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Vascular Dz-Dr Y
Ocular Disease III Exam 2
62
Medical
Graduate
03/14/2013

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Term
2nd most prevalent vascular disease
Definition
BRVO
Term
How would you categorize a BRVO that affects more than 5 DD of the retina?
Definition
Major BRVO
Term
How would you categorize a BRVO that affects 2-5 DD of the retina?
Definition
Primary BRVO
Term
How would you categorize a BRVO that affects <2 DD of the retina
Definition
Secondary BRVO
Term
Name 4 common systemic causes of BRVO
Definition
HTN
Cardiovascular dz
Diabetes
Glaucoma
Term
Describe vision associated with BRVO
Definition
sudden, unilateral, painless loss over 24-48 hours, partial field loss
Term
What is happening in the vasculature that causes a BRVO
Definition
An artery compresses the thin-wall of a vein
Term
What may be visualized in a retina with a BRVO
Definition
dilated, tortuous vessels
retinal hemes
CWS
Macular edema
Lipid infiltrates near occlusion
Collaterals
Term
5 DDX of BRVO
Definition
DR
HTN Retinopathy
Anemia-based retinopathy
Retinal vascular break
CMV retinitis
Term
BRVO
How does laser photocoagulation affect the risk of vitreous hemorrhages
Definition
Reduces risk by 30%
Term
2 indications ofr argon laser treatment of BRVO
Definition
Chronic ME
Retinal neo
Term
Age of onset of BRVO and CRVO
Definition
BRVO-40-50
CRVO after 50
Term
2 systemic diseases strongly correlated with CRVO
Definition
Carotid artery dz
Other vascular dx
Term
BRVo and CRVO, unilateral or bilaterl
Definition
Both generally unilateral
Term
3 causes of CRVO for individuals <50yo
Definition
Head injury
Hyperlipidemia
Estrogen-containing preparations (Birth control)
Term
Locations of CRVO
Definition
Right at lamina cribrosa, either inflammation, anatomical change or blood viscosity leads to thrombus build-up
Term
What is Reye's syndrome
Definition
Occurs in child when given aspirin
NEVER GIVE A CHILD ASPIRIN
Term
Are the majority of CRVO cases ischemic or non-ischemic?
Definition
75% non-ischemic
Term
Ischemic vs. Non-ischemic CRVO
Which is more often associated with an APD
Definition
Ischemic, no APD with non-ischemic
Term
CRVO
Ischemic= _________________- occluded CRV
Non-ischemic=_______________occluded CRV
Definition
Ischemic=completely occluded
non-ischemic=partially occluded
Term
Ischemic vs. Non-ischemic CRVO
Age of incidence
Definition
Non=younger to middle age
Ischemic-elderly
Term
Ischemic vs. Nonischemic CRVO
Which causes rubeosis irides
Definition
ischemic
Term
4 DDX of CRVO
Definition
Ocular ischemic syndrome
Diabetic Retinopathy
Hypertensive retinopathy
Papilledema
Term
2 possible complication sof CRVO
Definition
Neovascularization
Neovascular glaucoma
Term
CRVO vs. hemi-CRVO vs. BRVO
site of occlusion
Definition
CRVO and hemi-CRVO=in optic nerve at lamina
BRVO=arteriovenous-crossing
Term
CRVO vs. hemi-CRVO vs. BRVO
Retinal collaterals
Definition
CRVO=absent
Hemi-CRVO=present
BRVO=present
Term
When should CRVO be treated with PRP
Definition
Safe to wait for development of early NVI
Term
What results were found regarding treatment of CRVO with macular gridi photocoagulation
Definition
This method of treating ME was found to have no benefit
Term
What is the SCORE study looking into
Definition
Use of steroid (triamcinolone) injections to treat CRVO
Term
2 things to watch for in follow up of CRVO
Definition
ME
Neo
Term
T/F Anti-VEGF has been shown to be effective in treatment of BRVO and CRVO
Definition
True, use of Lucentis resulted in improvement of 16-18 letters depending on dosage
Term
Based on researchin 80's and 90's best tx for BRVO is ______________ and best tx for CRVO is__________________
Definition
BRVO=photocoagulation therapy
CRVO=Observation
Term
4 types of embolism that can cause BRAO
Definition
Cholesterol
Calcifications
Platelet-fibrin
Septic
Term
4 dz strongly associated with BRAO
Definition
HTN
hypercoagulation disorders
Carotid occlusive dz
Diabetes
Term
What part of the vascular are you most likely to find emboli
Definition
Bifurcations
Term
What type of drug may be given (IV or PO) to treat BRAO
Definition
CAIs, to attempt to lower fluid content and thus IOP, hopefully increasing perfusion
Term
In the event of BRAO, name 2 ways that were suggested to attempt to increase perfusion
Definition
Paracentesis
CAIs
Term
5 Aspects of BRAO work-up
Definition
BP
DFE
Visual field
OCT
Fundus photo
Term
BRAO vs. CRAO
Age of incidence
Definition
Both tend to occur in elderly
Term
Compare time frame of vision loss in CRAO vs. CRVO
Definition
CRVO and BRVO can happen over 24-48 hours, whereas CRAO vision loss occurs in seconds
Term
Which of the vascular occlusions is associated with cherry red spot macula
Definition
CRAO
Term
In case of CRAO name a test that needs to be done immediately and what condition is being ruled out
Definition
Immediately do ESR to rule out GCA
Term
Measures for normal BP
Definition
<120/<80
Term
Measure for pre-HTN BP
Definition
120-139/80-89
Term
Measure for Stage 1 HTN
Definition
140-159/90-99
Term
Measure for Stage 2 HTN
Definition
>160/>100
Term
another name for ACUTE HTN retinopathy
Definition
Malignant HTN Retinopathy
Term
Configuration of exudates associated with malignant HTN retinopathy
Definition
Macular star configuration
Term
Hallmark of Malignant phase of HTN retinopathy
Definition
Swelling of ONH
Term
4 DDX of HTN Retinopathy
Definition
Collagen vascular dz
DR
Anemia
Crvo/BRVO
Term
Difference between cerebral thromboembolism and cerebral embolism
Definition
embolism travels from its origin and lodges somewhere else, thromboembolism lodges where it was formed
Term
Common 'source' of subarachnoid hemorrhage
Definition
Rupture of Circle of Willis aneurysm
Term
Name 6 systemic causes of Ocular Ischemic Syndrome
Definition
HTN
Ischemic Heart Dz
Atherosclerosis
DM
Giant Cell Arteritis
Term
T/F vision loss in OIS is sometimes accompanied by pain
Definition
True, 40% of the time
Term
Describe the hemorrhages uiquely associated with OIS
Definition
Midperipheral (equatorial) heme
Term
8 objective signs of OIS
Definition
Red eye
Narrowed arteries
Dilated, not tortuous veins
Midperipheral heme
NVI
Neovascular glc
NVE/NVD
Uveitis
Term
Modern term for retrolental fibroplasia
Definition
Retinopathy of Prematurity
Term
Birth weight that indicates risk for ROP
Definition
<3 lbs 5 oz
Term
Length of gestation (how premature?) that indicates risk for ROP
Definition
<32 weeks gestation
Term
Describe the vascular changes that occur when a newborn is returned to room air after the incubator
Definition
Capillaries are no longer patent Hypoxia ensues, stimulating vasoproliferation and fibrotic proliferation. This results in cicatricial changes-->vitreoretinal traction and RD, bleeding and scarring
Term
______________ retinal vessels reach the ora at 8 mo gestation and ____________________retinal vessels reach ora after birth
Definition
1-Nasal (before birth)
2-Temporal (after birth)
Term
Follow up schedule for premature babies (under 2lbs 12 oz)
Definition
q2wks until 14week
q2wks to q1-2 mo
Then q6-12mo
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