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26 Cards in this Set
- Front
- Back
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70% post ______ CME ? |
cataract cme cases resolve on their own |
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TX CME |
topical ketorolac (NSAID) QID x 3mo acetazolamide 500mg- post op pts and ret pig and uveitis if ME persits 3-6 mo after BRVO and VA below 20/40 (worse) -- focal laser photocoag if vit incarceraceration- YAG laser lysis steroids- if pars planitis |
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macular holes starts |
at internal limiting membrane and go to the outer segment of the photoreceptor layer |
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macular holes is unilateral? |
FALSE ITS BILATERAL IN 30% pts |
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la macula esta mas expuesta a traction cuando hay PVD pq... |
es el 2nd weakest attacthcment to the vitreous |
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when does a true macular hole occur? |
when there's a posterior vitreous separation that pulls the macula |
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traccion del vitreo esta asociado a |
epiretinal membranes retinal thickening y NO FOVEAL REFLEX |
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stage 1 impending macular hole |
umbo elevated= no foveal reflex underlyign yellow spot schisis cavity- inner ret layers detatch from photo receptor level |
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Stage 1b - occult macular hole |
yellow ring asoc w/ metamorphopsia or VA decrease se puede curar solo todavia |
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Stage 2 small full thickness or early thickness |
diameter < 300 microns pasa 1 wk or several mo after stage 1b OCT can show a break in the ROOF |
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Stage 3- FULL size macular |
diameter >400 microns posterior vitreous todavia esta pegado RED BASE w/ yellow-white dots + grey cuff of sub ret fluid VA - 20/200 underlying operculum |
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Stage 4- FULL size mac hole w/ PVD |
todo lo de stage 3 + POSTERIOR VItrEOUS HAS COMPLETELY DETATCHED suggested by WEISS RING |
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tests for macular hole |
"woody" allen test OCT FA amsler grid= central distortion- not scotoma |
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DDX macular hole |
Macula pseudoholes in mac epiretinal membrane (ERM)= va remains good vitreomacular traction- solar retinopathy- central scotoma, bilateral macular microhole- red single sharply defined lesion lamelar hole- cuando un mh para d formarse o long standing CMV Foveal pseudocyst-first step of mh |
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Tx macular hole |
surgery indicatd for stage 2 or worse if 20/100 vitrectomy para reducir la traccion JETREA- ocriplasmin te hace una vitreolisis farmacologica |
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HIgher risk of getting Macular hole in the fellow eye IF: |
fellow eye has; NO PVD has RPE disturbances or retinal thinning |
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Central serous chorioretinopathy |
UNILATERAL detatchment of the sensory retina at the macula due a choriocapillary leak por un defecto del RPE causa metamorphopsia y micropsia steroids or epinephrine suben la choroidal and RPE hypermeability y tmb causan choroidal ischemia. |
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Central serous chorioretinopathy signs |
distortion dome shaped macula no hemes or exudation mild apd= washed out colors |
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Central serous chorioretinopathy FA patterns |
smokestack inkblot PEDs demonstrated multiple leakage |
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en que layers ocurre el CME? |
en el outer plexiform y el inner nuclear layers |
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a que edad ocurre mas el ARMD? |
peak entre 75-85 |
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cuales son los ICD de ARMD? |
ICD-9-CM - 362-51 dry y 52 wet ICD-10-CM- H35.31dry y 32 if wet |
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DRY ARMD SIGNS |
>50 y.o. DRUSENS BILATERAL central VA loss - pt sees fuzzy area decreased color vision geographical atrophy clumps of pigment at outer retina FA: window defects , exposed sclera late staining |
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Which one shows Early phase hyperfluorescence,well definedwith leaking Classic or Occult CNVM? |
Classic CNVM |
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Occult CNVM will show : |
mid to late phase hyperfluorescence mottled and not well defined |
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que contiene AREDS 2 |
Vit E 400iu Vit c 500mg Lutein 10mg/ Zeaxanthin 2mg zinc 80mg copper 2mg |
