Free ABO Retina and Vitreous Questions and Answers — Questions and Answers
Question 1: Which of the following findings is the defining feature that differentiates proliferative diabetic retinopathy (PDR) from severe non-proliferative diabetic retinopathy (NPDR)?
- Cotton wool spots
- Severe retinal hemorrhages in 4 quadrants
- Neovascularization of the disc (NVD) (Correct answer)
- Venous beading in 2 quadrants
Correct answer: Neovascularization of the disc (NVD)
The hallmark of proliferative diabetic retinopathy is neovascularization, which is the growth of new, abnormal blood vessels. These can occur on the optic disc (NVD) or elsewhere on the retina (NVE) and are a response to widespread retinal ischemia.
Question 2: A 75-year-old patient reports sudden, painless, distorted central vision in one eye. OCT reveals subretinal fluid and intraretinal cysts. What is the most appropriate initial treatment?
- Intravitreal anti-VEGF injection (Correct answer)
- Photodynamic therapy
- Observation with an Amsler grid
- Laser photocoagulation
Correct answer: Intravitreal anti-VEGF injection
The findings are classic for neovascular or 'wet' age-related macular degeneration (AMD). The standard of care and first-line treatment is intravitreal injection of an anti-vascular endothelial growth factor (anti-VEGF) agent to inhibit the growth of abnormal choroidal vessels and reduce fluid leakage.
Question 3: A patient presents with a sudden onset of numerous floaters and flashes of light, followed by a 'curtain' coming down over their vision. This presentation is most classic for which type of retinal detachment?
- Tractional
- Rhegmatogenous (Correct answer)
- Exudative
- Serous
Correct answer: Rhegmatogenous
Rhegmatogenous retinal detachment is caused by a tear or break in the retina, allowing vitreous fluid to seep underneath and separate the retina from the underlying retinal pigment epithelium. The initial tear often causes symptoms of flashes (photopsia) and floaters.
Question 4: An 80-year-old male with a history of atrial fibrillation presents with sudden, profound, painless vision loss in his right eye. Fundus exam reveals a pale retina and a 'cherry-red spot' in the macula. What is the most likely diagnosis?
- Central retinal vein occlusion (CRVO)
- Ischemic optic neuropathy
- Vitreous hemorrhage
- Central retinal artery occlusion (CRAO) (Correct answer)
Correct answer: Central retinal artery occlusion (CRAO)
A central retinal artery occlusion (CRAO) presents with acute, painless, severe vision loss. The cherry-red spot occurs because the macula receives its blood supply from the underlying choroid, so it remains red while the surrounding ischemic retina becomes pale and opaque.
Question 5: A 65-year-old patient with a history of hypertension is diagnosed with a central retinal vein occlusion (CRVO). What is the most common cause of vision loss in this condition?
- Neovascular glaucoma
- Macular edema (Correct answer)
- Vitreous hemorrhage
- Tractional retinal detachment
Correct answer: Macular edema
Macular edema is the most frequent cause of vision loss in both central and branch retinal vein occlusions. The venous obstruction leads to increased back pressure in the capillaries, causing fluid to leak into the macula.
Question 6: A young adult complains of progressive night blindness and peripheral vision loss. Fundus examination reveals mid-peripheral bone-spicule pigmentation, attenuated retinal arterioles, and waxy pallor of the optic disc. This triad of findings is classic for which condition?
- Retinitis pigmentosa (Correct answer)
- Choroideremia
- Gyrate atrophy
- Cone-rod dystrophy
Correct answer: Retinitis pigmentosa
The classic triad of bone-spicule pigmentation, attenuated vessels, and waxy optic disc pallor is pathognomonic for retinitis pigmentosa. This group of inherited retinal dystrophies primarily affects the rod photoreceptors, leading to nyctalopia (night blindness) and progressive peripheral visual field loss.
Question 7: A 72-year-old patient presents with severe pain, redness, and rapidly decreasing vision 3 days after uncomplicated cataract surgery. Examination reveals a significant anterior chamber reaction with a hypopyon. What is the most urgent diagnosis to consider?
- Toxic anterior segment syndrome (TASS)
- Retained lens fragment
- Acute post-operative endophthalmitis (Correct answer)
- Uveitis-glaucoma-hyphema (UGH) syndrome
Correct answer: Acute post-operative endophthalmitis
Acute post-operative endophthalmitis is a devastating intraocular infection that can occur after any intraocular surgery. It typically presents within the first week with severe pain, vision loss, and signs of intense inflammation like a hypopyon. It is an ophthalmologic emergency requiring immediate intervention.
Free ABO Retina and Vitreous Questions and Answers
Which of the following findings is the defining feature that differentiates proliferative diabetic retinopathy (PDR) from severe non-proliferative diabetic retinopathy (NPDR)?