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26 Cards in this Set
- Front
- Back
MC c/o failure of RRD repair?
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PVR (RPE and glial cells form membrane over retina) contracting causing more breaks, folds and RDs.
Not: VH/poor view, recurrent breaks or incomplete PVD. |
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Routine DFE uncovers this OU. Dx? Further testing?
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Gardner Syndrome: multiple, CHRPE-like lesions (ddx: multiple, OU, more ovoid, CHRPE uniformly dark w/ light lacunae) OU. Assoc: FAP, need: colonoscopy.
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Retinal finding SE of IFN therapy?
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CWS (Also: HTN, DM, HIV, ischemia, anemia
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Tay-Sachs, Fabry vs. Hunter
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Spingolipidoses. Tay-Sachs (A/r, 15, HEXA, hexosaminidase A defic) = cherry red spot, no Tx, death by 4. Fabry's X/r, verticillata, renal failure, periph neuropathy. Hunter X/r, pigmentary retinopathy
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Deepest retinal layer the retinal vessels supply blood to?
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INL
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Which finding is highest risk for PDR in DM-2?
a. exudates b. preretinal heme c. CWS d. dbh |
c. CWS (bc it represents ischemia and NFL infarct)
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Causes of photopsia (some)
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PVD, CAR, MEWDS, AZOOR, birdshot
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What does the EDTRS 4:2:1 rule predict regarding progression of diabetic retinopathy?
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4:2:1 quadrants of heme:venous beading:IRMA qualifies a patient for severe NPDR. Risk of progression to high-risk PDR is 1 yr=17%, 3 yr=40%.
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Risk of high-risk PDR at 1-, 3-years in presence of severe NPDR (based on ETDRS)?
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1 year: 17%
3 years: 40% |
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Which periph retinal lesions need eval/laser and which don't?
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Emmetropic: asymptomatic holes, flap tears w/wo lattice do not req laser. If symptomatic, eval for laser.
High myopes (-6.0 D): asymptomatic holes, tears should be evaluated/considered for laser by retina. |
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cc: 17yo M failed vision screening, 20/50 ou. Dx? Features? Prognosis?
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Stargarts: MC juvenile macular dystrophy
FA: dark choroid (diffuse lipofuscin blocking choroid) Color: dull FLR (beaten bronze), Bull's eye mac, pisciform flecks (if diffuse "fundus flavimaculatus") Onset: teens, final VA 20/50-20/200. ERG, EOG: wnl |
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Progressive VA loss and hemeralopia. Dx?
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Cone dystrophies.
Hemeralopia: day blindness bc rods (unaffected) better in dark. |
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26yo F c/o U/L photopsia, decr VA
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MEWDS. small (500u) fuzzy cream lesions throughout
Pathog: including fovea ("foveal granularity"), ERG= decr a wave DDx: - birdshot (no foveal stuff, 40-60yo F, ERG wnl) |
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Pathophys of VKH
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B/L granulomatous PANuveitis caused by systemic autoimmune dysregulation directed toward melanocytes. "sunset glow" maculas (sRD)
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Quenching on FA. Meaning? What disease?
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Quenching: when dye is supposed to be re-circulating phase it is less bright than normal.
Seen in: birdshot chorioretinopathy (BSCR) |
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What classic sign? Disease?
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Wreath sign, MEWDS
DDx: BSCR (lots of ONH hyper, larger lesions, some hypo/some hyper (variable)) |
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Risk factors for growth of choroidal melanocytic lesions (7).
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1. orange
2. SRF 3. +visual sx 4. juxtapapillary (<3mm) 5. thicker than 1mm (<1=nevi, >3=melanoma) 6. leakage on FA 7. B-scan: hollow center |
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"To Find Small Ocular Melanoma Using Helpful Hints Daily"
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Thickness >2mm
Fluid (SRF) Symptoms Orange pigment Margin <3mm from ONH U/S Hollowness Halo (if present suggests nevi) Drusen (if present, suggests nevi) |
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40yo M p/w decr VA OU. ERG/EOG wnl. +FH of this happening. DDx?
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Central Areolar Choroidal Dystrophy (CACD)
30-60yo (middle age), peripherin/RDS gene Pathog: round well-demarc lack of retina, RPE and choriod (full-thicness). FA: pretty normal except dark at lesions. DDX: North Carolina mac dystrophy (puberty-onset) |
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What is pictured? DDx?
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Angioid streaks ("PEPSI+"):
Paget's disease of bone Ehlers-Danlos Pseudoxanthoma elasticum Sickle cell Idiopathic +...and BETA-thalassemia |
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Pictured? Complication(s)? Tx?
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Angioid streaks: radial linear and circumpapillary breaks in Bruch's.
Compl: subretinal heme --> CNV (Tx: laser, recur: high) Assoc: PEPSI (PXE, Ehlers-Danlos, Paget, SCD, Idio) |
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Periph retinal lesions: which protect from RD and which increase risk?
-meridional fold vs. complex -cobblestone degen -microcysts |
MF/MCs: redundant retinal tissu (pictured), 20% pts, found sup/nasal usually, incr risk of RD
Cobblestone: inferior usually, 20% pts, protective against RD Microcysts: nearly 100% by 8yo, inconsequential |
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Risk factors for AMD
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Systemic/modifiable: HLD, HTN, obesity, smoking
Non-modifiable: female, HYPEROPIA, FH, light irides, age |
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Pictured? DDx? Tx options?
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DUSN (Diffuse Unilat subacute Neuroretinitis)
-youngish, healthy, no POHx from S. America/islands *vitritis, papillitis, white outer retina lesions, decr ERG -etio: intraoc nematode -Dx: direct visualization or clinical Hx -Tx: argon to zap worm or chase it to periph (no Rx) DDx: sarcoid, AMPPE, seripiginous, multifocal, MEWDS, toxo, histo |
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B/L finding. Dx? EOG vs. ERG findings? Pphys?
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Best's vitelliform maculopathy (creamy yolk maculas).
A/D, VMD2 gene EOG: abn (pphys: Cl channel on basal side of RPE) ERG: nml |
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3 classic retinal findings in LHON.
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1. ONH elevation
2. peripap telangiectasias 3. retinal arteriolar tortuosity |