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Review Session- PSD B15
Terms in this set (20)
Which of the following may involve the ciliary body- rhegmatogenous RD, Proliferative vitreoretinopathy, degenerative retinoschisis, or choroidal detachment?
What is a splitting within the retinal layers, and what layer is the split usually in?
Retinoschisis; usually OPL, but can be in the NFL
What layers are separated in a retinal detachment?
Neurosensory retina from RPE
True or false- Retinoschisis is accompanied by symptoms of flashes and floaters.
False- RD is accompanied by flashes and floaters, particularly Rhegmatogenous RD.
When do we treat in the case of a retinoschisis?
Whenever it progresses to the point of a RD.
If someone has a rhegmatogenous RD, what is the appropriate management?
Hurry, especially if the macula is still on, and reattach it to preserve function. If left unattached for too long, photoreceptors become dysfunctional and no longer work properly.
If someone has a rhegmatogenous RD that is more anterior, what is the often used method of treatment?
Seal off tear by laser or cryotherapy.
What is the commonly used method of treatment for a tractional RD?
Vitrectomy - generally scleral buckle won't work, but you could try it in combination
What type of RD is CSCR a form of?
Exudative RD - occurs when you get fluid separating retina from RPE (generally idiopathic)
CSCR is idiopathic, however what has a strong association with the fluid accumulating in the fovea?
Taking steroid medication or having increased circulating glucocorticoids
How does an exudative RD result from posterior scleritis?
Fluid forms from the scleral inflammation and percolates/separates RPE from neurosensory retina
What two layers separate in choroidal detachments?
Choroid separates from the sclera
What medication may result in a HS reaction that leads to swelling of the choroid and ciliary body, pushing everything up toward the angle, potentially leading to acute angle closure glaucoma?
Topamax (sulfa-based drug)
In the event that Topamax results in bilateral angle closure, what topical should we use?
NOT pilocarpine! In these scenarios where we have swelling of the choroid due to a HS reaction, we want to relax the choroid/ciliary body to push that back, so we would want to use cycloplegic agents.
True or false- Pilocarpine and laser peripheral iridotomy is not an effective treatment in the case of acute angle closure secondary to Topamax use.
True - because it's not due to pupillary block.
Microcystoid formation is not a problem that leads to RD. Instead, what does it sometimes lead to?
Coalescence of the vesicles could lead to separation of the layers within the retina (retinoschisis) which could then lead to a RD.
Is reticular pigmentary degeneration anything to be concerned about? What condition should we differentiate it from?
No- it is a common benign age-related change. There is no increased risk of RD. We should differentiate it from RP.
Rhegmatogenous RDs are commonly associated with high myopia. What is it about high myopia that makes it that way?
Generally, we get more liquefaction of the vitreous earlier on that could lead to a tear and we often seen Lattice degeneration more often.
When do we usually see a tractional RD?
Usually with some type of proliferative retinopathy accompanied by a fibrovascular membrane leading to detachment when it shrinks/contracts due to retinal NV.
What conditions do we see tractional RDs in?
**, ROP, CRVO, etc.
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