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32 Cards in this Set
- Front
- Back
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What is the most common cause of pre-retinal hemorrhages?
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Retinal Neovascularization
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________ _________ are confluent and will block all underlying retinal detail.
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Pre-retinal hemorrhages
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Which type of hemorrhages are most associated with retinal vein occlusions and hypertensive retinopathy?
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Flame shamed (nerve fiber layer) hemorrhages.
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Dot & blot hemorrhages are most associated with what 2 disease?
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Diabetic retinopathy (Diabetes), and ocular ishemic syndrome (OIS)
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T/F Any healthy patient with a single, isolated, blot hemorrhage must undergo an intensive medical evaluation.
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False; they won't have to.
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How can sub-retinal hemorrhages be identified?
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If you can see distinct retinal vessels overlying the hemorrhaging area, the hemorrhage must be beneath the retina.
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A single cotton wool spot warrants an intensive medical evaluation including what 5 diseases specifically?
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Hypertension (diastolic >110mmHg), diabetes, HIV/AIDS, Lupus and leukemia.
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What is the difference between Collateral vessels and the vessels developed from neovascularization?
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Collateral = Non-fenestrated and Non-leaking; Neo = Fenestrated and leaking (Esp. bad b/c can lead to pre-retinal and vitreal hemorrhages)
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What is the biggest cause of BOTH exudates and dot-blot hemorrhages?
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Diabetes
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How can you differentiate between CWS and lipid exudates?
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CWS have poor borders.
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White-without pressure is most common in which 2 ethnic groups? who is it uncommon in?
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1) Black 2) Asian; Caucasian.
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If you think that you see white-without-pressure in a Caucasian pt, you are likely seeing what?
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Prominent Vitreous base
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What are the main differences between RPE hypertrophy and RPE hyperplasia?
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Trophy = Congenital enlargement, benign. Plasia = Response to some insult, very dark with demarcation line after 90 days, will have vision loss, cure what caused it.
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Why do lesions in the choroid have their outlines and true color altered?
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They are beneath the RPE, which is a PIGMENTED structure.
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Why are changes in the RPE such as RPE hypertrophy and hyperplasia dark and well defined?
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Bc the RPE is beneath the retina, which is a CLEAR structure.
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Describe a vortex vein complex
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Unusual coloration or anatomic curiosity around a vortex vein complex.
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Primary Chorioretinal Atrophy (aka cobblestone degeneration) is expected in which population?
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Lighter than normal colored (blond) fundi.
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Typically, at what age does a vascular disease become prevalent? What is the exception to this rule?
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65; diabetes.
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What is the only substance you will see on an angiogram? Possible exceptions? Why?
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Fluorescein; pseudo-and autofluorescence; Filters allow only specific light to enter eye, and reach the camera.
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What condition gives a patchy, delayed choroidal filling? How long after baseline photos are taken are you able to witness this?
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Giant cell arteritis; After 9.5 seconds at least.
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What 5 things will HYPERfluoresce in angiography?
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1. Things that leak, 2. Pool, 3. Stain, 4. Transmission defects, 5. Abnormal vessels.
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What 2 things will HYPOfluoresce in angiography?
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1. Optical barriers (CWS), 2. Filling defects
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What is the most significant risk factor for the development of retinopathy?
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Duration of diabetes
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When testing for diabetes and evaluating level of control, what is the main factor? Why?
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HbA1C; gives insight into glucose levels of the preceding week, rather than the day of.
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What is "circinate retinopathy?" What does it indicate?
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ring of hard exudates. Indicates leaking microaneurysms (or choroidal neovascular membrane) within the center
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What justifies "clinically significant macular edema (CSME)?"
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1) Retinal edema at or within 1/3 DD of the center of macula. 2) Hard exudates associated with adjacent retinal edema within 1/3 DD of center of macula. 3) Retinal edema of 1 DD within 1 DD of center of macula.
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T/F A patient with CSME will NOT have entering VA of 20/20 or better.
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False, CSME can occur at any stage of diabetic retinopathy, therefore VA can be anything.
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Clinically significant macular edema (CSME) is a term used only in ________ _________.
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Diabetic retinopathy
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T/F You can only prevent further vision loss with laser photocoagulation for CSME, not improve vision.
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true
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What procedure is the best treatment for all proliferative retinopathies?
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Pan-retinal photocoagulation (PRP)
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T/F NPDR-with CSME and PDR are the only two diabetic statuses that need same day retinal specialist referral
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True
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In any disease where fundus neovascularization develops, the most serious potential sequelae are ________ ______ and ________ _________ _______ _______.
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vitreous hemorrhage; subsequent tractional retinal detachment.
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