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274 Cards in this Set
- Front
- Back
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What is the leading cause of blindness in the elderly in the US?
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ARMD
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__% of the elderly pop over age 75 have some form of ARMD.
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29
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Dry ARMD = __%Wet ARMD = __%
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Dry ARMD =85-90%Wet ARMD = 10-15%
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Hallmark sign of ARMD? What is this composed of?
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Drusen; lipids, inflammatory proteins, other proteins, hyaline
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Where are drusen found?
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b/w RPE and Bruch's
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What do drusen do to the back of the eye?
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RPE/photoreceptors atrophy over area of drusen
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What are the 2 theories of ARMD?
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Accumulated waste tissueInflammation in sub-retinal space
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Width of macula, fovea, foveal avasc zone, foveola?
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5500, 1500, 500, 350 microns
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Fxn of RPE?
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protects & nourishes retina, removes waste, prevents new BV growth
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The choriocapillaris is located where? What is its fxn?
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Beneath RPE, within choroid. Provides blood to RPE and photoreceptors
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Bruch's membrane is between...
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RPE and choriocapillaris
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What is the order of the following structures (ant to post): Photoreceptors, Choriocapillaris, RPE, Bruch's
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Photoreceptors, RPE, Bruch's, Choriocapillaris
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What accumulates in the RPE during ARMD?
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Basal laminar deposits (wide spaced collagen; different from basal LINEAR deposits in Bruch's?)
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What accumulates in Bruch's during ARMD? What is its impact?
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Basal linear deposits (lipid rich material) - leads to weakened RPE attachment. (different from basal LAMINAR deposits in RPE?)
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T/F - ARMD involves RPE disruption due to environment/genetics.
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True
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In ARMD, ____ cause an incr in macrophages, which eat away at ___.
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basal linear deposits, Bruch's
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In ARMD, there is (incr/decr) cytokines which causes...
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incr, causes CNVM (Choroidal Neovascular Membrane)
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In ARMD, what is the impact of the accumulation of deposits in Bruchs?
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Bruch's becomes thicker, leads to change in composition and permeability; decr O2 thru Bruch's, causing RPE to send Veg-F signal
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Drusen b/w Bruch's and RPE describes this type of ARMD.
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Dry
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Choroidal BV breaking thru RPE and infiltrating retina describes this type of ARMD.
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Wet
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Hard drusen are ___ microns and (smaller/larger)?
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63, smaller
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Soft drusen are ___ microns and (smaller/larger)?
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64, larger
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Which type of drusen has well demarcated borders?
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hard
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Which type of drusen have indistinct borders?
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soft
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T/F - All drusen can calcify.
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True
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What happens to drusen at end stage ARMD?
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calcify
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Which type of drusen is assoc w/ thickened Bruch's and more advanced ARMD?
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soft
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T/F - Your patient has a few hard drusen, which is not indicative of ARMD.
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True
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T/F - Dry ARMD is almost always hard drusen.
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False - soft and/or hard
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What is the first indication of RPE changes in Dry ARMD?
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Granularity/mottling of RPE
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In (dry/wet) ARMD, RPE (hypo/hyper)pigmentation or loss of RPE occurs. What is this called?
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dry, hypo, nongeographic atrophy
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In (dry/wet) ARMD, regression of (hard/soft) drusen occurs. What is this called?
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dry, soft, geographic atrophy
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In ARMD, you (can/can't) see choroidal vessels with nongeographic atrophy, with (distinct/indistinct) borders.
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can't (think 'non = can't'), indistinct
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In ARMD, you (can/can't) see choroidal vessels with geographic atrophy, with (distinct/indistinct) borders.
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can, distinct
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In geographic atrophy during ARMD, the macula is spared initially due to...
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protective effect of xanthophyll/lutein in macula, but later affected
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Drusenoid RPE detachments in dry ARMD are the cause of...
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coalesced soft drusen
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T/F - Drusenoid RPE detachments are associated with CNVM and usually resolve without Tx.
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False - not associated
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T/F - Aging is a risk factor for Dry ARMD.
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True (Age Related Macular Degeneration, duh)
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T/F - Obesity is a risk factor for Dry ARMD.
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True
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T/F - Hypotension is a risk factor for Dry ARMD.
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False - HTN
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What is the biggest risk factor for Dry ARMD that can be changed?
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Smoking
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T/F - Dark hair and dark eyes are risk factors for ARMD.
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False - light hair, light eyes
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(Males/Females) at higher risk for dry ARMD?
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Females
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Outline the AREDS formulation.
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- 15 mg beta-carotene (don't use with smokers)- 500 mg Vit-C- 400 IU Vit E- 80 mg Zinc- 2 mg copper
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Describe the risk of Vit E in the AREDS formulation.
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anticoagulant effect, incr risk of hemorrhagic stroke
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Describe the risk of beta-carotene in the AREDS formulation.
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Risk only with smokers - will incr risk of lung cancer
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Describe the risk of zinc in the AREDS formulation.
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Can cause GI/urinary probs
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Describe the reasoning of copper in the AREDS formulation.
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prevents anemia caused by zinc
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The AREDS formula reduces the progression to (dry/wet) ARMD by ___%.
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wet, 25
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The AREDS formula reduces vision loss in (dry/wet) moderate-severe ARMD by __% in one or both eyes, or in one eye with (dry/wet) ARMD.
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dry, 19%, wet
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T/F - The AREDS formula is not helpful for patients with mild or no ARMD.
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True
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What ingredient is replaced in the AREDS formula for smokers?
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Lutein replaces beta-carotene
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T/F - The AREDS formula comes in gel tabs that are dosed BID.
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True
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T/F - AREDS II trials show that a significant decr of lutein was found in patients with ARMD.
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True
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What ARMD supplement is a component of retinal photoreceptors and decr inflammation?
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Omega-3 FAs
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Omega-3 FAs are only effective if...
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not taking too much Omega-6 FAs (corn, veg oil, processed foods)
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ARMD pts can benefit from this kind of food...
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green leafy vegetables like spinach (vitamin K and lutein)
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If a patient is on warfarin, what food should the patient be wary of? Why?
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Green leafy veggies (has vitamin K and lutein) - Vitamin K is used for clot formation
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T/F - Sunglasses are not proven to prevent ARMD.
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True
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What are risks for having dry ARMD turning into wet ARMD?
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Multiple large, soft, confluent drusen; wet ARMD in one eye; RPE clumping, hyperpigmentation; smoking
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T/F - Wet ARMD in one eye will likely result in wet ARMD in both eyes eventually.
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True
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__% of vision loss due to ARMD is due to wet ARMD.
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85
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Your patient has complaints of metamorphopsia - this is a sign considered in (wet/dry) ARMD.
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wet
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Fluid in wet ARMD is usually located...
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sub-RPE or sub-retinal
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Blinding disciform scars are due to...
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wet ARMD left untreated
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Classic CNVM = well defined or poorly defined membrane?
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well defined
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Occult CNVM = well defined or poorly defined membrane?
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poorly defined
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Sub-retinal fluids, PED, sub-retinal hemes, and exudates are characteristic of...
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wet ARMD
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What is PED in ARMD?
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Pigment Epithelial Detachments; can be serous or fibrovascular, both can lead to a tear in RPE
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T/F - Only serous PEDs can lead to a tear in the RPE.
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False - both serous and fibrovascular
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In this (dry/wet) ARMD sign, serous fluid from the underlying choriocapillaris goes into sub-retinal space - what is this called? Is it assoc w/ choroidal net?
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wet; serous PED; not assoc w/ choroidal net
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In this (dry/wet) ARMD sign, occult CNVM causes ___ PEDs, which can lead to ___ PEDs.
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wet, fibrovascular, hemorrhagic
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Sub-retinal implies...
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within retina
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Pre-retina implies...
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on top of retina, b/w post hyaloid face of vitreous and retina
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Wet ARMD hemorrhaging can involve these 4 locations...
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sub-retinal, pre-retinal, sub-RPE, or intra-vitreal
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Tx of Wet ARMD?
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Laser photocoagulation (no longer used), PDT w/ visudyne, Anti-VEGF (Macugen, Lucentis, Avastin)
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PDT w/ Visudyne is used for what condition? Describe the Tx.
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Photodynamic Therapy - used for Wet ARMD. Visudyne injected, attaches to CNVM. Laser activates Visudyne which stops CNVM leaking
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Which Wet ARMD Tx is superior - laser photocoagulation or PDT w/ Visudyne?
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PDT w/ visudyne; less damage to healthy retinal tissue but have to get re-treatment; LP no longer used, too many complications
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What are the Anti-VEGF Tx used for Wet ARMD?
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Macugen, Lucentis, Avastin
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Leading cause of blindness in 20-74 yrs old?
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Diabetic ret
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What is the key factor in diabetic ret?
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duration of diabetes - incr length of having DM = incr risk of diabetic ret even if DM is controlled
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What is the pathophysiology of diabetic ret?
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Loss of pericytes (controls capillary blood flow) along endoth of caps; caps weaken; leads to retinal cap cell death, leads to hypoxia; leads to breakdown of blood-retina barrier thus incr vascular proliferation, permeability (bleeding, neo)
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Proliferative diabetic ret in general is defined with what signs?
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NVD, NVE, NVI, pre-retinal hemes, vitreal hemes
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Mild NPDR is defined by...
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Micro-aneurysms (due to weakened cap walls), dot/blot
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F/U of Mild NPDR should be...
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every 9 mos - 1 yr
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Dot/blot hemes occur in what layers?
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INL and OPL
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Moderate NPDR is defined by...
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incr dot/blot (4 quadrants or severe in 1 quadrant), MA, CWS, venous beading (<2 quadrants), IRMA
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F/U of moderate NPDR should be...
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6 mos
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What are CWS? What causes it?
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Cotton wool spots, seen in moderate NPDR and grade 3 HTN ret. Due to NFL infarct.
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What is IRMA?
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Intra-retinal microvasc abnormalities; seen in mod NPDR; represent either new BV growth or remodeling of pre-existing BVs, shunt blood to non-perfused areas
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What is the difference b/w IRMA and neo?
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IRMA = intra-retinal, doesn't leak on FA
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Severe NPDR is defined by...
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4:2:1 rule - 4 quadrants of hemes, 2 or more quad of venous beading, 1 big IRMA; need 2 or more of these to be severe NPDR
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What is the biggest predictor of PDR?
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2 or more quadrants of venous beading
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F/U of Severe NPDR?
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3 mos
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You see dot/blot, MA, CWS, IRMA; you also see venous beading in one quadrant. This must be..
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moderate NPDR
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__% of severe NPDR will develop PDR in 1 year.
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50
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T/F - PRP is indicated for severe NPDR.
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False - inconclusive whether early PRP will help
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Low risk PDR is defined as...
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NVD less than 1/4, NVE
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What is the cause of neovascularization?
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Hypoxia thus incr VEGF, which is the factor that grows neo vessels
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Low risk PDR f/u?
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Consult with retinal specialist in 1 week
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High risk PDR is defined as...
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1/4-1/3 DD NVD; any amt of NVD on or within 1 DD of disc, w/ vitreal heme or pre-retinal heme; NVE w/ pre-retinal heme or vitreal heme
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High risk PDR f/u?
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Consult 24-48 hrs
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__% reduction in risk of severe vision loss with PRP in high risk PDR.
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50
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How does PRP work?
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Pan-retinal photocoagulation; decr need of oxygen by killing off retina, thus less retina to provide O2 to; decr hypoxia which decr VEGF thus neo goes away
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T/F - CSME can occur in mild NPDR.
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True - occurs in ANY stage of diabetic ret
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What are the 3 criteria for CSME?
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1) Retinal thickening at or within 500um (1/3DD) of center of macula2) Exudates at or within 500um (1/3DD) of center of macula with retinal thickening3) Retinal thickening >1DD size within 1DD of center of macula
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T/F - Retinal thickening is required for exudates at or within 500um of the center of the macula in CSME.
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True
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Breakdown of the blood-retina barrier, leading to leakage of small BVs into macula including exudates; the exudates stay behind after fluid regresses. This describes...
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CSME
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Retinal consult for CSME should be within...
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2 weeks
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Tx CSME?
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Focal laser or grid laser, avastin, steroid injection
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Why steroid for CSME?
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addresses inflammatory component of CSME
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Focal laser in CSME Tx involves...
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pinpoint laser on focal areas of leakage
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For diffuse areas of leakage in CSME, use...
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grid laser
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T/F - Laser Tx in CSME improves VA.
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False - only stabilizes
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T/F - 20/20 VA is possible with CSME.
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True
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T/F - Diabetic macular edema is the same as CSME.
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False - remember DME is leaking that falls outside the 3 criteria for CSME!
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Diabetic macular edema is defined as...
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leaking that doesn't fall under CSME criteria
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Focal leaking in Diabetic macular edema involves this sign.
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circinate ring
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Ischemia in Diabetic macular edema is a result of...
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too much CSME and laser
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F/U of Diabetic macular edema?
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3 mos or retinal consult
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Hemorrhaging forms a sticky fibrous tissue afterwards, which can cause this retinal problem...
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tractional RD
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Tx tractional RD?
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Vitrectomy, PRP, avastin
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What causes vitreal hemorrhaging?
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Neo growing into vitreous and hemorrhaging
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Tx vitreal hemorrhage?
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vitrectomy if hemes are persistent or recurrent
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T/F - NVI is a late sign.
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True
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Where should you look for NVI particularly?
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pupillary ruff - must watch for this in DM pts before dilation since ruff hides during mydriasis
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Tx NVI?
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PRP
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Tx macular ischemia?
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No Tx - do not laser this area
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Mild optic nerve head edema with prominent surface vessels and fine hemes on the disc due to diabetes is called...
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Diabetic papillopathy
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Diabetic papillopathy is a form of (AION/non-AION).
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non-AION
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T/F - Diabetic papillopathy is closely correlated with the amount of diabetic ret.
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False - no correlation
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T/F - Diabetic papillopathy typically affects vision moderately since the edema is moderate.
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False - vision is mildly diminished (most are 20/40 or better), edema is mild
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What drugs can cause a +2.00 hyperopic shift? Is this shift permanent?
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Glyburide/glipizide (2nd gen sulfonylureas), resolves in 3-4 mos
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Which palsy out of CN 3,4,6 is most common? (in diabetes...?)
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CN 6
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Increase in blood sugar can cause a (hyperopic/myopic) shift. Every ___mg/dl causes a 0.50D shift. Usually don't notice until >___mg/dl.
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myopic, 100, 250
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T/F - Diabetic ret can be assoc w/ flame hemes.
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True
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Flame hemes in diabetic ret are located in what layer?
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NFL - hence shape
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What is the #1 reason for why people lose their vision from diabetes?
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macular edema
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T/F - Controlling blood sugar helps decr development of diabetic ret.
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True
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T/F - Controlling BP helps decr development of diabetic ret.
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True
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T/F - Incr cholesterol has no effect on diabetic ret.
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False - Incr cholesterol = incr exudates
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T/F - Aspirin is indicated as a Tx for diabetic ret.
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False - neither improves or worsens diabetic ret
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Why be careful with exercise if you have diabetic ret?
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BVs are weak so heavy lifting can break the BVs
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T/F - Blood sugar affects VEGF levels (why or why not?).
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True - higher BS = incr protein kinase C and hypoxia, thus incr VEGF
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T/F - VEGF contributes to blood-retinal barrier breakdown, in addition to promoting neo.
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True
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How can you prevent VEGF increase?
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PKC inhibitors, anti-VEGF drugs e.g. Avastin
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What defines grade 1 hypertensive ret?
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thickening and sclerosis of arteries, leads to narrowing
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What defines grade 2 hypertensive ret?
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Retinal arteriovenous nicking; hardened artery compresses vein
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What defines grade 3 hypertensive ret?
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Diastolic BP = 110-115; disrupted blood-retina barrier due to artery/cap dmg (also causes hypoxia); retinal hemes (dot/blot, but usually flame), CWS (more CWS than hemes), exudates
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T/F - You can see exudates in grade 2 hypertensive ret.
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False - grade 3 and 4
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T/F - You see CWS in grade 1 hypertensive ret.
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False - in grade 3
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T/F - You see more hemorrhaging vs CWS in hypertensive ret.
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False - see more CWS
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What is the typical kind of heme seen in hypertensive ret?
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flame (vs dot/blot)
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What grade of hypertensive ret do you see ON edema?
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Grade 4 (malignant HTN)
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Diastolic BP in malignant HTN (Grade 4 hypertensive ret) is usually...
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130-140
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A macular star in hypertensive ret means you have grade...
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4
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What grade(s) of hypertensive ret do you see hypertensive choroidopathy?
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3 or 4
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What causes hypertensive choroidopathy?
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choriocapillaris is extremely sensitive to HBP, so see ischemia of choroidal BVs (occlusion of capillaries) thus damage to RPE
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Hypertensive choroidopathy occurs in the choroid, but impacts which layer?
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RPE (remember choroid feeds RPE)
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What are Elschnig's spots?
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Yellow circular lesions that become pigmented due to RPE damage, seen in hypertensive choroidopathy
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What are Siegrist's streaks?
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Linear pigmented areas that run along sclerotic choroidal vessels, seen in hypertensive choroidopathy
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What happens to the RPE in hypertensive choroidopathy?
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Ischemia therefore RPE damage, also RPE detachment
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What is copper wiring in hypertensive ret?
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when lumen of BV begins to obscure blood within (thicker lumen wall)
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What is silver wiring in hypertensive ret?
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When blood is completely obscured by the vessel wall
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T/F - Tortuosity is a strong sign of hypertensive ret.
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False - many people are born w/ naturally tortuous vessels; early stages, arteries actually straighten then become tortuous
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BRVO/CRVO typically caused by...
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impingement of artery on vein, leading to endothelial cell damage
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How do the BVs look like in BRVO/CRVO?
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Dilated, tortuous veins
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BRVO/CRVO can be due to...
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impingement of artery on vein, or thickening of venous blood (from birth control or sickle cell)
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T/F - BRVO/CRVO assoc w/ NVD, NVE, CME, but not NVI.
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False - assoc w/ all these signs
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What is worse, ischemic or non-ischemic CRVO?
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ischemic has higher risk of VA loss
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What is an opticilliary shunt? What is it assoc w/?
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Connection of retinal vasculature with choroidal vasculature (assoc w/ CRVO)
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Which of the following is more likely to result in NVD and NVI?A) BRVOB) Ischemic CRVOC) Non-ischemic CRVOD) Hemi-retinal CRVO
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Ischemic CRVO
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Laser is indicated for (CRVO/BRVO)?
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BRVO (not for CRVO or hemi-central CRVO either)
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What is aka 'blood and thunder' all over the retina?
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CRVO
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A CRAO/BRAO is different from a CRVO/BRVO in that...
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blockage in CRAO/BRAO is due to plaques
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Hollenhurst plaques come from...
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carotid
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Fibrin-platelet plaques come from...
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carotids, cardiac valves
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Calcific plaques come from...
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cardiac valves
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Amarousis Fugax is associated with these retinal vascular problem...
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CRAO/BRAO
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T/F - In CRAO/BRAO, always consider giant cell arteritis.
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True
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T/F - BRVO, CRVO, BRAO, CRAO all are assoc w/ NVD, NVE, NVI, CME
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True - remember anything ischemic is assoc w/ neo
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T/F - Immediate APD is assoc w/ BRAO.
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False - CRAO
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A cherry red spot on the macula is assoc w/...
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CRAO
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CRAO/BRAO will go back to normal with these signs...
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ON pallor, box caring (segments in arteries w/o blood)
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'Box caring' is a sign seen...
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after BRAO, CRAO returns back to normal
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What is Acute ophthalmic artery obstruction?
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blockage of ophthalmic artery (think emboli)
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In this BV obstructive ocular disease, the patient has no light perception with little or no cherry red spot. You suspect...
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Acute ophthalmic artery obstruction
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Acute ophthalmic artery obstruction has (more/less) opacified retina vs CRAO.
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more
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CRAO involves NLP or hand motion/CF?
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hand motion/CF (Acute ophthalmic artery obstruction involves NLP)
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What are the causes of ERM?
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idiopathic, PVD, retinal vascular dz, uveitis, trauma, eye surgery
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T/F - Uveitis can cause ERM.
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True
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How does a PVD cause an ERM?
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PVD leaves posterior vitreous behind, or ILM gets disrupted, then proliferation of glial cells
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Besides PVDs, how else does an ERM form?
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Retinal cells turn into glial cells, which turn into an ERM
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ERMs are associated with missing retinal layers due to vitreal traction - what is this called?
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Pseudohole
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T/F - ERMs are not assoc w/ hemorrhages.
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False - can be assoc w/ hemes
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Tx ERM?
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vitrectomy w/ ILM strip (peel off ILM)
|
|
|
Macular holes are caused by...
|
vitreal tractions
|
|
|
Impending macular holes typically resolve __% of the time.
|
50
|
|
|
Tx Macular holes?
|
vitrectomy w/ gas bubble
|
|
|
T/F - Macular holes are a complication of Cystoid Macular Edema.
|
True - most CME seen after cataract surgery (Irvine-Gass syndrome)
|
|
|
What is Irvine-Gass syndrome?
|
CME after cataract surgery
|
|
|
Ocular ischemic syndrome is due to...
|
carotid obstruction
|
|
|
In Ocular ischemic syndrome, no flow disruption occurs until __% obstruction.
|
70
|
|
|
__% carotid obstruction will decr amt of perfusion in the CRA by __% - Ocular ischemic syndrome typically occurs at this time.
|
90, 50
|
|
|
Ocular ischemic syndrome is assoc with this Sx...
|
ocular angina (dull ache)
|
|
|
T/F - Ocular ischemic syndrome results in dilated and tortuous veins.
|
False - dilated but NOT tortuous
|
|
|
T/F - Ocular ischemic syndrome assoc w/ NVI, NVD, NVE, CME, hemes.
|
True
|
|
|
T/F - Ocular ischemic syndrome assoc w/ anterior uveitis.
|
True
|
|
|
Most common cause of macroaneurysm...
|
HTN
|
|
|
What is macroaneurysm?
|
Dilation of major arterial branch
|
|
|
Tx macroaneurysm?
|
Refer to cardiologist - indicates high mortality rate
|
|
|
PORN is found in what kind of pts?
|
immunocompromised pts
|
|
|
PORN is typically caused by...
|
HZV
|
|
|
What is PORN?
|
Progressive Outer Retinal Necrosis; devastating, necrotizing retinitis; deep retinal opacification which eventually coalesces and leads to complete retinal necrosis
|
|
|
What are the signs of PORN?
|
Deep retinal opacification, necrosis, RDs, ON edema
|
|
|
Prognosis of PORN?
|
Extremely poor
|
|
|
Interferon retinopathy is due to...
|
interferons used in Tx Hep C and MS
|
|
|
T/F - Interferon retinopathy is a non-ischemic retinopathy.
|
False - ischemic, looks like diabetic ret
|
|
|
T/F - Interferon retinopathy goes away after Tx is done.
|
True
|
|
|
Bilateral ON edema occurs due to the use of this heart drug...
|
Amiodarone
|
|
|
Non-AION = painful or painless loss of vision
|
painless (think 'non = no pain')
|
|
|
Non-AION is caused by decr perfusion of...
|
post ciliary artery
|
|
|
T/F - Non-AION risk is increased with large C/D or large disc.
|
False - small C/D or small disc
|
|
|
T/F - Non-AION risk is increased with hypotension, since it is an ischemia-related disease.
|
False - HTN
|
|
|
T/F - Non-AION risk is increased with DM.
|
True
|
|
|
T/F - Non-AION risk is increased with low cholesterol.
|
False - high
|
|
|
T/F - Non-AION risk is increased with profound blood loss.
|
True
|
|
|
Disc drusen contributes to the risk of this ON disease
|
Non-AION
|
|
|
____ incr risk of (AION/Non-AION) if the patient has (large/small) nerves and (hypo/hyper)tension.
|
Viagra, Non-AION, small, hyper
|
|
|
T/F - You see a positive APD in both Non-AION and AION.
|
True
|
|
|
When does Non-AION vision loss typically occur?
|
When wake up (nocturnal hypotension?)
|
|
|
Non-AION vision loss = acute or non-acute?
|
acute
|
|
|
AION vision loss = acute or non-acute?
|
acute
|
|
|
T/F - You can see disc edema with hemes in Non-AION.
|
True
|
|
|
Non-AION usually has (sectoral/total) edema which causes a ___ VF defect.
|
sectoral, altitudinal
|
|
|
Non-AION most commonly has this type of VF defect.
|
inferior field (altitudinal)
|
|
|
Following resolution of edema in Non-AION, the ON has...
|
sectoral or total pallor
|
|
|
In Non-AION, VA varies from ___ to ___ but usually 50% better than ____.
|
20/20, light perception, 20/60
|
|
|
T/F - Non-AION involves an improvement in VA.
|
True (vs AION - no VA improvement)
|
|
|
T/F - Non-AION is associated with systemic Sx.
|
False - no systemic Sx
|
|
|
Tx Non-AION?
|
None
|
|
|
AION is associated with this disease which causes headaches...
|
Temporal arteritis
|
|
|
AION is due to...
|
occlusion of short posterior ciliary arteries (infiltration of giant cells, inflammation)
|
|
|
AION involves (pain/no pain).
|
Temporal pain
|
|
|
T/F - AION involves systemic signs.
|
True
|
|
|
How does the ON look like in AION?
|
Infarcted and chalk white (total); sometimes can be edematous
|
|
|
T/F - AION not assoc w/ CWS and hemes.
|
False - assoc w/ CWS and hemes
|
|
|
Which has worse vision loss - NAION or AION?
|
AION - profound VA loss (NLP!)
|
|
|
Contralateral eye can be affected within ___ in AION.
|
days or weeks
|
|
|
Following resolution, what occurs to the ON in AION?
|
Cupping (vs pallor in NAION)
|
|
|
T/F - Most AION pts improve in acuity.
|
False - VA almost never improves
|
|
|
Tx AION?
|
Steroids
|
|
|
ONH drusen are made of...
|
calcified hyaloid bodies
|
|
|
What happens to ONH drusen as the pt gets older?
|
become larger, more to surface
|
|
|
ONH drusen occur in __% of the pop and usually (unilat/bilat).
|
1%, bilat
|
|
|
ONH drusen has (poor/good) VA and can cause VF defects especially (sup/inf/nasal/temp)?
|
good, inferior
|
|
|
T/F - Anomalous branching of BVs are assoc w/ ONH drusen.
|
True
|
|
|
T/F - ONH drusen do not involve hemes.
|
False - can get hemes
|
|
|
What does the PITS mnemonic device mean?
|
Parietal lobe = Inf VF defectTemporal lobe = Sup VF defect
|
|
|
Complex visual hallucinations that occ consistently or periodically in visually impaired people w/ good intellect and cognitive ability, no psychiatric disorders or neurologic lesions/abnormalities. What is this???
|
Charles Bonnet syndrome
|
|
|
___% of people w/ visual impairment experience visual hallucinations in this syndrome.
|
10-15, Charles Bonnet syndrome
|
|
|
Charles Bonnet syndrome typically presents in age range of ___ to ___.
|
74.9-83.8
|
|
|
T/F - Charles Bonnet syndrome typically occurs in males.
|
False - no apparent predilection to any sex
|
|
|
T/F - Charles Bonnet syndrome hallucinations are of pleasant nature.
|
True
|
|
|
T/F - Most Charles Bonnet syndrome hallucinations involve animals.
|
False - most involve people, next most common involve animals followed by plants/trees
|
|
|
T/F - Charles Bonnet syndrome hallucinations can involve complex geometric figures.
|
True
|
|
|
T/F - Most Charles-Bonnet syndrome hallucinations are in vivid color
|
True
|
|
|
T/F - Charles-Bonnet syndrome occurs in people with normal vision but with neurological lesions/abnormalities.
|
False - in people with impaired vision and no neurological lesions/abnormalities
|
|
|
T/F - What are PKC inhibitors used for?
|
Treat VegF (prevent neo)
|
|
|
RPE (hypo/hyper)pigmentation increases the risk of wet ARMD?
|
hyper
|
|
|
Dry ARMD has drusen located between what layers?
|
RPE and Bruch's
|
|
|
T/F - Both Non-AION and AION affect the posterior ciliary artery.
|
True:Non-AION = decr perfusionAION = occlusion of SHORT post ciliary a. due to inflammation/giant cells
|
|
|
T/F - It's possible to have 20/20 in NAION.
|
True
|
|
|
Diastolic BP in Stage 3 hypertensive ret?
|
Diastolic BP = 110-115
|
