic hole is commonly associated with a RD

Back 58

false an atrophic hole is seldom associated with a RD

Front 59

when a horse shoe tear is seen you can tell where the ON is b/c in general the horse runs away from or towards the ON?

Back 59

the horse runs towards the ON

Front 60

true or false it is quite possible to see lattice on the flap of a horse shoe tear

Back 60

true

Front 61

often what is the cause of a retinal horseshoe tear

Back 61

trauma

Front 62

what is more likely to cause a RD, a horseshoe tear or a hole

Back 62

horse shoe tear b/c the vitreous is still connected to the flap

Front 63

what is it called when there is a piece of the retina that has "completely" torn off and still floating above the hole

Back 63

operculated tears. (same name as a macular hole)

Front 64

you notice a some type of hole in a patients eye. what is the best way to tell if it is a horse shoe tear or an operculum?

Back 64

do indentation and look for a point of attachment

Front 65

during a RD the RPE will under go hyperplasia. why?

Back 65

b/c of the tugging of the flap. It will appear as a dark pigmented line. (think of a persons angry red face b/c someone is pulling on them)

Front 66

when are you most likely to see shafers sign. With rhegmatogenous or nonrhegmatogenous?

Back 66

rhegmatogenous because there is a break in the retina

Front 67

In both rhegmatogenous and nonrhegmatogenous there is fluid accumulation under the retina.
what then is the difference

Back 67

rheg has a break in the retina and nonrheg does not have a break it is usually due to traction.

Front 68

list some of the treatments for a retinal detachment

Back 68

cryotherapy/laser photocoagulation, scleral buckle, aspiration of subretinal fluid, pheumatic retinopexy(gas bubble), primary vitrectomy, silicone oil.

Front 69

there is a test you can perform with your BIO and a drpressor that involves a shadow. describe the test and what problems you are using for.

Back 69

you place your depressor b/t your BIO and the lens to cast a shadow on the retina. You are DDx retinoschisis from a RD. If the pt can see the shadow when it is over the lesion then it is a RD, and if they cannot see it then it is retinoschisis

Front 70

will retinoschisis blanch with depression or not

Back 70

yes

Front 71

can you see choroidal detail with retinochisis or not? How about with a RD?

Back 71

yes with retinoschisis but not with a RD.

Front 72

what retinal problem could you see a honeycomb appearance with?

Back 72

retinoschisis

Front 73

the chance of retinoschisis increases wtih age and myopia or hyperopia?

Back 73

hyperopia

Front 74

who is more likely to have retinoschisis males or females

Back 74

females with small hyperopic eyes.

Front 75

what layers is the splitting occurring in retinoschisis

Back 75

b/t the IPL and the ONL

Front 76

holes are a possibility with retinoschisis. in what location could they contribute to a RD

Back 76

when they are located in both the outer and the inner layers of the retinoschisis. otherwise there is a very low probability of a RD

Front 77

when would you refer a retinoschisis patient for laser therapy

Back 77

if the macula is in danger

Front 78

what is the follow up for retinoschisis

Back 78

q 6 months if the lesion is with in 25 deg from the temporal arcades otherwise q year

Front 79

a patient with recent trauma has a vitreous base that appears like a white floating strip. what is this called?

Back 79

avulsed vitreous base

Front 80

Securities that are EXEMPT from registration requirements in the State, as well as from advertising filing requirements:

Back 80

Government and Municipal issuers.
Issuers already regulated under other laws (e.g. banks, savings and loans, insurance companies)
Non profit institutions
exchange listed securities

Front 81

what quad is an avulsed vitreous base usually located in

Back 81

the superior nasal - think gravity

Front 82

what other significant findings could you see with avulsed vitreous base

Back 82

vitreous hemorrhages, retinal tear or retinal detachments

Front 83

what is the treatment for an avulsed vitreous base

Back 83

none unless there is a retinal tear or retinal detachment then treat the tear or detachment

Front 84

white glistening drusen like structures on the pars plana are called what (possibly)

Back 84

oral pearls

Front 85

raised clear leasion on the pars plana .25 to 3 DD in size are known as what

Back 85

pars plana cysts

Front 86

pars plana cysts is a seperation of what layers

Back 86

pigmented and non pigmented layers

Front 87

a person with a history of RD and posterior uveitis has a higher probability of having what type of a problem with the pars plana

Back 87

pars plana cysts