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6 Cards in this Set
- Front
- Back
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Toxo |
Chorioretinal scar with edge of active vitreal inflammation Dx: Toxo DDx: Rubella, syphilis, TB, sarcoid Evaluation: Anterior exam, peripheral retina, FA/OCT. Can cause neuroretinitis If HIV patient perform CT scan for intracranial lesions Can do serum IgG for toxo Tx: Observation if outside the macula, Bactrim or trimethoprim pyramethamine with folate. Can start steroids after 3 days |
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POHS |
Peripapillary atrophy, punched out scars (histo spots), absence of vitritis Dx: POHS DDx: ARMD, high myopia, polypoidal, toxo, idiopathic CNVM, White dot syndromes Evaluation: Live in Ohio or MS river valley, history blurry vision, NO VITRITIS, FA/OCT Tx: Observation, amsler grid, PDT/anti-vegf, triamcinolone, submacular surgery, macular translocation |
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Wet ARMD |
Collection of lipofuscin leads to RPE degeneration and photoreceptor death, CNVM Dx: ARMD DDx: Stargardts, POHS, polypoidal, idiopathic CNVM, high myopia RFs: Smoking, age, FH, wet in other eye (10% per year), blue eyes, HTN, women) Evaluation: FA/OCT Tx: PDT, anti-vegf, amsler for the other eye, no smoking Indications for AREDS: 1. 1 large druse, >20 med druse (65-125 microns), 2. Wet ARMD in one eye |
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CRVO |
Hemorrhages in all four quadrants, possible discedema Dx: CRVO DDx: Hypertensive retinopathy, Terson's syndrome, Radiation retinopathy, DM Hx: HTN, DM, hyperlipidemia, connective tissue disease (lupus), multiple myeloma, migraines, glaucoma, oral contraceptives Evaluation: Conjunctiva for dilated conj vessels, gonio for blood in schlemm's canal, FA/OCT Workup: BP, glucose, lipids, ANA, RPR/FTA, SPEP, CBC FA shows delayed transit, leakage and blocking from hemorrhages Tx: Anti-vegf for edema, prp for NV |
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Neuroretinitis |
Discedema with a macular star Dx: Neuroretinitis DDx: Papillitis, optic neuritis, papilledema Possible etiologies: - HTN - Bartonella - Syphilis - TB - Sarcoid Hx: Cat scratch, new cat, immunosuppression
Prognosis: Generally vision resolves |
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Choroidal melanoma |
Elevated pigmented subretinal mass DDx: Nevus, melanocytoma, metastasis, ch hemangioma Hx: melanomas, prone-ness to sunburns, FH melanomas, prior eye exams Eval: Sclera feeder vessels, Iris and angle for NV or malignancies, cataract, vitritis, tumor size, height (>2-3 mm bad), proximity to ON (<3 mm bad), SRF, orange pigment, drusen (good), lack of halo (atrophied retina around nevi), ultrasound hollowness FA: Double circulation (circulation within tumor and also in retina, hypofluorescence
Workup: CXR, abd ultrasound, hepatic function tests Tx: Observation for small, TTT, plaque for medium, enuc for large |
