Retina Review

7/21/2019 Retina Review

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Retina Review

Part 1



80 yo 20/100





83 yo male 20/200



AMD: Neovascular

• Define classic choroidal neovascularization

– Early, ri!ht uniform hy"erfluorescence #$ithin 30

seconds% e&hiitin! lea'a!e in the late frames



(2 yo 20/)0 *D



AMD: Neovascular

• Define the t$o ty"es of occult choroidalneovascularization – Fibrovascular PED: early sti""led hy"erfluorescence #$ithin

first minute% e&hiitin! lea'a!e or stainin! in the late frames

– Late leakage of undetermined etiology: late s"ec'ledhy"erfluorescence $ith no corres"ondin! source in the early

frames



)3 yo c/o needs stron!er readin! !lasses, 20/+0





88 yo - *D



AMD: Prevention

• .ummarize results of the ED. .tudy

– eneficial su!rou"s

• ntermediate 4D in oth eyes or advanced 4D

in one eye

– 56year ris' of "ro!ression to advanced 4D

• Placeo 287

• ntio&idants 9inc 207

– -ormulation

• :itamin 500m!• :itamin E +00;

• eta carotene 15m!

• 9inc 80m!



AMD: Treatment

• 4P. .tudy 6 <hermal laser eneficial for e&trafoveal and =u&tafoveal classic lesions

• <P .tudy 6 PD< eneficial for classic sufoveal lesions

• :P .tudy 6 PD< sli!htly eneficial at 2 years for "urelyoccult sufoveal lesions

• 4> 6 ?ucentis eneficial for minimally classic lesions

• >@* 6 ?ucentis eneficial for "redominantly classiclesions



+( yo recent distorted vision *.





OHS

• Descrie the clinical triad of *@.A

– Punched out chorioretinal lesions #histo s"ots%

– Peri"a"illary atro"hy

– horoidal neovascularization

• Bhat is the endemic !eo!ra"hic re!ionC

– 4ississi"i and *hio iver :alley



50 yo male h/o

"seudo&anthoma

elasticum









Angioid Streaks

• Bhat are systemic diseases associated

$ith an!ioid strea'sC

– Pseudo&anthoma elasticum

– Ehlers6Danlos syndrome

– Pa!ets disease of one

– .ic'le cell disease

– dio"athic



50 yo lon! time contact lens $earer





Pathologic Myoia

• Bhat is the commonly acce"ted definition ased

on a&ial len!th and refractive statusC – &ial len!th 2)mm

– ."herical eFuivalent G 68A00D

• Bhat is the s"ectrum of fundus findin!sC

– ?acFuer crac's – .uretinal hemorrha!e

– -uchs s"ot

– Posterior sta"hyloma

– PE/choroidal atro"hy

– ystoid, "avin!6stone, lattice de!eneration

– etinal thinnin!/holes

– .cleral thinnin!

– >:



33 yo usiness consultant, distortion *., 20/25













!S!

• @o$ is the characteristic "atient descriedC

– @ealthy male, 30650 yo, ty"e6 "ersonality

• Bhat is the most common an!io!ra"hic findin!C

– .mall, focal hy"erfluorescent PE lea'

• @o$ freFuently does a Hsmo'estac' occurC

– 107

• Bhat is the rate of s"ontaneous resolution ofsuretinal fluidC

– 806I07

• Bhat is the recurrence rateC

– +06507



!S!

• Bhat are indications for laser

"hotocoa!ulationC

– Persistence of serous detachment 36+mo

– ecurrence in eyes $ith visual deficit from "riore"isode

– Presence of "ermanent visual deficit in fello$

eye from "rior e"isode

– Develo"ment of chronic si!ns #cystic chan!e inretinaJ $ides"read PE anormalities%

– *ccu"ational need



50 yo 20/50 *.





"iretinal Mem#rane

• Bhat are the clinical findin!sC

– 4etamor"ho"sia K decreased acuity

– etinal striae

– .uretinal fluid or cystic chan!e

– lmost al$ays associated $ith P:D

• Bhat is the incidence of ilateralityC

– 207

• Bhat "ercenta!e of eyes maintain vision 20/50or etterC

– (57



)0 yo 20/100



$MT

• Bhat are the clinical findin!sC

– 4etamor"ho"sia and decreased vision

– Partial "osterior vitreous detachment

– :itreous traction on the macula $ithsuretinal fluid accumulation or 4E



55 yo, 20/200

#not from !l&%





Macular Hole

• Descrie the + sta!es of macular hole

– a foveolar detachment

– full6thic'ness defect G+00µm

– full6thic'ness defect +00µm, no P:D

– : sta!e $ith P:D

• Bhat is the incidence of ilateralityC

– 106207



(0 yo 5 $' s/" E $ith vit loss, 20/80



!M"

• n $hat histolo!ic layer does fluid collectC – *uter "le&iform

• Bhat are common causesC – Posto"erative

– ;veitis

– etinal venous occlusive disease

– horoidal neovascularization

– E"iretinal memrane/:4<

– etinitis "i!mentosa

• Bhat is the incidence of clinical 4E follo$in!

e&traca"sular E $ith intact ca"suleC – G17

• Bhat "ercenta!e of cases s"ontaneouslyresolveC

I57

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Retina Review