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42 Cards in this Set
- Front
- Back
what are areas of NFL edema that are yellow areas with soft edges
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cotton wool spots
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cotton wool spots are caused by what
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focal ischemia that leads to an interuption of axoplasmic flow that allows axoplasmic content drainage
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give some examples of vascular dz's that cotton wool spots are associated with
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AIDs, DR, HTN retinopathy
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the most advanced from of late AMD is
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geographic atrophy
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geographic atrophy is AKA
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central geographic atrophy (CGA)
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late AMD with geographic atrophy is usually bilateral/unilateral, symmetrical/asymmetrical
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bilateral and symmetrical but may have a different rate of onset and progression
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areas of atrophy present with geographic atrophy, do they grow over time or do they stay stable
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they grow over time spreads around the fovea and engulfs it
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the pathogenesis of geographic atrophy is unclear but what are some of the thoughts on how it occurs
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areas of confluent large, soft drusen that have undergone regression
accumulation of lipofuscin and A2E multiple areas of hyper/hypopigmentation that progresses spontaneous flattenting of a PED |
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what layers are affected by geographic atrophy
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there is a gradual loss of the RPE, choriocapillaris and the photoreceptor function, also the outer plexiform layer is thinned and vacuoled so the outer nuclear laryer rests directly on the RPE (but Dr. Erickson mentioned in lecture that the RPE is basically gone?)
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true or false a CNV may form within the atrophic zone of geographic atrophy. explain your answer
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false most will not have formation of a CNV. the 20% that will get CNV, it only occurs at the edges not within if this occurs you just consider it as a combo CNV and GA
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true or false with geographic atrophy the choroidal vessels are less prominent
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false they are more prominent b/c the RPE ect....are becoming thinner
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how do you handle a pt with geographic atrophy? ....treatment, RTC...ect
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unfortunately there is no treatment and you should see them at least every 6 months maybe a year depending on severity and their risk factors
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the trial ART has shown that the use of what is safe and effective for treatment of dry AMD.
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rheopheresis - (RHEO)
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the use of what drug to treat dry AMD is in trial right now and could be used by the time we are practicing? Hence it is showing promise
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fenretinide
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the main cause of vision loss in patients with AMD is
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b/c of exudative AMD (CNV)
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what is the hallmark sign of exudative AMD
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formation of CNV
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a CNV grows through a break in what layer of the "fundus"
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it grows through a break in Bruch's membrane stemming from the choriocapillaris
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what causes the sensory retinal detachment associated with exudative AMD
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the leakage of blood from the choriocapilaris
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if you see blood leakage on a persons retina what three things should you consider the possible causes
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high bp, diabetic or CNV
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a CNV that has hemorrhaged and formed a scar is called what (type of scar)
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a disciform scar
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what are the two locations that CNV could be located
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just posterior to the RPE or just anterior to it
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name four things that CNV leakage can lead to
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serous detachment or the RPE
lipid exudation hemorrhages RPE tears |
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true or false you can get cotton wool spots with CNV
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false
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size of the lesion in wet AMD can be associated with vision loss. How many lines of VA loss would you expect with a patient that has a lesion 1DD in size? how about 2 DD, and 3DD
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1DD= 1 line of loss
2DD= 2 lines of loss 3DD= 3 lines of loss |
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trivial question. what is the growth rate of a wet AMD lesion
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about 18 microns per day
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if you catch and treat CNV early, say you catch a patient and their VA is 20/50. what could you expect to get their VA back to
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maybe back to 20/32
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PHP stands for
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preferential hyperacuity perimeter
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The Foresee PHP monitor is used to monitor what
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AMD from dry to wet
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the Foresee PHP measures how many degrees of the retina
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up to 14
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comparing eyes with CNV what percent will the PHP catch compared to the amsler grid
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the PHP saw 100% and the amsler grid caught 53%
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what is the one problem with the PHP monitor for wet AMD
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there are a lot of false positives
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what are the three types of CNV membranes seen with FA's
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classic CNVM
minimally classic CNVM occult CNVM |
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what CNVM pattern on a FA shows up as a lacey pattern with a well defined membrane. this type accounts for about 13% of CNVM and will fluoresce brightly and then leak into subretinal space
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classic cnvm
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what type of cnvm seen with FA accounts for 87% of cnvm's, has a poorly defined membrane and less precise features
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occult cnvm
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describe minimally classic cnvm
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it is a combo of both the classic cnvm and the occult
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what must be done prior to treatment of wet AMD
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you must do a FA
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disciform scaring is from what
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healing hemorrhages
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the initial appearance of a hemorrhagic RPE detachment is
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very dark red and elevated
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what type of FA staining would you expect to see with a hemorrhagic RPE detachment
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hyper corresponding to the RPE detachment and an area o hypo corresponding to the hemorrhage
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what type of FA staining would you expect to see with a CNV that has not been treated and has caused a hemorrhagic sensory retinal detachment
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hypo due to blockage of background choroidal fluorescence
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how will a hemorrhagic sensory detachment show up on an FA
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as hypo b/c the blood is blocking the choroidal fluorescence
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what is it called when a hemorrhage breaks through the sensory retina
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a vitreous hemorrhage
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