OD week2

Question 1

Front

Answer 1

Back

Question 2

Age-Related Macular Degeneration (AMD) – What is it?

Answer 2

Degenerative retinal disorder affecting the macula in people aged 55+, characterized by drusen and RPE changes.

Question 3

AMD – Types?

Answer 3

Atrophic (dry) with drusen and pigmentary changes; Exudative (wet) with neovascularization and haemorrhage.

Question 4

AMD – Risk factors?

Answer 4

Age, smoking (most important modifiable), genetics (CFH, ARMS2), hypertension, obesity, poor diet, sunlight exposure.

Question 5

AMD – Symptoms?

Answer 5

Gradual central vision loss in dry AMD; rapid distortion or vision loss in wet AMD; preserved peripheral vision.

Question 6

AMD – Hallmark signs?

Answer 6

Drusen deposits between RPE and Bruch’s membrane, RPE pigmentary changes, possible geographic atrophy.

Question 7

AMD – Management?

Answer 7

Lifestyle modification, antioxidant supplements (AREDS for intermediate), anti-VEGF injections for wet AMD.

Question 8

Dry (Atrophic) AMD – What is it?

Answer 8

Non-neovascular form with drusen and RPE atrophy, gradual central vision loss.

Question 9

Wet (Neovascular) AMD – What is it?

Answer 9

Neovascular form with CNV and subretinal fluid or haemorrhage causing rapid vision loss.

Question 10

Geographic Atrophy – What is it?

Answer 10

Advanced dry AMD with well-defined RPE loss and visible choroidal vessels.

Question 11

Polypoidal Choroidal Vasculopathy – What is it?

Answer 11

Type 1 MNV variant with branching choroidal vessels and polypoidal ends, common in Asians.

Question 12

Polypoidal Choroidal Vasculopathy – Management?

Answer 12

Anti-VEGF injections, sometimes photodynamic therapy.

Question 13

Retinitis Pigmentosa (RP) – What is it?

Answer 13

Inherited rod-cone dystrophy causing progressive peripheral vision loss and night blindness.

Question 14

RP – Symptoms?

Answer 14

Nyctalopia, tunnel vision, glare sensitivity, field loss beginning mid-periphery.

Question 15

RP – Hallmark signs?

Answer 15

Bone spicule pigmentation, arteriolar attenuation, waxy optic disc pallor.

Question 16

RP – Complications?

Answer 16

Posterior subcapsular cataract, CME, epiretinal membrane, optic disc drusen.

Question 17

RP – Systemic associations?

Answer 17

Laurence-Moon/Bardet-Biedel, Usher, Kearn-Sayer syndromes.

Question 18

RP – Management?

Answer 18

No cure; genetic counselling, vitamin A (some benefit), manage complications, gene therapy (RPE65 mutation).

Question 19

Leber Congenital Amaurosis – What is it?

Answer 19

Severe rod-cone dystrophy from birth causing blindness, absent PLR, and optic atrophy.

Question 20

Sectorial RP – What is it?

Answer 20

Localized RP affecting isolated retinal quadrants with slower progression.

Question 21

Retinitis Punctata Albescens – What is it?

Answer 21

Atypical RP with scattered white spots in periphery, nyctalopia and progressive vision loss.

Question 22

Tay-Sachs Disease – What is it?

Answer 22

Autosomal recessive neurodegenerative disease causing cherry-red spot and blindness in infancy.

Question 23

Stargardt Disease – What is it?

Answer 23

Autosomal recessive macular dystrophy with RPE degeneration and yellow pisciform flecks.

Question 24

Stargardt Disease – Hallmark signs?

Answer 24

Beaten bronze macula, yellow fish-tail flecks (fundus flavimaculatus), silent choroid on FA.

Question 25

Stargardt Disease – Symptoms?

Answer 25

Onset in childhood, bilateral central vision loss, slow to 6/12 then rapid to 6/60.

Question 26

Stargardt Disease – Management?

Answer 26

No cure; avoid vitamin A; low vision support; genetic counselling.

Question 27

Best Vitelliform Dystrophy – What is it?

Answer 27

Autosomal dominant macular dystrophy with lipofuscin accumulation forming 'egg-yolk' lesion.

Question 28

Best Dystrophy – Hallmark signs?

Answer 28

Yellow vitelliform lesion 1–2 DD wide at macula; EOG abnormal, ERG normal.

Question 29

Best Dystrophy – Stages?

Answer 29

Previtelliform, vitelliform, pseudohypopyon, vitelliruptive ('scrambled egg'), atrophic/scarring.

Question 30

Best Dystrophy – Management?

Answer 30

Monitor; anti-VEGF if CNV; vision usually good until middle age.

Question 31

Adult-Onset Vitelliform Dystrophy – What is it?

Answer 31

Late-onset variant with small lipofuscin lesions, mild vision loss, part of pattern dystrophies.

Question 32

X-Linked Juvenile Retinoschisis – What is it?

Answer 32

X-linked recessive macular condition in males, splitting of sensory retina with stellate cystic spaces.

Question 33

Juvenile Retinoschisis – Symptoms?

Answer 33

Reduced central vision (6/9–6/12), slow decline to 6/60 by middle age.

Question 34

Juvenile Retinoschisis – Complications?

Answer 34

Peripheral schisis, vitreous haemorrhage, or retinal detachment.

Question 35

Juvenile Retinoschisis – Management?

Answer 35

No cure; topical dorzolamide may reduce cysts; gene therapy trials ongoing.

Question 36

Cone Dystrophy – What is it?

Answer 36

Inherited degeneration of cone photoreceptors causing central vision loss and colour defect.

Question 37

Cone Dystrophy – Hallmark signs?

Answer 37

Bullseye maculopathy, photophobia, abnormal cone ERG, normal rod ERG until late.

Question 38

Cone Dystrophy – Symptoms?

Answer 38

Blurred vision, photophobia, red-green colour defect, nystagmus, central scotoma.

Question 39

Cone Dystrophy – Management?

Answer 39

No treatment; tinted lenses for glare; low vision and genetic counselling.

Question 40

Myopic Retinal Changes – What is it?

Answer 40

Axial elongation causing degenerative fundus changes in high myopia.

Question 41

Myopic Retinal Changes – Hallmark signs?

Answer 41

Tessellated fundus, lacquer cracks, patchy or macular atrophy, posterior staphyloma.

Question 42

Lacquer Cracks – What are they?

Answer 42

Fine yellow lines from Bruch’s membrane breaks due to elongation; risk of CNV.

Question 43

Myopic CNV – What is it?

Answer 43

Subretinal neovascular membrane above RPE in high myopes, can cause haemorrhage.

Question 44

Posterior Staphyloma – What is it?

Answer 44

Localized scleral bulge at posterior pole due to axial elongation; worsens vision.

Question 45

Myopic Retinal Changes – Management?

Answer 45

Eye protection, regular review, anti-VEGF for CNV, no cure for atrophic lesions.

Question 46

Toxic Maculopathies – What is it?

Answer 46

Drug-induced retinal damage leading to central vision loss and characteristic maculopathy.

Question 47

Chloroquine Maculopathy – What is it?

Answer 47

Due to chloroquine/hydroxychloroquine accumulation in RPE; causes bullseye maculopathy.

Question 48

Chloroquine Maculopathy – Monitoring?

Answer 48

Baseline and 12-monthly review with OCT, FAF, 10-2 VF, colour vision testing.

Question 49

Tamoxifen Maculopathy – What is it?

Answer 49

Fine yellow crystalline deposits in inner retina; reversible on drug cessation.

Question 50

Phenothiazine Retinopathy – What is it?

Answer 50

Macular RPE atrophy with pigment clumping; stabilizes after stopping medication.

Question 51

Canthaxin/Orobronze Maculopathy – What is it?

Answer 51

Crystalline ring deposits at posterior pole; cosmetic use; minimal visual effect.

Question 52

Talc Retinopathy – What is it?

Answer 52

Retinal vessel talc emboli from IV drug use; may cause vascular occlusion.

Question 53

Sildenafil Toxicity – What is it?

Answer 53

Transient blue-tinged vision, light sensitivity; linked to NAION risk.

Question 54

Vigabatrin Retinopathy – What is it?

Answer 54

Anticonvulsant causing bilateral peripheral VF loss; irreversible in 80%.

Question 55

Toxic Maculopathies – Management?

Answer 55

Baseline and regular monitoring; drug cessation if toxicity detected.