Term
| What single test has the highest specificity and best precision for diagnosing glaucoma? |
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Definition
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Term
| Can NFL loss occur before evidence of VF loss? |
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Definition
| yes, which is why ONH is important |
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Term
| What are the 4 main ways to measure ONH disc size? |
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Definition
Planimetry
scanning laser tomography
Contact lens (central 3 mirror gonio)
High plus |
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Term
| What are the correction factors for contact lenses and high plus lenses? |
|
Definition
1.27 for contact
HP lens depends on power/brand |
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Term
| What is the equation for calculating ONH area? |
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Definition
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Term
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Definition
| a localized irregularity in the radius of the optic cup,red flag for glaucoma |
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Term
| Where is ONH thinning most common to occur first? |
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Definition
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Term
| How does the central retinal artery (CRA) induce notching? |
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Definition
| The CRA trunk is more commonly nasal-superior and notching tends to occur opposite in the inferior-temporal area |
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Term
| Why does nerve fiber loss due to glaucoma require a evaluation rim to disk and not just cup to disc ratios? |
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Definition
| If an ONH is elliptical, then changes in C/D vertically vs horizontally will be different and more difficult to determine expressed as a percentage of the cup, while if it is expressed as a percentage of rim tissue, any changes will be more apparent |
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Term
| When determining rim to disk and cup to disk ratios, what is the primary mathematical principle to keep in mind? |
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Definition
| Both the vertical and horizontal proportions should add up to '1.0' |
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Term
| When does the C/D horizontal vs vertical proportion indicate glaucoma concern? |
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Definition
| Horizontal C/D divided by Vertical C/D should be greater >1 with a typical value of 1.15-1.19 |
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Term
| Is diffuse arteriole narrowing pathognomonic for glaucoma? |
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Definition
| No, though it can occur in glaucoma, it can occur in many other types of ONH damage |
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Term
| What is indicated by shifting locations of vessels over time? |
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Definition
| Usually a sign of more severe damage in glaucoma. A senstive way to discern ONH damage secondary to glaucoma. |
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Term
| What is 'bayoneting' of ONH blood vessels? |
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Definition
| It comes to a very fine point due to the BV dropping off into the cup. However, it is not a reliable indicator of glaucoma. |
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Term
| What is a splinter hemorrhage? |
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Definition
| Another name for Drance hemorrhage, common (but not limited to) glaucoma damage. |
|
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Term
| What are common causes of splinter hemorrhages? |
|
Definition
Glaucoma
PVD
Resolving BRVO
Diabetic Retinopathy |
|
|
Term
| Regardless of cause, what does an optic disc hemorrhage indicate? |
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Definition
| Tx is necessary, so determine the active pathology |
|
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Term
| How long does an optic disc hemorrhage take to resolve? |
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Definition
|
|
Term
| In an advanced glaucoma patient, what do optic disk hemorrhages signify? |
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Definition
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Term
| What is peripapillary pigmentary atrophy? |
|
Definition
| mottled appearance to RPE seen around the disc |
|
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Term
|
Definition
| central zone of RPE and choriocapillaris atrophy leading to visibility of choroidal vessels and sclera |
|
|
Term
|
Definition
| peripheral zone RPE atrophy surrounding the ONH |
|
|
Term
| How does alpha atrophy compare to a choroidal crescent? |
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Definition
| alpha atrophy is more mottled and less uniform, irregular borders |
|
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Term
| What is the suspected etiology of peripapillary pigment changes? |
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Definition
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|
Term
| Where is peripapillary pigmentary atrophy typically found? |
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Definition
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|
Term
| Is alpha atrophy present in normal eyes? |
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Definition
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|
Term
| Is beta atrophy present in normal eyes? |
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Definition
| not commonly. Usually pathologic. |
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|
Term
| What is the progression of peripapillary pigmentary atrophy? |
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Definition
| Patches typically start as alpha and progresses to beta over time if pathologic mechanism is not intervened |
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|
Term
| What does peripapillary pigment atrophy usually indicate is happening in the eye? |
|
Definition
| advanced damage, often associated with rim loss in the same sector |
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|
Term
| What is an acquired pit of the ONH? |
|
Definition
| sharp localized depression of lamina cribrosa |
|
|
Term
| What color is typically seen around acquired pts of the ONH? |
|
Definition
| Usually found in pallorous ares of ONH |
|
|
Term
| What is the most likely location of acquired pits of the ONH? |
|
Definition
| inferior temporal quadrant (opposite of CRA trunk?) |
|
|
Term
| What pathology are acquired pits of the ONH most commonly found in? |
|
Definition
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