AOA Ocular Disease and Pathology 2 — Questions and Answers
Question 1: The cup-to-disc ratio (CDR) that is most suspicious for glaucomatous damage is:
- 0.8 with asymmetry between eyes (Correct answer)
- 0.3 symmetric bilaterally
- 0.5 symmetric bilaterally
- 0.4 with small disc
Correct answer: 0.8 with asymmetry between eyes
A CDR of 0.8 or greater, especially with inter-eye asymmetry exceeding 0.2, is highly suspicious for glaucomatous optic nerve damage.
Question 2: Which layer of the cornea is replaced by pump activity and is responsible for maintaining corneal deturgesence?
- Endothelium (Correct answer)
- Bowman's layer
- Epithelium
- Stroma
Correct answer: Endothelium
The corneal endothelium maintains corneal clarity through active fluid pumping to prevent swelling of the hydrophilic stroma.
Question 3: Rubeosis iridis (neovascularization of the iris) is a complication most associated with which condition?
- Central retinal vein occlusion (Correct answer)
- Primary open-angle glaucoma
- Fuchs' endothelial dystrophy
- Phlyctenular keratoconjunctivitis
Correct answer: Central retinal vein occlusion
Central retinal vein occlusion causes widespread retinal ischemia that can stimulate VEGF-driven neovascularization of the iris, leading to neovascular glaucoma.
Question 4: What is the hallmark sign of a posterior vitreous detachment (PVD)?
- Weiss ring (Correct answer)
- Shafer's sign
- Cherry red spot
- Roth spots
Correct answer: Weiss ring
A Weiss ring is the annular floater seen upon PVD, representing the detached peripapillary glial tissue ring formerly attached at the disc margin.
Question 5: Which systemic disease is most associated with optic neuritis leading to a central scotoma in young adults?
- Multiple sclerosis (Correct answer)
- Hypertension
- Type 2 diabetes
- Hypothyroidism
Correct answer: Multiple sclerosis
Optic neuritis in young adults carries a significant risk of multiple sclerosis, and demyelination is the most common systemic cause.
Question 6: Drusen deposits beneath the retinal pigment epithelium are most associated with which disease process?
- Age-related macular degeneration (Correct answer)
- Diabetic retinopathy
- Retinitis pigmentosa
- Central serous chorioretinopathy
Correct answer: Age-related macular degeneration
Drusen are extracellular deposits between the RPE and Bruch's membrane and are the hallmark early finding of age-related macular degeneration.
AOA Ocular Disease and Pathology 2
The cup-to-disc ratio (CDR) that is most suspicious for glaucomatous damage is: