ABO Retina and Vitreous Disorders 2 — Questions and Answers
Question 1: In DRCR.net Protocol T, for center-involved diabetic macular edema with baseline visual acuity of 20/50 or worse, which agent produced the greatest 1-year visual gain?
- Bevacizumab
- Ranibizumab
- Aflibercept (Correct answer)
- Triamcinolone acetonide
Correct answer: Aflibercept
Protocol T showed aflibercept was superior at 1 year in eyes with worse baseline vision (20/50 or worse), with the difference narrowing by 2 years.
Question 2: A 78-year-old presents with sudden painless monocular vision loss and a cherry-red spot. What is the most urgent next step in workup?
- Carotid duplex ultrasound
- ESR, CRP, and platelet count to evaluate for giant cell arteritis (Correct answer)
- Fluorescein angiography
- Transthoracic echocardiogram
Correct answer: ESR, CRP, and platelet count to evaluate for giant cell arteritis
Arteritic CRAO must be excluded immediately in older patients because the fellow eye is at high risk without prompt corticosteroids.
Question 3: Which feature most strongly predicts successful pharmacologic release of vitreomacular traction with ocriplasmin?
- Presence of an epiretinal membrane
- Pseudophakic status
- Adhesion diameter greater than 1500 µm
- Absence of an epiretinal membrane (Correct answer)
Correct answer: Absence of an epiretinal membrane
Ocriplasmin works best in phakic, younger patients with focal adhesion ≤1500 µm and no epiretinal membrane.
Question 4: According to ETROP, which retinopathy of prematurity finding meets type 1 criteria for treatment?
- Zone II, stage 2 with plus disease (Correct answer)
- Zone II, stage 3 without plus disease
- Zone III, stage 2 without plus disease
- Zone II, stage 1 without plus disease
Correct answer: Zone II, stage 2 with plus disease
Type 1 ROP includes zone I any stage with plus, zone I stage 3 without plus, and zone II stage 2 or 3 with plus.
Question 5: Which exposure is most strongly associated with central serous chorioretinopathy?
- Hydroxychloroquine
- Systemic or topical corticosteroids (Correct answer)
- Tamoxifen
- Ethambutol
Correct answer: Systemic or topical corticosteroids
Exogenous and endogenous corticosteroids are the best-established risk factor for CSC.
Question 6: Which hemoglobin genotype is most associated with proliferative sickle cell retinopathy?
- HbSS
- HbAS
- HbSC (Correct answer)
- HbAA
Correct answer: HbSC
HbSC disease carries the highest risk of proliferative retinopathy, despite milder systemic disease than HbSS.
Question 7: What is the most common cause of acute retinal necrosis in immunocompetent adults?
- Cytomegalovirus
- Toxoplasma gondii
- Varicella-zoster virus (Correct answer)
- Epstein-Barr virus
Correct answer: Varicella-zoster virus
VZV is the most common cause of ARN, followed by HSV, and requires prompt antiviral therapy.
ABO Retina and Vitreous Disorders 2
In DRCR.net Protocol T, for center-involved diabetic macular edema with baseline visual acuity of 20/50 or worse, which agent produced the greatest 1-year visual gain?