Podcast
Questions and Answers
A patient reports seeing wavy or distorted images. Which of the following terms BEST describes this symptom?
A patient reports seeing wavy or distorted images. Which of the following terms BEST describes this symptom?
- Atrophy
- Metamorphopsia (correct)
- Hyperplasia
- Scotoma
Increased pigmentation observed during an eye exam is most likely a result of which cellular change?
Increased pigmentation observed during an eye exam is most likely a result of which cellular change?
- Migration
- Metaplasia
- Hyperplasia
- Hypertrophy (correct)
Which cellular change involves the movement of cells from their original location to another?
Which cellular change involves the movement of cells from their original location to another?
- Metaplasia
- Atrophy
- Migration (correct)
- Hyperplasia
What type of cellular change describes the proliferation of cells, resulting in a larger number of cells in a tissue?
What type of cellular change describes the proliferation of cells, resulting in a larger number of cells in a tissue?
Which cellular change is characterized by one cell type being replaced by another cell type?
Which cellular change is characterized by one cell type being replaced by another cell type?
What cellular change correlates with missing cells?
What cellular change correlates with missing cells?
Which of the following BEST describes a hamartoma?
Which of the following BEST describes a hamartoma?
A patient reports a partial loss of vision or the presence of a blind spot in their visual field. Which of the following terms best describes this symptom?
A patient reports a partial loss of vision or the presence of a blind spot in their visual field. Which of the following terms best describes this symptom?
What remote macular findings might be observed in association with retinal tumors?
What remote macular findings might be observed in association with retinal tumors?
Ultrasonography of a retinal tumor typically reveals which characteristics?
Ultrasonography of a retinal tumor typically reveals which characteristics?
A patient presents with suspected RPE atrophy. Which imaging modality is the MOST useful for monitoring changes and potential complications?
A patient presents with suspected RPE atrophy. Which imaging modality is the MOST useful for monitoring changes and potential complications?
Which of the following is a key finding associated with RPE atrophy?
Which of the following is a key finding associated with RPE atrophy?
Why is it important to closely monitor patients with RPE atrophy?
Why is it important to closely monitor patients with RPE atrophy?
A child is diagnosed with a combined hamartoma of the retina and RPE. Besides vision loss and strabismus, which systemic condition should the clinician be particularly vigilant in screening for?
A child is diagnosed with a combined hamartoma of the retina and RPE. Besides vision loss and strabismus, which systemic condition should the clinician be particularly vigilant in screening for?
What characteristic feature is most commonly observed in combined hamartoma of the retina and RPE?
What characteristic feature is most commonly observed in combined hamartoma of the retina and RPE?
Which of the following is a potential complication associated with combined hamartoma of the retina and RPE that necessitates close monitoring?
Which of the following is a potential complication associated with combined hamartoma of the retina and RPE that necessitates close monitoring?
What finding on fluorescein angiography (FA) is most characteristic of a combined hamartoma?
What finding on fluorescein angiography (FA) is most characteristic of a combined hamartoma?
Which of the following is the most important initial management step for a young child diagnosed with combined hamartoma?
Which of the following is the most important initial management step for a young child diagnosed with combined hamartoma?
A patient with combined hamartoma of the retina and RPE experiences decreased visual acuity. What secondary condition is most likely contributing to this decline?
A patient with combined hamartoma of the retina and RPE experiences decreased visual acuity. What secondary condition is most likely contributing to this decline?
Which diagnostic modality is most useful in differentiating combined hamartoma from other similar conditions?
Which diagnostic modality is most useful in differentiating combined hamartoma from other similar conditions?
A patient is diagnosed with an RPE adenoma. What is the most critical differential diagnosis to rule out?
A patient is diagnosed with an RPE adenoma. What is the most critical differential diagnosis to rule out?
Though surgical intervention is debated, what surgical procedure might be considered in certain cases of combined hamartoma to improve visual acuity?
Though surgical intervention is debated, what surgical procedure might be considered in certain cases of combined hamartoma to improve visual acuity?
What is the typical appearance of an RPE adenoma/adenocarcinoma?
What is the typical appearance of an RPE adenoma/adenocarcinoma?
A patient presents with excessive skin cells in a bone. This condition is best described as:
A patient presents with excessive skin cells in a bone. This condition is best described as:
Increased pigmented cells are found during a retinal exam. What is the most appropriate next step?
Increased pigmented cells are found during a retinal exam. What is the most appropriate next step?
Which of the following is NOT a differential diagnosis (DDx) of CHRPE (Congenital Hypertrophy of the Retinal Pigment Epithelium)?
Which of the following is NOT a differential diagnosis (DDx) of CHRPE (Congenital Hypertrophy of the Retinal Pigment Epithelium)?
A patient is diagnosed with CHRPE. What is the most appropriate management strategy?
A patient is diagnosed with CHRPE. What is the most appropriate management strategy?
Reactive hyperplasia of the RPE is often associated with which of the following conditions?
Reactive hyperplasia of the RPE is often associated with which of the following conditions?
What characteristic feature is commonly associated with reactive hyperplasia of the RPE?
What characteristic feature is commonly associated with reactive hyperplasia of the RPE?
In Optical Coherence Tomography (OCT), hyperplasia of the RPE causes what characteristic finding in the choroid?
In Optical Coherence Tomography (OCT), hyperplasia of the RPE causes what characteristic finding in the choroid?
A key difference between congenital simple hamartoma of the RPE (CSHRPE) and typical hyperplasia is:
A key difference between congenital simple hamartoma of the RPE (CSHRPE) and typical hyperplasia is:
Which of the following features is MOST characteristic of congenital simple hamartoma of the RPE (CSHRPE)?
Which of the following features is MOST characteristic of congenital simple hamartoma of the RPE (CSHRPE)?
A patient is diagnosed with congenital simple hamartoma of the RPE (CSHRPE) and presents with macular edema. What is the most likely effect on vision?
A patient is diagnosed with congenital simple hamartoma of the RPE (CSHRPE) and presents with macular edema. What is the most likely effect on vision?
Which clinical feature is MOST indicative of RPE adenocarcinoma rather than RPE adenoma?
Which clinical feature is MOST indicative of RPE adenocarcinoma rather than RPE adenoma?
A patient presents with a pigmented retinal mass. Which additional finding would MOST strongly suggest RPE adenocarcinoma over adenoma?
A patient presents with a pigmented retinal mass. Which additional finding would MOST strongly suggest RPE adenocarcinoma over adenoma?
What cellular characteristic distinguishes RPE adenocarcinoma from adenoma upon histological examination?
What cellular characteristic distinguishes RPE adenocarcinoma from adenoma upon histological examination?
A patient is diagnosed with RPE adenoma. What is the MOST appropriate initial management strategy?
A patient is diagnosed with RPE adenoma. What is the MOST appropriate initial management strategy?
In the context of RPE tumors, the term 'malignant epithelioma' refers to which type of lesion?
In the context of RPE tumors, the term 'malignant epithelioma' refers to which type of lesion?
Where do primary malignant adenocarcinomas of the RPE typically originate and potentially invade?
Where do primary malignant adenocarcinomas of the RPE typically originate and potentially invade?
What finding on EDI-OCT is MOST suggestive of an RPE tumor?
What finding on EDI-OCT is MOST suggestive of an RPE tumor?
A key distinguishing feature of RPE adenocarcinoma compared to adenoma is its potential to cause which of the following?
A key distinguishing feature of RPE adenocarcinoma compared to adenoma is its potential to cause which of the following?
What is a typical color of RPE adenoma?
What is a typical color of RPE adenoma?
A patient presents with a black, full-thickness retinal mass. Which of the following is LEAST likely to be associated with this lesion, based on the provided information?
A patient presents with a black, full-thickness retinal mass. Which of the following is LEAST likely to be associated with this lesion, based on the provided information?
Flashcards
Asymptomatic lesions
Asymptomatic lesions
Lesions that do not show symptoms and are often found during routine eye care.
Macular lesions
Macular lesions
Lesions located in the macula, can lead to significant vision symptoms.
Metamorphopsia
Metamorphopsia
Visual distortion where straight lines appear wavy or bent.
Scotoma
Scotoma
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Atrophy
Atrophy
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Hypertrophy
Hypertrophy
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Hyperplasia
Hyperplasia
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Metaplasia
Metaplasia
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Choristoma
Choristoma
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CHRPE
CHRPE
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Differential Diagnosis (DDx) of CHRPE
Differential Diagnosis (DDx) of CHRPE
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Management of CHRPE
Management of CHRPE
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Reactive Hyperplasia of the RPE
Reactive Hyperplasia of the RPE
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Pigment Clumping
Pigment Clumping
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Congenital Simple Hamartoma of the RPE
Congenital Simple Hamartoma of the RPE
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Vitreous Traction
Vitreous Traction
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OCT in RPE Conditions
OCT in RPE Conditions
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Follow-up Recommendations
Follow-up Recommendations
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Remote macular findings
Remote macular findings
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Rugged pattern
Rugged pattern
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Ultrasonography findings
Ultrasonography findings
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RPE atrophy
RPE atrophy
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Choroidal vascular formation
Choroidal vascular formation
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RPE adenoma
RPE adenoma
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RPE adenocarcinoma
RPE adenocarcinoma
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Nuclear pleomorphism
Nuclear pleomorphism
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Choroidal invasion
Choroidal invasion
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Feeder vessel
Feeder vessel
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Exudation in adenocarcinoma
Exudation in adenocarcinoma
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Vitreous hemorrhage
Vitreous hemorrhage
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Subretinal exudation
Subretinal exudation
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OCT findings
OCT findings
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Vitreous seeds
Vitreous seeds
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Combined Hamartoma
Combined Hamartoma
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Unilateral Appearance
Unilateral Appearance
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Epiretinal Membrane (ERM)
Epiretinal Membrane (ERM)
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Tractional Changes
Tractional Changes
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Visual Acuity Impact
Visual Acuity Impact
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Neurofibromatosis Type 2
Neurofibromatosis Type 2
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Choroidal Neovascularization
Choroidal Neovascularization
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Management Strategies
Management Strategies
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Differential Diagnosis (DDx)
Differential Diagnosis (DDx)
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Study Notes
Eye Lesions
- Most eye lesions are asymptomatic and discovered during routine eye exams.
- Macular lesions can cause significant vision loss (metamorphopsia, scotoma).
- Lesions are categorized by cellular changes:
- Atrophy: loss of cells
- Hypertrophy: increased cell size (pigmented cells increase pigment granules)
- Hyperplasia: increased cell number (cells are normal size)
- Migration: movement of cells
- Metaplasia: transformation of one cell type to another.
- Hamartoma: excessive cells in inappropriate location (not considered cancerous)
- Carcinoma: cancerous epithelial cells.
- Cellular changes influence lesion appearance.
- Patient history (family history, especially eye tumors) is vital.
- Examination techniques (to determine benign or malignant) and monitoring are crucial.
- Choroidal lesions are often dangerous, especially melanoma.
- OCT, ultrasound, and fluorescein angiography (FAF, FA) can help diagnose.
- Congenital hypertrophy of the retinal pigment epithelium (CHRPE) is a benign condition.
- CHRPE has an association to other systemic diseases or other ocular diseases.
- Some CHRPE can increase in size over time and are not common..
- Minimum size to be a CHRPE is half to 1 disc diameter, can go up to 14 disc diameters .
- Lacunae (openings) and halo features are typical for CHRPE.
- CHRPE lesions do not change in size as opposed to other lesions.
- Histopathology of CHRPE shows photoreceptors under the RPE to lose their membranes.
- Histopathology of CHRPE cells are 1.5-2 times bigger than normal and increased number of pigment granules.
- CHRPE have a extremely rare potential for malignant transformations.
- Red-free filters and green-free filters can help distinguish lesions.
- Using a green filter, a lesion in the choroid disappears.
- Choroidal nevus may cause vision loss and difficulty differentiating it from other lesions.
- Visual acuity (VA) and visual field (VF) are crucial for diagnosis and assessment.
Congenital Grouped Pigmentation of the RPE
- Clustered lesions, small, brown-black, flat, in a specific location.
- Vary in size, generally much smaller than CHRPE.
- Lesions are typically unilateral but can be bilateral in one quadrant.
- Histopathology suggests an increase in pigment granules within RPE cells.
- Not associated with anything else, but can be unilateral.
Congenital Simple Hamatoma of RPE
- Benign lesion, non-progressive
- Usually as a small darkly pigmented lesion.
Combined Retinal Pigmented Epithelial Hamartoma
- Less common, typically unilateral, and involves both retina and RPE.
- Characterized by a nonuniform, gray-white, fibroglial mass, sometimes obscured.
- Often related to other conditions like neurofibromatosis type 2.
Reactive Hyperplasia of the RPE
- Common, condition of the RPE (idiopathic or due to inflammation, trauma, hemorrhage, etc.)
- Can be stable, not necessarily malignant though.
Atrophy of the RPE
- Defects in the RPE layer continuity; atrophy resembles a map-like appearance.
- Multiple potential causes, like AMD, choroidal scarring, macular dystrophies or other conditions.
- Geographic atrophy is an example of RPE atrophy, associated with AMD.
RPE Adenoma
- Benign, rare intraocular tumor.
- Difficult to differentiate from malignant choroidal melanoma
- Characterized by abrupt elevation of masses, and sometimes accompanied by exudates or retinal hemorrhages.
RPE Adenocarcinoma
- Malignant tumor.
- May invade the choroid or retina, often has distinct features (exudation, feeder vessels, etc).
- Not typically seen in a flat sheet.
Management
- Management of most of the conditions often involves monitoring, referral to specialists (retina-oncologist), and sometimes specific therapy.
- Early diagnosis is crucial and treatment should be personalized.
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Description
This quiz covers key concepts in ophthalmology, focusing on cellular changes and associated visual symptoms. It explores conditions like distorted vision, pigmentation changes, cell proliferation, and retinal tumors. Understand the relationship between cellular abnormalities vision problems.
