JCAHPO Imaging 4 — Questions and Answers
Question 1: When photographing the fundus, a hazy image with reduced contrast most likely indicates:
- Incorrect camera focus setting
- Media opacity such as cataract or vitreous haze (Correct answer)
- Over-illumination of the fundus
- Incorrect film sensitivity (ISO) setting
Correct answer: Media opacity such as cataract or vitreous haze
Media opacities (cataract, corneal scar, vitreous hemorrhage) scatter light and reduce fundus image contrast and clarity.
Question 2: The 'early arteriovenous phase' of a fluorescein angiogram typically occurs how many seconds after injection?
- 1-5 seconds
- 10-15 seconds (Correct answer)
- 30-45 seconds
- 60-90 seconds
Correct answer: 10-15 seconds
The arteriovenous (transit) phase of FA typically occurs 10-15 seconds after antecubital injection, showing arterial filling before venous return.
Question 3: On OCT, a 'double hump' foveal contour in a young patient most likely suggests:
- Vitreomacular traction
- Foveal hypoplasia (Correct answer)
- Epiretinal membrane
- Lamellar macular hole
Correct answer: Foveal hypoplasia
Foveal hypoplasia is characterized by absent foveal pit development on OCT, sometimes appearing as a shallow or double-humped contour without the normal central depression.
Question 4: Which scanning laser ophthalmoscope (SLO) wavelength is best for visualizing the choroid?
- 488 nm blue laser
- 532 nm green laser
- 785-830 nm near-infrared laser (Correct answer)
- 1050 nm swept-source laser
Correct answer: 785-830 nm near-infrared laser
Near-infrared wavelengths (785-830 nm) penetrate the RPE more effectively, allowing better visualization of choroidal structures with SLO.
Question 5: A patient undergoes wide-field fluorescein angiography. The primary advantage of wide-field imaging over standard 30-degree FA is:
- Higher resolution of the foveal avascular zone
- Visualization of peripheral retinal pathology in a single capture (Correct answer)
- Elimination of fluorescein dye requirement
- Faster image acquisition speed
Correct answer: Visualization of peripheral retinal pathology in a single capture
Wide-field FA (100-200 degrees) captures far peripheral retina in a single image, revealing ischemia, neovascularization, and vasculitis not visible on standard fields.
Question 6: In automated perimetry, which reliability index measures the patient's response to stimuli presented at locations previously identified as blind?
- False positive rate
- False negative rate (Correct answer)
- Fixation loss rate
- Mean deviation
Correct answer: False negative rate
False negative rate measures how often a patient fails to respond to suprathreshold stimuli in areas previously seen; elevated rates suggest inattention or fatigue.
Question 7: Enhanced depth imaging (EDI) OCT was developed primarily to improve visualization of:
- Inner plexiform layer
- Retinal pigment epithelium detail
- Choroid and its boundaries (Correct answer)
- Vitreoretinal interface
Correct answer: Choroid and its boundaries
EDI-OCT places the zero-delay line closer to the choroid, improving sensitivity at that depth and enabling clear visualization of choroidal thickness and vasculature.
JCAHPO Imaging 4
When photographing the fundus, a hazy image with reduced contrast most likely indicates: