NBEO NBEO Posterior Segment & Retinal Disease 2 — Questions and Answers
Question 1: Which treatment is first-line for neovascular (wet) age-related macular degeneration?
- Intravitreal anti-VEGF injections (Correct answer)
- Laser photocoagulation
- Photodynamic therapy
- Oral antioxidant vitamins
Correct answer: Intravitreal anti-VEGF injections
Intravitreal anti-VEGF agents (ranibizumab, bevacizumab, aflibercept) are the first-line treatment for wet AMD, reducing CNV leakage and improving visual acuity.
Question 2: The AREDS2 formula for dry AMD supplementation includes which two carotenoids?
- Lutein and zeaxanthin (Correct answer)
- Beta-carotene and lycopene
- Astaxanthin and canthaxanthin
- Lutein and astaxanthin
Correct answer: Lutein and zeaxanthin
AREDS2 replaced beta-carotene with lutein (10 mg) and zeaxanthin (2 mg) due to beta-carotene's lung cancer risk in smokers.
Question 3: What is the hallmark OCT finding in central serous chorioretinopathy (CSCR)?
- Subretinal fluid beneath the neurosensory retina (Correct answer)
- Drusen under the RPE
- Intraretinal fluid in the outer plexiform layer
- Epiretinal membrane with retinal folds
Correct answer: Subretinal fluid beneath the neurosensory retina
CSCR is characterized by a serous detachment of the neurosensory retina overlying a focal RPE leak, appearing as subretinal fluid on OCT.
Question 4: A patient with sickle cell disease is at highest risk for which posterior segment complication?
- Proliferative sickle cell retinopathy (Correct answer)
- Central retinal artery occlusion
- Choroidal neovascularization
- Exudative retinal detachment
Correct answer: Proliferative sickle cell retinopathy
Sickle cell retinopathy progresses to a proliferative stage with sea-fan neovascularization, vitreous hemorrhage, and traction retinal detachment.
Question 5: Which peripheral retinal degeneration is considered a significant risk factor for rhegmatogenous retinal detachment?
- Lattice degeneration (Correct answer)
- Pavingstone degeneration
- Microcystoid degeneration
- Drusen
Correct answer: Lattice degeneration
Lattice degeneration causes thinning of the peripheral retina with overlying vitreous liquefaction and strong vitreoretinal adhesions at its edges, predisposing to tears and detachment.
Question 6: Macular pucker (epiretinal membrane) is best evaluated with which imaging modality?
- Optical coherence tomography (OCT) (Correct answer)
- Fluorescein angiography
- Fundus autofluorescence
- Visual field testing
Correct answer: Optical coherence tomography (OCT)
OCT clearly delineates the epiretinal membrane as a hyperreflective layer on the inner retinal surface and quantifies associated retinal distortion and thickening.
NBEO NBEO Posterior Segment & Retinal Disease 2
Which treatment is first-line for neovascular (wet) age-related macular degeneration?