"once hydrochloroquine is stopped, can further vision loss occur"
yes
what is stickler syndrome
"autosomal dominant disease characterized by optically empty vitreous cavity due to premature vit breakdown -> high incidence of RD (lattice and retinal thinning), cataract, glaucoma, strabismus; associated with facial dysgenesis in Pierre Robin sequence with micrognathia, cleft palate, glossoptosis, hyperflexibility, arthritis"
when do you start steriods in toxo
3 days after abx tx
what treatment can you give noncompliant toxo patients
intravitreal clindamycin and dexamethasone
what layer of retina are drusen
extending between bruchs and rpe
what hla associated with pars planitis? Birdshot? Behects?
"HLA-dr2, hla-a28, hla-b51"
"what disease causes corneal and conjunctival crystals, patchy retinopathy, and renal failure"
cystinosis
what is meridonal fold
"redundant peripheral retina that project into vitreous, mostly in superonasal quadrant, increased risk of rd"
what is parinaud's ocularglandular syndrome
"granulomatous nodules in the palpebral conj, ipsilateral preauricular or submandibular adenopathy, occurs in 10% of cat scratch"
what causes irvine gass syndrome
inflammation induced blood-retina barrier breakdown since postaglandins disrupt blood vessel integrity resulting in leakage of fluid in macula
how can you differentiate POHS and MCP?
MCP has vitritis while POHS doesnt
what FB material is most toxic to the eye
copper
what is chalcosis and what are signs of it
"copper toxicity; deposits in Descemet's, sunflower cataract, greenish color iris, brown vitreous opacities, metallic flecks on retinal vessels"
what type of bacteria is bartonella henselae
GNR
what makes up internal limiting membrane
footplate of Muller cells (nucleus located in inner nuclear layer)
what are erg findings of iron toxicity (siderosis)
loss of amplitude of b-waves on erg eventually can be extinguished
what are fundus characteristics of stargardt's disease
"yellow parafoveal ""pisciform"" flecks and a ""beaten bronze"" macula"
what is the FA finding of stargardts
dark choroid due to blocking since lipofuscin like material accumulates in RPE
what is stargardts
inherited juvenile onset rod-cone dystrophy that causes progressive vision loss to 20/50-20/200
what disease do you see fluorescein quenching
birdshot; idiopathic rapid fluorescein clearing
what disease do you see patchy delayed choroidal filling
"choroidal ischemia in GCA, hypertensive choroidopathies, wegener associated choroidopathy"
what mutation in stargartdts
abca4
what is tx for RMA
photocoagulate if macular edema; observatino otherwise
what are erg/eog findings of best
"normal erg, abnormal EOG ALWAYS no matter the time period"
what are ocular and systemic findings of bardet-biedl syndrome
"macular pigment mottling, pigmentary retinopathy like RP, polydactyl, poor night vision, obese, mental retardation, hypogonadism, renal failure"
what's the difference between bardet-biedl and lawrence moon syndrome
along the same spectrum; lawrence moon has spastic paraplegia and NOT polydactyll
what are findings of alstrom syndrome
"AR d/o, tapetoretinal degeneration, obesity, DM, hearing loss, renal failure, dilated cardiomyopathy; CENTRAL VISION LOSS EARLY "
what visual acuity findings separate alstrom syndrome and other pigmentary retinopathy
central losss of vision early while others you lose peripheral vision first
what allergic reactino do you have to ask for to get ICG
iodide and shellfish allergies
why should you not repair small extremely posterior scleral lacerations?
extreme duction can cause vitreous prolapse through the wound
what are indications for repair of RRD with pneumatic retinopexy
"tear is at superior 8 clock hours, clear media, confidence that all breaks found, absence of PVR grade C and D"
"what is ddx of disruption of normal inner segment, outer segment, and RPE layers?"
"mewds, AZOOR, solar retinopathy, commotio retinae"
what is the most important prognostic factor for BRVO
retinal ischemia
what sickle cell traits are worst for the eye
SC and Sthal
what are the risk factors for brvo and crvo and which ones are different for them?
"HTN, glaucoma, cardiovascular disease; BRVO also morbid obesity; CRVO also DM"
what are indications for lasering lattice degeneration
"aphakic, presence of RD in other eye, presence of flap tears, high myopia"
how do you differentiate senile retinoschises from RD
"smooth domed, reacts to photocoagulation, no shifting subretinal fluid, no vit pigment/heme, absolute scotoma"
what are 2 types of retinoschises and where does split occur in each type
"1. typigcal degenerative- split occurs in outer plexiform layer; 2. reticular degenerative- split occurs in nerve fiber layer, higher chance of posterior extension"
is retinoschises assocaited with myopia or hyperopia
hyperopia
whats the most common cause of failure of rheg retinal detachment reppair
PVR
what is the prognosis of severe and very severe NPDR in progression to PDR
15% and 45%
what layer of the retina are exudates in the macular star of neuroretinitis
outer plexiform layer
what is ddx for bone spicules
"RP (bilateral), DUSN (unilateral), old trauma, syphilis"
what is DUSN
"subretinal spread of nematode causing poor va, multifocal choroiditis, vitritis, ON edema, bone spicules; if worm is found, treatment is laser; raccoons are carriers of nematode"
what genetic disease causes cherry red spot
tay -sachs disease
what is tay sachs disease
defect in hexosamindase A enzyme causing accumulation of ganglioside GM2 which can be deposited in brain and retina -> cherry red spot due to accumulation of abnormal protein
what is the tx for cme assocaited with RP
"diamox first, then can try subtenons or intravitreal triamcinolone"
what is ddx for dalen fuchs spots
VKH and SO
what are forster-fuchs spots
spots found in myopic degeneration; dark spots due to RPE hyperplasia in response to small CNV lesion that does not progress
what are characteristics of coat's disease
"male predominant, non-hereditary, gene found on chromosome 4, no systemic manifestations, unilateral"
what are the prominent cell types involved in vitreomacular traction
glial cells
what is treatment of vitreomacular traction
surgery improves VA > 2 lines in 75% of eyes; intravitreal ocriplasmin can result in resolution of traction
what test can you get to see if theres an intraocular FB in severe trauma
ct scan
what are choroidal melanocytoma and how do you manage
"benign rare neoplasm immediately adjacent to ON, extremely darkly pigmented -> can very rarely undergo malignant transofrmation so you should follow with photos"
can you have birdshot without vitritis
"normal erg, abnormal EOG ALWAYS no matter the time period"
what is foveal granularity pathomneumonic for?
"mewds, "
what week do nasal and temporal retina completely vascularize
36 and 40
what are the most common locations for scleral rupture
limbus and under insertion of rectus muscles
what abx to tx b cereus
vanc and clinda
how do you distringuish birdshot and pohs
pohs never had vitritis; birdshot always has vitritis