Certified Retinal Angiographer (CRA) Examination With complete solution 100% VERIFIED CORRECT NEW!! 2025/2026

Certified Retinal Angiographer (CRA) Examination With
complete solution 100% VERIFIED CORRECT NEW!!
2025/2026
Sorsby Fundus Dystrophy (SFD) Il` Il` Il`




Similar symptoms to AMD, but can start at a much younger age. Inherited in an autosomal fashion
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




(faulty gene from either parent.) A progressive autosomal dominant macular dystrophy.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Characteristics:

- thick drusen-like deposits between the inner collagenous layer of Bruch’s membrane and the
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




basement membrane of the retinal pigment epithelium (RPE).
Il` Il` Il` Il` Il` Il` Il` Il` Il`




- Slit lamp examination typically reveals drusen deposition in the posterior pole and along vascular
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




arcades, although reticular drusen may also be seen. These drusen are described as yellow,
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




extracellular deposits between Bruch’s membrane and the RPE.
Il` Il` Il` Il` Il` Il` Il` Il`




Early symptoms are night blindness (Nyctalopia) and difficulty distinguishing between green and
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




blue red and yellow.
Il` Il` Il` Il` Il`




Later on macular cells die off, new blood vessels form, and central vision loss can occur.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




No proven treatment, but anti-VEGF injections can sometimes slow new blood vessel growth.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Testing: OCT. FA. FAF. Fundus Images. Il` Il` Il` Il` Il`




Background Diabetic Retinopathy Il` Il`




Another name for NON proliferative Diabetic retinopathy, early stage of the disease.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




AD

Proliferative Diabetic Retinopathy (PDR) Il` Il` Il`




The final and most severe stage of this disease. Has all the other factors of the lesser stages except
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




this stage has Neovascularization (development of new, weaker blood vessels) and/or
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




vitreous/pre retinal hemorrhage.
Il` Il` Il`

,Neovascularization can occur at the margin of normal perfused retina and capillary dropout or in Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




severe cases of ischemia at the optic disc. This type is prone to grow into the vitreous. Vessels are
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




brittle and subject to vitreous traction that can cause bleeding which can lead to significant
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




vitreous hemorrhage.
Il` Il` Il`




When Neovascularization is pervasive and there is fibrosis that has infiltrated the vitreous, it is
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




called retinitis proliferans.
Il` Il` Il`




Time Domain OCT Il` Il`




Comparison of light waves from the retina was derived from a time delay. Beam going through Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




eye has slight delay before it reaches the detector. A scan beam moved from one scan to the next
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




through a rapidly rotating mirror. Meant acquisition time was specific and sometimes spanned
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




several seconds.
Il` Il`




Original made in 1996, not as quick. Not used as much due to scan acquisition taking too long
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




allowing patient to blink which caused artifacts in the image. Also specificity of scan (<1mm across
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




and 2mm down through tissue) made it easy to miss pathology by mere micrometers.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Spectral domain OCT (Fourier domain OCT) Il` Il` Il` Il` Il`




Greater tissue resolving power, higher scan density, and faster data acquisition than Time
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




domain ____.
Il` Il`




Relies on changes in spectra in the layers rather than relying on time of flight changes for
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




comparison. Rotating mirror was replaced with a stationary spectrophotometer at the detector.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




This allows scans to be performed more quickly. Ability to perform multiple B-scans in rapid
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




succession. Much less likely to "miss" pathology. Also has increased axial resolution.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Retinal Neovascularization Il`




Retinas response to a lack of oxygen or blood flow in the retina. When the retina becomes
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




ischemic (lack of blood flow), the body's response is to grow new vessels in the retina to help
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




reestablish blood flow. Problem is these new vessels are leaky and fragile, end up creating more
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




damage.
Il` Il`




Cause is slow to develop like in diabetic retinopathy and central retinal vein occlusions.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`

,Doesn't develop after artery occlusions due to sudden and complete cutoff of blood supply, with
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




limited viable cells reacting to the ischemic environment by releasing VEGF (Vascular endothelial
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




growth factor)
Il` Il`




Appearance: ('Tangled Thread') Fine, thread like vessels that are different than normal retinal Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




vessels.
Il`




Testing: FA Il`




Macular Edema (ME)/ (#2) Diabetic macular edema Il` Il` Il` Il` Il` Il`




Build-up of fluid in the macula. Fluid buildup causes layers within the macula to swell and thicken,
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




which distorts vision.
Il` Il` Il` Il`




Most commonly age related.
Il` Il` Il` Il`




Imaging:

- Thickening of the center of the retina
Il` Il` Il` Il` Il` Il` Il`




- Retinal vessels become leaky and fluid accumulates within the macula (inraretinal)
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




-Cysts are formed Il` Il`




For this to be categorized as #2 must have diabetes along with #1
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Other causes: inflammation from infections, post ocular surgery, and diseases that affect vessel
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




health in and around macular region like diabetic retinopathy and retinal vascular occlusions.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Testing: OCT, Posterior pole, FA. Il` Il` Il` Il`




Central Serous Retinopathy (CSR) Il` Il` Il`




A disorder that causes a _____ detachment in the Macula. Occurs spontaneously and often
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




resolves without intervention.
Il` Il` Il` Il`

, Small break in the outer blood retina barrier(RPE) allows Fluid to build up under the retina. The
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




fluid leakage comes from a layer of tissue under the retina, called the choroid. The layer of cells
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




between the retina and choroid is called the retinal pigment epithelium (RPE).
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




When RPE does not work as it should, fluid builds up under the retina or the RPE resulting in a
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




small detachment and visual distortion (metamorphophopsia), loss of visual acuity, and
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




sometimes color change (dyschromatopsia). Most patients return to 20/25 or better vision.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Looks very similar to Macular Degeneration. Subretinal fluid build up related to: increase in
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




steroid levels, from medications or endogenous sources such as stress, chronic disease, and
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




pregnancy.
Il` Il`




Posterior Pole. FA. Il` Il`




During an FA source of break will be identified with a pinpoint hyperfluorescent leak occurring
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




early on, which will gradually pool and fill the _____ detachment/blister later. Mid phase will
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




show "smokestack" appearance for the leak - classically seen in Central ____ Retinopathy. Early
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




frames to catch the origin of leak and late frames to demonstrate extent of blister.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Sometimes go to 10 min lates on FA to show full extent of leaking and pooling. Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Under Exposure Il`




Too little light hitting image sensor causing the image to appear dark and loss of detail in
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




shadows.
Il`




Hyperopia

Farsightedness , Patients can see objects that are further away clearly and objects that are close Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




to their face appear blurred.
Il` Il` Il` Il` Il`




Eyeball is too short, causing the light to be refracted behind it.
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




Occurs when cornea doesn't provide enough refraction, creating an issue where the plane of
Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




focus occurs behind the retinal plane.
Il` Il` Il` Il` Il` Il`