0. Post Seg Exam 2 - Know These

Conditions that can cause MNV (CNV):

Choroidal Rupture,

Histoplasmosis,

Best’s Disease,

Angioid Streaks,

Lacquer Cracks,

AMD

Diseases that can cause Angioid Streaks:

Pseudoxanthoma Elasticum,

Ehler-Danlos Syndrome,

Paget’s Disease of Bone,

Sickle Cell Disease,

Idiopathic

(lacquer cracks/ angioid streaks) are due to high myopia

lacquer cracks

(lacquer cracks/ angioid streaks) are due to disease

angioid streaks

Stargardt Disease think:

excessive lipofuscin in RPE

Best’s Vitelliform Dystrophy think:

Egg Yolk, Abnormal Arden Ratio (abnormal EOG)

Dominant Drusen/ Doyne Honeycomb think:

AMD presentation in young folk

Progressive Cone Dystrophy think:

progressive loss of cones by 30 yo, maculopathy

Rod Monochromatism think:

No Cones (lack of cones) from birth, non-recordable ERG

Retinitis Pigmentosa think:

nyctalopia,

arterial attenuation,

waxy ON pallor,

bony spicules (unless sine pimento),

systemic disease? (Usher’s, Bardet-Biedl, Leber’s),

reduced ERG

Congenital Stationary Night Blindness (CSNB) think:

STABLE/ non-progressive nyctalopia,

collection of genetic diseases,

Fundus Albipunctatus,

Oguchi Disease

Fundus Albipunctatus think:

congenital stationary night blindness (CSNB),

dull, peripheral, white spots,

abnormal → normal scotopic ffERG (after full dark adaptation)

Oguchi Disease think:

congenital stationary night blindness (CSNB),

mizuo phenomenon (unremarkable fundus when dark adapted, yellow/ iridescent fundus after light exposure)

Choroidemia think:

nyctalopia,

progressive VF constriction,

progressive RPE/chorioretinal deterioration + pigment clumping,

X-linked

Gyrate Atrophy think:

nyctalopia,

progressive chorioretinal deterioration,

progressive VF constriction,

scalloped RPE

OAT enzyme deficiency (autosomal recessive)

cRORA indicates:

Geographic Atrophy

iRORA indicates:

pre-GA / AMD warning sign

Wet AMD Neo:

(Type 1/ Type 2) is well-demarcated hyper-fluorescence on FA

Type 2

Wet AMD Neo:

(Type 1/ Type 2) is an undefined source of hyper-fluorescence on FA

Type 1

Wet AMD Neo:

Prevalence of Polypoidal Choroidal Vasculopathy (PCV) is highest in what countries/ populations???

Asian (Japan)

Wet AMD Neo:

Gold standard test for polypoidal choroidal vasculopathy (PCV)?

ICG-A

Wet AMD Neo:

common sign of polypoidal choroidal vasculopathy (PCV)?

two PEDs

Wet AMD Neo:

How does treatment for polypoidal choroidal vasculopathy (PCV) differ from other wet AMD treatments?

anti-VEGF and PDT (verteporfin)

Wet AMD Neo:

“stars in the sky” FA pattern corresponds to what finding?

basal laminar/ cuticular drusen

Wet AMD Neo:

What type of neo is commonly associated with hemorrhagic PEDs?

Polypoidal Choroidal Vasculopathy (PCV)

other causes of MNV:

most common cause of angioid streaks?

pseudoxanthoma elasticum (PXE)

other causes of MNV:

(T/F): MNV due to inflammation can only occur due to a physical break in Bruch’s

False

How common is pathological myopia in myopic patients?

25% (1/4) of myopes will develop pathological myopia

other causes of MNV:

what’s the most common cause of CNV in individuals younger than 50?

myopia

(mactel 1 / mactel 2) is more common

mactel 2

mactel 2, type of disease?

neurovascular degenerative condition (structural)

T/F: mactel 2 leakage is due to new blood vessels forming in the retina

false - likely due to muller cell support causing vessel dilation and warpage

Can CSCR and PED occur simultaneously?

yes

most typical treatment of VMT?

monitoring (spontaneous release)

At what stage of a macular hole will you first see a (+) Watzke-Allen sign?

Macular Hole - Stage 2

if you do an OCT and find a macular hole with an operculum, what stage is the mac hole?

Stage 3

At what stage macular hole should you consider more treatment than observation?

2, 3, 4

Mac Hole surgery steps?

PPV + ILM peel + Gas

ERM is more commonly caused by (aging / secondary) factors

aging (idiopathic)

the two ERM pathophys theories involve what cell types?

retinal glial, vitreous cells (hyalocytes)

How will a pseudo-hole appear on Watzke-Allen Beam?

thinning

When might a vitrectomy/ membrane peel surgery be indicated for a patient with an ERM?

decrease in VA

retinal layers are split in a (pseudo macular/ lamellar) hole

lamellar

all retinal layers remain in a (pseudo macular/ lamellar) hole

pseudo-macular

CME think (pathophysiology):

inflammation

ocular dx associated with CME/ causes of CME: (8)

vascular,

post-op,

inflammation,

medication,

retinal dystrophy,

tractional,

anatomical,

neoplastic

medication causes of CME think:

prostaglandin analogs (-prost),

tamoxifen

retinal dystrophy causes of CME think:

retinitis pigmentosa

vascular CME treatment think:

anti-vegf

post-surgical CME treatment think:

Ketorolac (topical NSAID)

Retinitis Pigmentosa CME treatment think:

oral CAIs (acetazolamide)