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Macular Disease
Yud-Final
82
Medical
Graduate
12/09/2013

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Term
Another name for Retinal Glial Cell Proliferation
Definition
Epiretinal Membrane
Term
New treatment for Vitreoretinal Traction
Definition
Jetra/Ocriplasmin
Term
Epiretinal Membrane is best detected with a ________________ filter
Definition
Red Free filter
Term
4 things that can cause secondary Epiretinal Membranes
Definition
Retinal procedures (RD/PRP/Cryo)
Retinal Vascular Disease
Intraocular Inflammation
Trauma
Term
Treatment of Epiretinal Membrane
Definition
Vitrectomy and membrane peeling-only if VA significantly reduced
Term
Risk of treating an Epiretinal Membrane
Definition
May cause an even worse ERM
Term
4 Etiologies of Macular Holes
Definition
Idiopathic
Myopia
Trauma
Solar Retinopathy
Term
Why is it rare to see a Stage 2 Macular hole
Definition
It quickly progresses from Stage II to III
Term
Describe a stage 2 macular hole
Definition
An EARLY macular hole, yellow ring enlarges, tangential tear at one edge
Term
Usual VA for a Stage III Macular Hole
Definition
20/200 or worse
Term
Describe a stage 3 Macular Hole
Definition
Halo of RD surrounds hole
Round/punched out area
Yellow deposits at RPE in hole
Term
Appearance of Macular Hole on FANG
Definition
Hyperfluorescence in hole (RPE=window defect)
Term
2 Goals with treatment of macular hole
Definition
Stimulate glial cell proliferation/migration
Relieve vitreo-retinal traction
Term
What causes a macular pseudohole
Definition
Epiretinal Membrane causes appearance of a macular hole
Term
Name another retinal condition that occurs in the same layers as CME
Definition
Retinoschisis
Term
Appearance of CME on FANG
Definition
Petaloid hyperfluorescence
Term
CME WITH or WITHOUT vascular leakage when due to...
Diabetic Retinopathy
Definition
WITH leakage
Term
CME WITH or WITHOUT vascular leakage when due to….
BRVO
Definition
WITH leakage
Term
CME WITH or WITHOUT vascular leakage when due to…
Pseudophake/aphakia
Definition
WITH leakage
Term
CME WITH or WITHOUT vascular leakage when due to…
Idiopathic Retinal telangiectasia
Definition
WITH leakage
Term
CME WITH or WITHOUT vascular leakage when due to…
Retinitis Pigmentosa
Definition
WITHOUT leakage
Term
CME WITH or WITHOUT vascular leakage when due to…
Early Macular Hole
Definition
WITHOUT leakage
Term
CME WITH or WITHOUT vascular leakage when due to…
Nicotinic Acid Maculopathy
Definition
WITHOUT leakage
Term
CME WITH or WITHOUT vascular leakage when due to…
Choroidal neo
Definition
WITHOUT leakage
Term
3 Treatment modes of CME (depends on cause)
Definition
Laser Photocoagulation, Vitrectomy
Systemic CAIs
Steroids/NSAIDs
Term
Compare treatment of CME to just observation
Definition
Same end result but resolution is much quicker with triamcinolone
Term
Name 2 injections used to treat uveitic macular edema
Definition
Avastin and Triamcinolone
Term
What is the most common cause of vision loss with DM
Definition
CSME
Term
T/F
CSME can occur on it's own without any other signs of DR
Definition
1
Term
3 types of laser treatment of CSME
Definition
Focal
Grid
Panretinal
Term
What condition is likely to develop after panretinal treatment of CSME
Definition
CME
Term
3 forms of treatment of CSME
Definition
Laser
Anti-VEGF
Intra-Vitreal steroid
Term
Conclusion of study that investigated effectiveness of Lucentis on DME
Definition
Lucentis (ranibizumab) reduced DR progression and improved VAs
Term
What type of retinopathy stereotypically occurs in young, type A males
Definition
Central Serous Retinopathy
Term
FANG appearance of Central Serous
Definition
Smokestack or Umbrella hyperfluorescence
Term
Visual symptoms of Central Serous
Definition
sudden VA reduction
relative scotoma
metamorphopsia
micropsia
impaired dark adaptation
Term
Approx what proportion of Central Serous cases resolve on their own
Definition
80% resolve on their own within 1-6 mo
the remaining 20% generally within 1 year
Term
2 reasons why central serous retinopathy may have permanent visual disturbance
Definition
prolonged detachment
multiple, recurrent attacks
Term
1 advantage and 1 disadvantage of focal laser photocoagulation in treating Central Serous
Definition
Adv-may speed up resolution by a few months
Disadv-does not improve visual outcome
Term
Why might 'Micro-Pulse Diode Laser Therapy' be superior to anti-VEGF injections
Definition
Micropulse creates less heat and therefore causes less sub-retinal fluid to form
Term
Describe SRT (Selective Retina Therapy)
Definition
New laser for CSR with PED that selectively treats RPE while sparing photoreceptors, causes outer b-r-b reconstruction
Term
How is normal PDT therapy modified to treat CSR
Definition
Half-dose PDT
Term
Breaks in Bruch's membrane due to Myopic Degeneration
Definition
Lacquer Cracks
Term
Term for secondary pigment proliferation from choroidal vessel growth
Definition
Fuch's spot
Term
Fuch's spots are associated with what type of degeneration
Definition
Myopic Macular Degeneration
Term
Patients with medical history of malaria, rheumatoid arthritis or lupus need to be examined for what type of retinopathy
Definition
Antimalarial Maculopathy, ie chloroquine maculopathy
Term
What cumulative dose of chloroquine increases risk of maculopathy
Definition
300g cumulative dose (250mg/day for 3 years)
Term
Which has less risk, hydroxychloroquine or chloroquine
Definition
Hydroxychloroquine
Term
Antimalarials tend to concentrate on melanin-containing structures such as __________ and ___________
Definition
RPE and Choroid
Term
True or False
Antimalarials can cause corneal deposits that need to be monitored very closely
Definition
False-they are relatively benign
Term
3 components of a baseline retinal evaluation of a patient starting anti-malarials
Definition
Visual Field 10-2
Dilation
AF, SD-OCT or mfERG
Term
What can cause this group of symptoms
VA loss
Fixed/dilated pupils
Retinal Edema
Attenuated arterioles
constricted VF
Optic atrophy
Definition
Overdose of quinine, causes whats called cinchonism
Term
2 drugs used to treat schizophrenia or other psychoses that can also cause retinopathy
Definition
thioridazine
Chlorpromazine
Term
What type of retinopathy can be caused by thioridazine or chlorpromazine
Definition
Salt and Pepper Maculopathy
Eventually Geographic atrophy with hyperpigmented clumps
Term
Visual symptoms of Phenothiazine Maculopathy
Definition
Decreased VAs
Poor Dark adaptation
Term
Describe Tamoxifen Maculopathy
Definition
Multiple, superficial yellow crystalline ring-like deposits at macula
Term
Effects of Tamoxifen other than maculopathy
Definition
Vortex Keratopathy
optic Neuritis
Term
What is tamoxifen used to treat
Definition
Breast Carcinoma
Term
What is Canthaxanthin
Definition
An Oral drug that enhances suntanning
Term
Describe how Canthaxanthin can affect the retina
Definition
causes maculopathy that looks like tiny, glistening yellow dots in donut shape around macula, in superficial retina
Term
How might Talc Maculopathy appear different than Canthaxanthin?
Definition
Talc scatters throughout posterior pole, Canthaxanthin concentrates around the macula
Term
Other retinal manifestations of Talc maculopathy
Definition
Macular Edema
Venous Engorgment
Punctate/Flame hemes
Arterial Occlusion
Term
If you discover Talc maculopathy, what other form of examination should you refer your patient for?
Definition
Pulmonary consultation, cuz if there is lots in the eye, there is lots in the lungs and it may be compromising lung function
Term
Approximately how long after sun exposure can solar maculopathy present
Definition
2 weeks after exposure
Term
What might you see on OCT of solar maculopathy
Definition
very small lamellar hole or cyst on foveola
Term
How does solar maculopathy tend to affect vision
Definition
VAs normal, small central scotoma
Term
Classic Triad of Presumed Ocular Histoplasmosis Syndrome
Definition
Histo spots
Peripapillary atrophy
CNVM
Term
End result if Histoplasmosis Maculopathy is not treated
Definition
Fibrous disciform scar
Term
Treatment of CNVM due to histo
Definition
Argon laser photocoagulation, best if >0.25DD from macula
or Visudyne
Term
3 serologic tests for Toxo
Definition
ELISA
Indirect immunofluorescent antibody tests
Hemoagglutination
Term
Medical treatment of active toxo
Definition
Pyrimethamine
Sulfadiazine
Clindamycin, Atovaquone
Systemic Steroids
Term
Appearance of angioid streaks on FA
Definition
Hyperfluorescence of RPE 'window' defect over streaks
Term
3 findings associated with Angioid streaks
Definition
Peau d'orange/Leopard skin spotting
Salmon spots
Optic nerve drusen
Term
3 complications of angioid streaks
Definition
Choroidal rupture
Foveal involvement
choroidal Neo
Term
4 systemic associations of Angioid Streaks
Definition
Pseudoxanthoma Elasticum
Paget's disease
Ehler's Danlos Syndrome
Hemoglobinopathies-sickle cell and thalassemia
Term
5 Common Causes of CNVM
Definition
Exudative AMD
Myopic Macular Degernation
Ocular Histoplasmosis
Angioid Streaks
Choroidal Rupture
Term
Most important differential diagnosis of Choroidal Folds
Definition
Retrobulbar Mass-need CT
Term
5 causes of choroidal folds
Definition
Idiopathic
Orbital Disease (mass, thyroid)
choroidal tumor
Posterior Scleritis
Ocular Hypotony
Term
Retinal folds are associated with Stage 3 of this condition
Definition
Retinopathy of Prematurity
Term
What is the mildest form of idiopathic retinal vascular anomaly?
Definition
Idiopathic Juxtafoveal Retinal Telangiectasia
Term
3 forms of idiopathic retinal vascular anomaly, from mild to severe
Definition
Mild-IJRT
Leber's Miliary aneurysm
Coat's Disease-severe
Term
Briefly describe 3 main types of IJRT
Definition
1) Mostly males, easily seen by Dr.
2) either gender, VA affected, FA helps
3) rarest, poor macula 02, CNS strokes
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