Collagen

Proteins

Sugars

Hyaluronic Acid

Anteriorly at the pars plana

Posteriorly at the Optic Nerve

Surgery

High myopia

Intraocular inflammation

T/F

Anterior vitreal detachment is more common than posterior

False,

Posterior is more common

DFE, follow up in 1-4 weeks and repeat DFE

See again in 4-8 weeks if persistent

T/F

It is normal to see leukocytes in the vitreous

T/F

Retina and choroid thicken in the periphery, ie. towards the ora

Differentiate

Specify

Correlate

Etiology

Formulate

Effect

V-Vacular, vitamin deficiency

I-Inflammation, infection

Systemic Disease

T-trauma, toxic

A-Age-related

M-Mass

I-Infantile, idiopathic

N-neoplasm

D-Demyelination

T/F

Toxoplasmosis can be acquired through a break in the skin

White fluffy lesions with edema on the retina

Foggy vitreous due to inflammation

Blur

floaters

red eye

VF loss if papillitis/retinal scar

Manage the Anterior Uveitis

Watch for retinal tears

Cryopexy

Vitrectomy

Photocoagulation

Eating dirt

or 

Pica

Cough

Chest pain

Intermittent fever

Loss of appetite

White granuloma in posterior pole with RPE hyperplasia and fibrotic bands that radiate from the lesion towards the optic nerve

Presentation of which infection?

Retinoblastoma

Coat's dz

Persistent hyperplastic primary vitreous

Retinopathy of prematurity

Diffuse unilateral subacute neuroretinitis

Steroids

Antihelminthic drugs

Photocoagulation

RD repair

Anterior Uveitis management

Pars Plana Vitrectomy

Circumpapillary choroidal scarring

Peripheral choroidal punched-out histo spots

choroidal neovascularization at macula

Amsler grid

FA

OCT

Fundus photos

Steroids

Amphotericin B

Ketoconazole

Take home Amsler grid

Photocoagulation

Anti-VEGF if there is neo

multiple, flat, yellow/gray chorioretinal lesions

Hyperpigmentation with scarring

Just the stroma

Endo and epi are uninvolved

Penicillin G IV

then long term tetracyline/doxycycline

Coughing

Night sweats

Recurrent fever

weight loss

pleurisy (inflammation of pleura)

Anterior granulomatous

and posterior

Isoniazid PO qd

Rifampin PO qd

Pyrazinamide PO qd x 2 mos

Ethambutol

Candida albicans

Aspergillus

Cryptococcus

Traditional Antifungals like amphotericin B

Azoles-like fluconazole

Echinocandins-caspofungin, micafungin

Vitreal tap

Vitrectomy

Sarcoidosis

Lupus

Pars planitis

Vogt-Koyanagi-Harada Syndrome

Busacca and Koeppe

Koeppe are near the pupillary margin

Busacca are more peripheral

Sarcoidosis

TB 

Syphilis

Histo

Toxo

Syphilis

TB

Sarcoidosis

Fever

Joint pain

malar rash

(woman of child-bearing age)

Retinal hemorrhages

Cotton wool spots (NFL)

Periphlebitis (less common than above)

Intermediate uveitis

Cyclitis

Peripheral uveitis

dirty, yellow exudates aggregate near vessels in extreme periphery

Snowballs

Snowbanking

Cystoid Macular Edema

Periphlebitis

Cystoid Macular Edema

Cataracts

Steroids

Crytotherapy to snowbank

Photocoagulation to neovascularization

Pars plana vitrectomy

Immunosuppresives

Alopecia

Poliosis

Vitiligo

Headache

Nausea

Vomiting

Encephalopathy (rarely)

Granulomatous Anterior Uveitis

Multifocal choroiditis that can result in sensory retina detachment

Vitritis

Posterior Uveitis

Retinal Hemes

SUNSET glow

How is VKH diagnosed

FA

Ultrasound

Lab tests (HLA)

Idiopathic Central Serous Chorioretinopathy

Acute Posterior Multifocal Placoid Pigment Epitheliopathy

Behcet's disease

Treat uveitis

Intensive steroids via Oral, IV or periocular

Immunosuppresive agents

Pre-arterial phase  (Choroidal flush)

Arterial-venous phase

Late Phase

Artery core

artery wall

capillaries

vein wall

vein core

Decrease in choroidal flush

hyperfluorescence at ONH

Recent immune system trigger

VA decrease/scotoma

Bilateral, painless vision loss with viral illness

HA

Metamorphopsias, floaters etc. 

Vitritis in 35%

Lesions that leave residual mottling 

Delayed choroidal filling

Hypofluorerscence in both early and late phases

Early hypofluorescence

Late Hyperfluorescence

CNVM

Central serous RD

Choroidal vasculitis

CRVO

Hemorrhagic maculopathy

Optic neuropathy

Blurry vision

Metamorphopsias

Central scotomas

RPE

Choroid

Vitritis in 30%

Early hypo of central scar and

early hypo of inactive creamy lesions

Immunosuppressive agents

Oral Steroids

Amsler Grid

Monitor for complications

RTC 6 mos

CME

CNVM

Vitritis (90%)

Anterior Uveitis (50%)

Optic Disc Edema

CNVM

CME

Subretinal Fibrotic Scarring

Multifocal Choroiditis

Tendency for recurrence 

Amsler

Oral steroids

laser tx of CNVM

Immunosuppressives 

Young female with prodromal flu-like symptoms

Acute unilateral vision loss and photopsia

May see spots (not floaters)

Unilateral

Many creamy, flat dots in posterior pole that spare the fovea

Possible disc edema and vitritis

Macula has granular appearance

wreath-like hyperfluorescence and late focal staining

disc hyperfluorescence

ERG is abnormal in 90%

Reduced B wave response (photoreceptors)

Chronic vitritis

Retinal vasculitis

CME

AION

Early hypo 

late accumulation of dye

Vascular leakage in larger veins

Low dose steroid

Immunosuppressives

Best spectacle Rx/Low vision devices

Recurrent multifocal choroiditis

MEWDS

Clinical Appearance:

Creamy multiple placoid lesions in posterior pole; anterior uveitis and vitritis in 50%

Clinical Appearance:

Pseudopod subretinal scarring extending out from disc in propeller-like pattern; gray lesions develop at scars during activity; choroidal neo may develop

Geographical Helicoid Peripapillary Choroidopathy

(Serpiginous)

Clinical Appearance:

Small, multiple, yellow white lesions that are grey when active, occur in posterior pole, may develop choroidal neo or subretinal fibrosis

Clinical Appearance:

Several small white dots in posterior pole with a granular macula. With resolution granularity and white dots fade

Clinical Appearance:

Multiple creamy white spots midperipherally,

chronic vitritis, optic disc edema

vasculitis, cystoid macular edema

VZV

HSV1

HSV2

Anterior uveitis

Vitritis

Retinal vasculitis

Repair RD

Treat 'itis' with steroids/cycloplege

Antivirals

Low dose aspirin to prevent occlusive vasculitis

Young

Caucasian

Strange multi-colored lights

Sudden vision loss

AZOOR

Generally unilateral or bilateral

Pain 

Vision Loss  

Abnormal Post-surgical inflammation 

Lid edema

conjunctival chemosis

corneal edema

Vitritis

Wound abnormalities

Hypopyon

Pts who have only Light perception Visual acuity

Not as beneficial if VA better than that. 

Vancomycin

Amikacin

ceftazidime

Fungal infection

Retained lens material 

Toxic reaction to irrigating fluid

 Difficult/prolonged surgery

Gram positive bacteria, especially Staph

Diabetic Retinopathy

HTN

Severe anemia

SLE

leukemia

HIV/AIDS

Flame shaped

Dot/blot

Roth spots

Painless vision decrease

Hazy vision

Floaters/flashes

Metamorphopsia

VF defect 

Patchy yellow-white areas with secondary hemorrhage along the edges

Full thickness necrotizing retinitis

Occurs along major vascular arcades and near ONH

Hemorrhagic

Brushfire

Granular

Vessel attenuation

Calcifications where atrophied

Capillary nonperfusion

Chorioretinal scarring

Loss of VA

Optic Atrophy

RD

HIV Retinopathy

PORN

HZV retinitis

HSV retinitis

Toxo retinochoroiditis

Infectious multifocal choroiditis

Papillitis

Macular edema

Vasculitis

Uveitis

Ganciclovir

Foscarnet

Cidofovir

Name the eye implant used to treat CMV retinitis

What does it release?

Lymph nodes

GI tract

Pulmonary Involvement

Conj and or lid

Radiation

Chemo

Excision

ELISA

Ultrasound