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271 Cards in this Set

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(T/F) Choroidal Nevus are always considered malignant until proven otherwise.
T
(T/F) Choroidal Nevi are congenital
T
Why are choroidal nevi often not see when pts are young?
Precursor cells haven't released pigment yet.
What race gets choroidal nevi the most?
Whites
How big are choroidal nevi typically?
1-5 mm
(T/F) Choroidal margins are always smooth.
F. Can be smooth to slightly irregular.
(T/F) Choroidal nevi that are not symmetrical are malignant.
F. Can be assymetrical and be ok.
(T/F) Choroidal nevi can enlarge over time.
T. But they rarely do and the change is minimal.
(T/F) If choroidal nevi touches the ONH, then it is a red flag for malignancy.
T
In Optos, the choroidal nevi will show up with the _____ light and will disappear with the _____ light.
Red. Green.
Name the 3 ways choroidal nevi affects visual function.
1) It doesn't usually. 2) It compresses choriocapillaries so the RPE doesn't get enough nutrition so RPE and photoreceptor degeneration can occur. 3) Visual field dfects can occur, if it's near the posterior pole.
Choroidal nevi is associated with _____ and _____
RPE detachments and CNVMs
What is the most common ocular malignancy?
Choroidal melanomas
(T/F) Choroidal melanomas are always isolated and bilateral.
F. Only unilateral.
What kind of pts haven have choroidal melanomas?
Old pts with lots of UV light exposure when they are young.
(T/F) People who got lots of UV exposure as adults are at risk for a choroidal melanoma
F. Exposure happened when kids.
If a choroidal melanoma breaks through __________, it will resemble a ______ or _______.
Bruch's membrane. Dome. Mushroom
What does a choroidal melanoma typically grow towards?
What is the main treatment for choroidal melanomas?
Enucleations
Transpupillary Thermal Therapy uses a ____ to kill the tumor every ___ months for a total of ____ months.
Laser. 3. 9.
(T/F) PRP is an effective way to remove choroidal melanomas.
F.
Name 2 types of radiotheraphy to kill a choroidal melanoma?
1) Plaque brachytherapy and proton beam irradiation.
This radiotherapy method kills a choroidal melanoma uses iodine 125 with a gold wall to radiate the tumor.
This radiotherapy method kills a choroidal melanoma using a proton-beam and two clips to direct the laser into the tumor.
Which radiotherapy method for choroidal melanomas have more complications? What are they?
Madarosis, exposure keratitis, dry eye, radiation retinopathy, cotton wool spots, hemorrhages, macular edema, vascular occlusions, cataracts, VF loss and vision loss, NVI. Necrotic sclera.
Why might we not do radiotherapy to kill a choroidal melanoma for a 90 year old man?
Because the side effects aren't worth it.
When choroidal melanomas metastasize, they go to the ____ 98% of the time. Therefore, we should order tests to check the health of this thing.
Liver.
A thickness of >_____ indicates a choroidal melanoma instead of a nevus.
2mm
A choroidal melanoma pt typically experiences _______, ________, and _______. But a benign nevus pt often has no symptoms.
Flashes, floaters, distortion
(T/F) A benign nevus may undergo lipofuscin, which is an orange pigment
F. Choroidal melanoma
(T/F) A benign nevus might touch the ONH
F. Always assume it's malignant.
(T/F) Increase in size is often a sign that you have a choroidal melanoma instead of a nevus.
T
(T/F) The presence of drusen is a sign that you have a choroidal melanoma.
F. It is probably a nevus b/c it's been there a while.
(T/F) The presence of RPE changes is a sign that you have a choroidal melanoma.
F. It is probably a nevus b/c it's been there a while.
What does a choroidal melanoma look like in a B-scan?
Initial spike correlating to front of melanoma. Then spike decreases because melanoma is hollow in the middle.
(T/F) A benign nevi will stain intensly with FANG because it has feeder vessels that get filled with fluorescein.
F. Choroidal melanoma do that. Nevi's block the fluorescein.
(T/F) Choroidal nevi typically have active/acute sub-retinal fluid that causes RPE and photoreceptor disruption.
F. The fluid doesn’t have time to damage the RPE and photoreceptors. If there is damage, it is probably a nevus because it's been there a long time.
(T/F) Tumors that metastasized to the eye often show excessive pigmentation.
F. Often amelanotic.
Tumors that metastasize to the eye usually came from ____ from women and ____ from men.
Breast cancer. Lung cancer.
How does a tumor that metastasized to the eye typicall look like? Why?
Leopard skin. Lipofuscin with pigment.
(T/F) Tumors that metastasized to the eye are often multilobular (see multiple ones).
T
(T/F) Tumors that metastasized to the eye are often unifocal (others attached to it.).
T
(T/F) Tumors that metastasized to the eye are often bilateral.
F. Unilateral.
(T/F) Men often get more tumors that metastasized to the eye.
F. Women.
Treatment when tumor metastasized into the eye?
Refer to oncologist.
What are 3 ways lymphoma tumors are different from choroidal melanomas?
Bilateral, multiple tumors, vitritis.
Pts who get lymphoma are often (young/middle/elderly) and ______.
Elderly. Immunocompromised.
Treatment when lyphoma found?
Refer to oncologist.
(T/F) Lymphomas are not always malignant.
F.
(T/F) CHRPE are nevi
T
CHRPE are always asymptomatic unless they are near the _____ or _____.
Macula. ONH.
(T/F) CHRPE are often progressive.
F
What are the 3 types of CHRPE?
Solitary. Grouped. Multiple.
What does a solitary CHRPE look like?
White halo around it. (lacunae). Dark black inside. Flat, distinct borders. Can be big: .2-13 mm.
What does a grouped CHRPE look like?
Bear tracks. Flat, distinct borders. Groups of 3-30. Sectoral often in midperiphery and nasal to ONH. Unilateral. Small .1-2 mm. NO LACUNAE.
What does a multpile CHRPE look like?
Comet shaped tail that's depigmented. Bilateral. Irregular borders. Typically 6 per eye, but can go up to 30. In periphery.
What is multiple CHRPE associated with?
Gardner's syndrome aka Familial adenomatous polyps (FAP): colon cancer.
What are the 2 mains causes of chorio-retinal scars?
Inflammation. Trauma.
What 2 conditions are specifically mentioned as causing chorio-retinal scars?
Histoplasmosis. Toxoplasmosis.
(T/F) A chorio-retinal scar has an increased chance of getting a retinal tear. Why?
T. The vitreous tends to condense over the scar.
(T/F) Chorioretinal scars are typically benign lesions.
T
(T/F) Choroidal hemangiomas are malignant vascular tumors.
F. Benign.
(T/F) Choroidal hemangiomas are often unilateral and in the posterior pole.
T
What condition is a large hemangioma with diffuse, poorly defined borders related to?
Sturge-Weber syndrome.
What can be done for a large choroidal hemangioma caused by sturge-weber syndrome?
Nothing.
How does a large choroidal hemangioma look like in a B scan? Why?
Lots of reflectivity because it's vascular.
What does a choroidal hemangioma look like?
Orange/red. Dome shaped. Can be large.
(T/F) Choroidal melanocytomas are malignant.
F. Benign usually.
(T/F) A choroidal melanocytoma can cause an APD.
T
(T/F) Choroidal melanocytomas are unilateral? Non-progressive? Always on the ONH? Slightly dark?
Unilateral. Somewhat progressive. Always on ONH. Very very dark.
What condition is a proliferation of large cells?
Choroidal granuloma.
What condition is choroidal granuloma associated with? Give 2 specific examples.
Uveitis. Toxocariasis (worm). Sarcoidosis.
(T/F) Choroidal granulomas will usually result in a vitritis.
Cells in the vitreous.
What is the leading cause of blindness in pts between 20-74 years old?
Diabetic retinopathy
What is the most important thing for diabetic retinopathy pts?
Get checked for diabetes early via blood sugar
(T/F) Leakage in the retina and choroid is normal.
F. Leakage in the choroid is normal but not in the retina.
Explain the pathogenesis of diabetic ret?
Pericytes, which control blood flow, which line capillaries are damaged. The capillary walls are damaged and capillary endothelial cells are lost. Therefore, oxygen exchange can't occur.
What 3 things does diabetic ret lead to?
Hypoxia, neo and exudates from breakdown of blood-retina barrier.
How are RBCs shaped with diabetic ret?
Dumbbells
What is the difference between non-proliferative and proliferative diabetic ret?
Proliferative = neo.
What is involutional proliferative diabetic ret?
Involutional means they had it, but don't any more.
If a pt is diagnosed with diabetic ret before 30 y/o, they are ____% likely to get diabetic ret after 15 years.
97%
If a pt is diagnosed with diabetic ret after 30 y/o, they are ____% likely to get diabetic ret after 15 years.
78%
What diabetes affects younger people more. Type 1 or 2?
Type 1
What pts are more at risk of diabetic ret? Type 1 or 2?
1 because they get it younger.
If a pt sees better up close but things are blurry at far, they probably had a (myopic/hyperopic) shift
Myopic
Why do we check VAs for a diabetic pt? (2 things)
Fluctuating VAs and myopic shift
(T/F) Pupils can be affected by diabetic ret.
T. More sluggish.
Diabetics are more prone to getting CN palsies. Most common is CN___, and then CN___.
6. 3.
Why do we do an amsler grid with diabetics?
Look for edema at the macula.
For diabetics, where on the iris should we look when looking for NVI?
Pupillary ruff.
(T/F) There is no link between diabetes and POAG.
F. Pretty big link.
(T/F) Diabetes can lead to neovascular glaucoma.
T.
What test is great for looking for macular edema in a diabetic ret pt?
OCT
How often should diabetic ret pts be checked?
Yearly.
What 5 things do we want to document with a diabetic ret pt?
No NVI, NVD, NVE, CSME. No diabetic retinopathy.
What is the first thing diabetic pts need to do for treatment?
Control their blood sugar.
What is focal laser good for in diabetic ret pts?
It has smaller spot sizes to treat focal areas of swelling/edema.
What is grid laser good for in diabetic ret pts?
It has larger spot sizes to treat larger areas of edema.
What is Pan-Retinal-Photocoagulation good for in diabetic ret pts?
To get rid of neo in the mid-periphery.
(T/F) Pan-Retinal Photocoagulation is good for treating edema.
F. It will make it worse.
(T/F) focal and grid laser treatment can improve VA in diabetic ret pts.
F. It just stops vision loss.
(T/F) A side effect of pan retinal photocoagulation is peripheral vision field loss.
How can I tell the difference between PRP induced vision loss and glaucoma induced?
Glaucoma progresses.
What is atrophic creep for diabetic pts?
When a lot of PRP is done near the posterior pole and then it expands into the ONH and macula.
(T/F) If you see neo from diabetic ret, you should do PRP.
T.
(T/F) If you see angle closure from neo in a diabetic ret pt, we should do PRP.
F. Do a filtering bleb to increase circulation from anterior and posterior chamber.
Neo usually needs ___ to ___ weeks to regress after PRP.
4 to 6
After PRP, pts should RTC in _____.
1 month.
If you see that neo has regressed at your 1 month exam after a PRP, make pts RTC in ___.
3 months.
If a pt has a cataract, you should always take out the cataract first.
F. Usually do PRP first, unless cataract is prevention a good view of the retina.
(T/F) Vitrectomy and ILM strip are also treatments for diabetic ret.
T.
(T/F) Anti-VegF is also a treatment for diabetic ret. Why?
T. Kill neo.
Name 3 anti-VegF drugs. Which one is the biggie?
Avastin (biggie), Macugen, Lucentis.
What is a microaneurysm?
A focal enlargement of the capillary.
What happens when a microaneurism bursts in the eye?
You get a dot or flame heme.
What helps differentiate dot/flame hemes from microaneurysms?
FANG. Microaneurysms will hyperfluoresce. Dot/flame hemes will be black because they cover up the fluorescence behind them.
(T/F) A way to differentiate a microaneurysm from a dot/flame heme is to see if they change over time.
T. If you see a "heme" in the same spot 6 months later, it's probably a microaneurysm.
How can we differentiate dot hemes from flame hemes?
Dot hemes are smaller with distinct borders. Flame hemes are larger with fuzzy borders.
In mild non-proliferative diabetic ret, what will we find in the retina?
Microaneurysms, dot hemes, flame hemes.
What is the RTC for non-proliferative diabetic ret pts?
6 months to 1 year.
What is the criteria for moderate non-proliferative diabetic ret?
Moderate amount of dot/blot hemes in 4 quadrants or severe in 1 quadrant.
What are the 4 quadrant locations for quadrant 1, 2, 3, 4 for diabetic ret pts?
1-superior nasal, 2-inferior nasal, 3-inferior temporal, 4-superior temporal.
What are cotton wool spots? (precisely)
Areas of NFL infarcts.
What is venous beading?
When vessels look like swollen sausages.
If you have venous beading in 1 quadrant, you have (mild/moderate) non-proliferative diabetic ret. But if you have 2 or more, you have moderate/severe) diabetic ret.
Moderate. Severe.
IRMA stands for _____.
Intra-Retinal microvascular abnormality.
(T/F) IRMA is basically the same thing as neo.
F.
How can IRMA be differentiated from neo with FANG?
IRMA will never/rarely leak, but neo will.
How does neo grow differently from IRMA?
Neo grows towards the vitreous but IRMA is flat on the retina.
When should a pt RTC with moderate diabetic ret?
3-6 months.
How do exudates look different from cotton wool spots?
Exudates have hard borders and are smaller but bunched together. CWS are bigger with softer borders.
How do young CWS look different from old CWS?
When young, white, bright and fluffy looking.l When older, grayish, greasy, not as fluffy
RNFL myelination looks similar to CWS. How can we differentiate them?
RNFL mylination has striations
What is the criteria for severe non-proliferative diabetic ret?
4:2:1 rule 4 quadrants of severe hemes or 2 quadrants of venous beading. Or 1 big IRMA. Must have 2 of 3 to be severe.
What is the RTC for severe non-proliferative diabetic ret pts?
1 month.
___% of severe non-proliferative diabetic ret pts get proliferative diabetic ret within 1 year.
50%
Studies are inconclusive on whether PRP prevents the converstion from non-proliferative diabetic ret to proliferative. Why do they still do it sometimes? (2 reasons)
If pt has poor compliance. Rapid progression.
A pt who has ____ has the highest likelihood to get neo from diabetic ret.
Venous beading.
What is the definition of NVD?
Neo within one disk diameter of the nerve.
What is the definition of NVE?
Neo that is not within one DD of the nerve.
Where on the iris is neo most likely to start? But it can also happen where?
Pupillary rough. Angle.
What characteristics define low risk proliferative diabetic ret?
NVD on less than 1/4 of the disc or if only NVE.
What is the referral time for low risk proliferative diabetic ret?
1-2 weeks
What is the referral time for high risk proliferative diabetic ret?
1-2 days
What characteristics define high risk proliferative diabetic ret?
NVD on more than 1/4 of the disc. Or less NVD than 1/4, but vitreal hemorrhage.
Doing PRP for diabetic ret neo reduces the risk of severe vision loss by ___%
50%
A pt has macular edema and neo from diabetic ret. What should they do?
First focal laser for edema. Then PRP.
How does PRP reduce the grow of neo?
It kills the retina so less oxygen is needed.
With diabetic pts, Dr. Y stresses to ___.
Look at the pupillary ruff for NVI.
If I see NVI at the pupillary ruff, do ____.
Gonio.
If a pt has advanced diabetic ret but no neo at the pupillary ruff ____
Do gonio to look in the angle.
If a diabetic ret pt has neo on the iris but no angle closure, treatment is ____
PRP
If a diabetic ret pt has angle closure, treatment is ____
Bleb to decrease pressure.
How is neo different from a normal iris blood vessel?
They are thin, wispy, come from the pupillary ruff and goes everywhere without direction.
(T/F) If a pt has blue or green eyes, I am likely to see normal vessels on the iris, but not for brown.
T
(T/F) Typically, blood vessels on the iris grow towards the angle.
F. Neo often does this.
If someone had sickle cell anemia, what would their neo look like?
Seafan.
How are collateral vessels formed?
A vein occlusion.
How are collateral vessels distinguished from neo?
In FANG, collateral vessels don't leak.
What is the treatment for collateral vessles? For neo?
None. PRP.
How is neo different from optocilliary shunt vessles?
Optocilliary shunt vessels are typically on the optic nerve and thicker than neo. They are also flat.
What do optocilliary shunt vessels for?
Connect retinal circulation to choroidal circulation
What are the 3 classifications of CSME?
1) Exudates within 500 microns of macula and retinal thickening. 2) Retinal thickening within 500 microns of macula. 3) 1 DD of retinal thickening within 1 DD of the macula.
You see edema in a diabetic pt that doesn't qualify for CSME. So what is it?
Diabetic macular edema.
1 DD is ____ microns.
1500
Where does exucate leakage typically occur? (What layers)
outer plexiform and inner nuclear.
When can CSME form for diabetic pts?
ANY stage.
If you see exucates but no retinal thickening, what does it mean?
There once was retinal thickening, but it went away.
What is a circinate ring?
With CSME, you'll get a ring of exudates with the outside being exudates and the middle being leakage.
For CSME we can do grid/focal laser to improve vision.
F. Both are good for preventing vision loss.
(T/F) You can have 20/20 vision with CSME
T
For CSME, if laser therapy isn't working, you can do a ____ to _____.
Steroid shot (kenelog) to reduce inflammation
(T/F) Avastin is a treatment for CSME.
T
(T/F) PRP is a treatment for CSME.
T
What are the 3 types of diabetic macular edema?
Focal (small circinate ring), diffuse (large area of leakage), Ischemic (too much CSME so macula becomes ischemic).
RTC plan for CSME? Other options?
3 months. Or refer to retinal specialist.
What is the best way to see edema? 3 other ways?
OCT. Stereo. Optic section. FANG
What are 2 other signs of edema?
Blurring of choroidal vasculature. No FR.
(T/F) Cotton wool spots are bright spots on FANG
F. Dark spots
What does rhegmatogenous RD mean?
It's secondary to a tear or hole.
(T/F) Diabetics typically get non-rhegmatogenous RDs.
T
What kind of non-rhegmatogenous RDs do diabetics get?
Tractional RDs.
What is the treatment (4 steps) for rhegmatogenous RD?
Vitrectomy to relieve traction. Then do ILM strip to remove fibrovascular tissue. Then PRP to tack down retina. Then Avastin.
Where is a preretinal hemorrhage?
Between the ILM and posterior hyaloid face of the vitreous.
(T/F) Preretinal hemorrhages happen on older people typically. Why?
F. Younger. Because if you have PVD, you can't have a preretinal hemorrhage.
What do preretinal hemorrhages look like?
Keel boat shaped hemorrhages.
What does old blood in the vitreous look like?
Brown and white clumps that sink to the bottom.
What must we assume if we see vitreal hemorrhaging or preretinal hemorrhaging?
Neo.
What do retinal specialists do with intravitreal hemorrhages?
Wait to see if it resolves. If it causes other problems or stays too long, then vitrectomy.
What 4 things should someone do with an intravitreal hemorrhage?
Reduce aspirin. No strenuous activity. Relax. Sleep with head elevated.
What is a typical VA if they have blood in their vitreous.
20/200
Why might we do a vitrectomy for a pt with intravitreal hemorrhages? (5)
Longstanding, returned, monocular pt, in both eyes, tractional RD.
What are complications of vitrectomy? 3
Endophthalmitis, RD, cataracts.
What is the RTC for vitrectomy pts?
1 days, 1 week, 1 month, 3 months.
(T/F) For normal pts, FANG will show a light macula.
F. Dark.
Why does a macula look dark in FANG? 2
Avascular. Xanthophylls block FA.
What will macular ischemia look like in FANG?
Super dark.
What is the treatment for macular ischemia?
No treatment. Too dangerous.
What is the best way to pick up capillary nonperfusion?
FANG
What will the retina look like with capillary nonperfusion?
Mottled/uneven
What is the proper name for diabetic nerve head edema?
Diabetic Papillopathy.
(T/F) Diabetic papillopathy is a mild form of nonAION
T
What are some things you'll see ophtalmoscopy wise with diabetic papillopathy?
Unilateral mild ONH edema (margins not distinct). Fine hemes on disc.
(T/F) A diabetic papillopathy pt will have an APD
T
___% of pts with Diabetic Papillopathy see 20/40 or better.
75%
What is the treatment for diabetic papillopathy?
None.
What typically happens with diabetic papillopathy.
Resoves in weeks to months.
(T/F) Diabetic papillopathy correlates to the amount of diabetic retinopathy.
F. Can happen at any stage.
What are the 8 differentials of diabetic ret?
Hypertensive retinopathy. Retinal vein occlusion. Anemic retinopathy. Ocular ischemic retinopathy. Radiation retinopathy. Coat's disease. Eale's disease. Antiphospholipid syndrome.
How is hypertinsive ret different from diabetic ret? 4
More cotton wool spots than hemes. Flame hemes vs than dot hemes. Vessels have AV nicking an attenuation vs vascular loops and venous beading. Exudates in macular star vs. circinate ring.
What kind of hemorrhage is red with white in the center?
Roth spot.
How is anemic ret different from diabetic ret?
You see roth spots.
How is CRVO different from diabetic ret?
Vessles are tortued and dilated and explosion of blood (CRVO is everywhere, BRVO is one quadrant)
If I see blood 360 in the peripheral retina, what do I probably have?
Iritis
What does ocular ischemic syndrome look like?
Hemes more in periphery. Unilateral. Vessels dilated but not tortuous. Also has associated carotid occlusion
How can you differentiate radiation retinopathy from diabetic ret?
Case history
How can you differentiate Coat's disease from diabetic ret?
Unilateral with lots of exudation for Coats.
What kind of pts typically get Eale's Disease?
Young males.
What do we see in Eale's Disease?
Vascular sheathing - inflammation of vessels, which looks white.
Diabetes makes a (hyperopic/myopic) shift
Myopic
Glyburide and glypizide makes a (hyperopic/myopic) shift.
Hyperopic.
(T/F) Glyburide and glypizide makes a hyperopic shift that resolves in 1 year.
F. 3-4 months.
(T/F) Flame hemes are never seen in diabetic ret.
F. They can occur but are usually associated with hypertensive ret.
(T/F) Macular edema is the #1 reason why pts lose vision from diabetes.
T.
(T/F) Diabetic pts get deutan defects.
F. Tritan.
(T/F) Diabetic pts often have a decrease in nocturnal vision.
T
(T/F) Diabetic pts do not usually have decreases in peripheral vision.
F.
What are typical complaints for an retinitis pigmentosa pt.
I can't drive at night and bump into things.
(T/F) Pts with retinitis pigmentosa are unlikely to have 20/20 vision.
F.
Name 3 variations of RP.
1) RPE hypoplasia in one quadrant. Bone spicules in posterior pole but not in periphery. No pigmentary changes but RP symptoms (RP sine pigmento)
What are the symptoms of Stargardts Fundus Flavimaculatus?
Macular changes leading to central vision loss.
How is Stargardts Fundus Flavimaculatus different from Dry ARMD?
Affects young people
What is the nick name for Bests's Vitelliform Dystrophy?
Egg Yolk disease
What happens in Best's Vitelliform Dystrophy?
Lipofuscin liquefies
(T/F) Pts with Best's Vitelliform Dystrophy may have improved vision over time.
T. B/c liquefied lipofuscin could be reabsorbed.
What is Familial Dominant Drusen?
Drusen at the posterior pole at a much younger age.
What other disease is Familial Dominant Drusen's problems similar to?
ARMD
What are symptoms of Albinism?
Light complexion. Light sensitive. Pront to sunburns.
What a macular hypoplasia and how does it relate to albinism?
Light fundus b/c little/no pigmentation and development of macula.
(T/F) Nystagmus is related to oculocutaneous albinism.
T.
What is the treatment for albinism? 2
Low vision and sunglasses.
What is a good test to see if we have an RD?
B scan
What is oculocutaneous albinism?
A severe case of albinism causing problems.
How will the iris, eye movement and Vas be for someone with oculocutaneous albinism?
Will transilluminate, nystagmus, bad Vas (like 20/200)
What does ERGs evaluate?
Rods and Cones
What do diminised A and B waves indicate on an ERG?
Decreased ability for electrical impulses to pass from photoreceptors.
What does a VEP tell you?
Whether stimulus is passing through to the brain.
(T/F) If a pt does EOG and the light peak/trough and dark peak/trough are 2:1, that is a sign of decreased RPE function.
F. If the ration is 1:1, that is reduced RPE function. 2:1 is normal.
(T/F) The amplitude of peaks on VEPs tells me how much info is going from eyes to brain and the speed.
T.
What kind of pt might have reduced peaks on VEPs?
MS pts who have demyelinated axons and therefore decreased transmission amplitude and speed.
What would the retina look like for an RP?
Bone spicules. Moth eaten areas of retinal atrophy.
(T/F) The ONH will become pale with RP.
T. Because retina is degenerating over time.
(T/F) You might find drusen on the ONH in RP
T.
Name 2 reasons why RP pts might have central vision loss.
CME. PSC.
(T/F) RP usually happens in older people
F. If 20 y/o pt has nigh blindness, then they might have RP.
How does the ring scotoma form in RP pts?
Superior depression. Then scotoma. Then ring scotoma. Then scotoma moves outwards an dinwards.
(T/F) Vitamin E is helpful (15000IU) for RP pts.
F. Vitamin A!
What is the management for RP?
Genetic counseling. Possible driving restrictions. Low vision referral. Goldman VFs. Vitamin A.
RP albescens symptoms.
Pigment changes in equitorial regions moves peripherally and towards macula.
(T/F) RP albescens, Sector RP, RP sine pigmento, Inverse RP are treated just like normal RP.
T
What is sector RP?
RP in a single sector.
What is RP sine pigmento?
Not much RPE degeration but symptoms are the same.
What test can confirm RP sine pigmento?
Electrodiagnostics like ERG and EOG.
What is Inverse RP?
RP symptoms showing up in the posterior pole than periphery.
What 2 diseases are noted as having symptoms similar to RP?
Syphillus and Rubella
Why do stargardts pt like darkness?
Macula is obliterated but rods are spared. So pts prefer dim light.
What are 2 things that we might see in an Stargardts retina.
Yellow flecks in posterior pole. Beaten bronze look that could look like a bullseye.
When does Bests Vitelliform Dystrophy typicall onset?
10 y/o.
What does Bests Vitelliform Dystrophy look like under FANG?
Darker in the egg yolk b/c lipofuscin blocks fluorescence.
What type of tests is generally useful for diagnosing RPE problems?
Electrodiagnostics like ERG and EOG.