The Tension is High
Clog it up
C
D
E
100
What findings on exam represent infarction of the NFL
Cotton wool spots
100
what is the most common complication of RVO
intraocular neovascularization
100
What are symptoms suggestive of OIS (name 2)
gradual vision loss
aching pain localized to orbital area, worse when upright
prolonged visual recovery when exposed to bright light
100
What does the comma sign refer to?
comma shaped thrombi that dilate and occlude capillaries can be seen on the conj and fornix of patients with sickle cell
100
Name that condition: vascular abnormalities (telegectasias, ecstatic arterioles, MAs, venous dilations, fusiform cap dilation) which are associated with exudative retinal detachment
Coats
200
What is the Modified Scheie classification for hypertensive retinopathy
Grade 1: barely detectable arteriolar narrowing
Grade 2: obvious a narrowing with focal irregularities
Grade 3: 2 + retinal hemorrhages/ exhudates
Grade 4: 3 + ONH swelling
200
Would you recommend systemic anticoagulation in patient with RVOs?
No, some studies show worse outcomes as a result of bleeding
200
What are exam findings suggestive of OIS (Name 3)
NVI, AC cell and flare, low/normal IOP even if NVA is present, narrowed arteries, dilated but not tortuous veins, mid peripheral DBH.
200
Name two findings in nonproliferation sickle cell retinopathy
salmon- patch hemorrhages, refractile spots, 'sunburst' lesions
200
Which layers of the retina are most affected in CME
inner unclear and outer plexiform layers --> radial foveal arrangement creates classic petaloid appearance
300
Name 2 classic findings of hypertensive choroidopathy
Elschnig spots: lobular non perfusion of the CC that in time become hyper pigmented with a surrounding margin of hypopigmentation
Siegrist streaks: linear configuration of similar appearing hyperpigmentation following the meridional course of choroidal arteries
300
What have clinical trials shown in respect to macular grid or peripheral scatter laser for patients with BRVO treated with anti-VEGF
no additive benefit
300
How can you differentiate OA occlusion from CRAO?
vision loss to the level of LP or NLP
no cherry red spot
300
Association with retinal hemangioblastoma
Von Hippel- Lindau (chr 3- AD)
300
What is Purtscher retinopathy and describe its mechanism
acute compression of thorax/head: retinal whitening and cotton wool spots. Result of injury induced compliment activation and leukoembolization.
400
What retinal vascular disease is uncontrolled HTN most commonly associated with
CRVO/ BRVO
400
What do studies show regarding dexamethasone implant vs anti-VEGF (ranibizumab) regarding ME in BRVO
Bonus if can name the trial
COMRADE study: dex implant vs monthly ranibizumab
Similar efficacy but at month 4-6 eyes treated with ranibizumab had better vision
400
Which hemoglobinpathies are at the highest risk for retinopathy?
HbSC>> Steal > HbSS
400
Cutoff radiation dose for radiation retinopathy
30-35 grays or more
mimics DR and occurs on average 18 months after exposure
400
Give 3 causes of Purtscher like retinopathy
pancreatitis, amniotic fluid embolism, fat embolism from fracture, orbital steroid injection ...
500
Name 4 causes if isolated CWS
DR (Most common), HTN, HIV, severe anemia, radiation, sickle cell, cardiac embolic dz, carotid artery dz, vasculitis, leukemia, purtscher, GCA
500
Which retinal vascular occlusion has the highest risk of developing NV?
ischemic CRVO
500
How are macular telangectasias divided
type 1: unilateral parafoveal (congenital or acquired)- aneurysmal telangiectasia. anti VEGF ineffective
type 2: bilateral parafoveal - juxtafoveal tel. most common
type 3: bilateral parafoveal with retinal capillary obliteration. very rare
500
what is terson syndrome
VH/ sub ILM or sub hyaloid bleed after abrupt rise in intraocular venous pressure 2/2 acute intracranial hemorrhage
500
what is Cody Blanchard's middle name