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26 Cards in this Set

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MC c/o failure of RRD repair?
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.
Routine DFE uncovers this OU.  Dx?  Further testing?
Routine DFE uncovers this OU. Dx? Further testing?
Gardner Syndrome: multiple, CHRPE-like lesions (ddx: multiple, OU, more ovoid, CHRPE uniformly dark w/ light lacunae) OU. Assoc: FAP, need: colonoscopy.
Retinal finding SE of IFN therapy?
CWS (Also: HTN, DM, HIV, ischemia, anemia
Tay-Sachs, Fabry vs. Hunter
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
Deepest retinal layer the retinal vessels supply blood to?
INL
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)
Causes of photopsia (some)
PVD, CAR, MEWDS, AZOOR, birdshot
What does the EDTRS 4:2:1 rule predict regarding progression of diabetic retinopathy?
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%.
Risk of high-risk PDR at 1-, 3-years in presence of severe NPDR (based on ETDRS)?
1 year: 17%
3 years: 40%
Which periph retinal lesions need eval/laser and which don't?
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.
cc: 17yo M failed vision screening, 20/50 ou. Dx?  Features? Prognosis?
cc: 17yo M failed vision screening, 20/50 ou. Dx? Features? Prognosis?
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, E...
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
Progressive VA loss and hemeralopia. Dx?
Cone dystrophies.
Hemeralopia: day blindness bc rods (unaffected) better in dark.
26yo F c/o U/L photopsia, decr VA
26yo F c/o U/L photopsia, decr VA
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)
Pathophys of VKH
B/L granulomatous PANuveitis caused by systemic autoimmune dysregulation directed toward melanocytes. "sunset glow" maculas (sRD)
Quenching on FA. Meaning? What disease?
Quenching: when dye is supposed to be re-circulating phase it is less bright than normal.

Seen in: birdshot chorioretinopathy (BSCR)
What classic sign?  Disease?
What classic sign? Disease?
Wreath sign, MEWDS

DDx: BSCR (lots of ONH hyper, larger lesions, some hypo/some hyper (variable))
Risk factors for growth of choroidal melanocytic lesions (7).
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
"To Find Small Ocular Melanoma Using Helpful Hints Daily"
Thickness >2mm
Fluid (SRF)
Symptoms
Orange pigment
Margin <3mm from ONH
U/S Hollowness
Halo (if present suggests nevi)
Drusen (if present, suggests nevi)
40yo M p/w decr VA OU.  ERG/EOG wnl.  +FH of this happening. DDx?
40yo M p/w decr VA OU. ERG/EOG wnl. +FH of this happening. DDx?
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)
What is pictured?  DDx?
What is pictured? DDx?
Angioid streaks ("PEPSI+"):
Paget's disease of bone
Ehlers-Danlos
Pseudoxanthoma elasticum
Sickle cell
Idiopathic
+...and BETA-thalassemia
Pictured?  Complication(s)? Tx?
Pictured? Complication(s)? Tx?
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)
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
Risk factors for AMD
Systemic/modifiable: HLD, HTN, obesity, smoking
Non-modifiable: female, HYPEROPIA, FH, light irides, age
Pictured?  DDx?  Tx options?
Pictured? DDx? Tx options?
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
B/L finding.  Dx?  EOG vs. ERG findings?  Pphys?
B/L finding. Dx? EOG vs. ERG findings? Pphys?
Best's vitelliform maculopathy (creamy yolk maculas).
A/D, VMD2 gene
EOG: abn (pphys: Cl channel on basal side of RPE)
ERG: nml
3 classic retinal findings in LHON.
1. ONH elevation
2. peripap telangiectasias
3. retinal arteriolar tortuosity