Posterior Segment - Sample Questions
by Reed - Quiz by Michael
Quiz
Which of the following ocular anatomy statements is correct?
The vitreous has three attachments: the ciliary body, ciliary muscle, and iris.
The fovea, like the rest of the neurosensory retina, has 10 layers.
The RPE functions to absorb light, phagocytose rod & cone outer segments, act as a blood-ocular barrier, and aids in healing/scar formation.
Retinal circulation is controlled by sympathetic tone with capillary plexi in the outerplexiform & outer nuclear layers and is supplied by the short posterior ciliary arteries.
Which of the following is true regarding the current classification of hypertension (HTN)?
There are three classifications: primary/essential HTN, secondary HTN, and tertiary HTN.
Normal blood pressure is classified as < 140/90 mmHg.
Stage III is classified is > 180/110 mmHg.
Any systolic blood pressure > 160 mmHg is considered emergent.
All of the above are true.
A blood pressure of 162 / 108 would match with which classification of hypertension ?
Normal
Stage I
Stage II
Stage III
Which is an incorrect statement regarding papilledema?
Papilledema is disc swelling produced by increased intracranial pressure.
Papilledema usually occurs in one eye only.
Clinical findings with papilledema may include; cranial nerve VI palsy, dilated and tortuous veins with disc hemorrhages, and visual field defects.
Management includes above all, immediate emergency referral to emergency room.
Which of the following is not a clinical finding in diabetic retinopathy?
Choroidal neovascularization.
Hard exudates and retinal edema.
Venous beading, intraretinal microvascular abnormalities, and Retinal hemorrhages.
Cotton wool spots.
Retinal neovascularizartion.
Which of the following statements is not part of the definition of clinically significant macular edema as defined by the ETDRS (Early Treatment Diabetic Retinopathy Study) ?
Retinal thickening at or within 500 microns of the center of the macula.
Vision loss secondary to retinal thickening within 500 microns of the center of the macula.
Hard exudates at or within 500 microns of the center of the macula with adjacent retinal thickening.
Retinal thickening one disc diameter in size within one disc diameter of the center of the macula.
Which of the following is an incorrect statement pertaining to the management of patients with diabetic retinopathy?
Scatter laser photocoagulation with an argon green laser is recommended for all patients with “high risk” proliferative diabetic retinopathy.
Focal laser photocoagulation is recommended for patients with clinically significant macular edema and is performed to stabilize, not improve, visual acuity.
If a patient has clinically significant macular edema and high risk proliferative diabetic retinopathy, scatter laser for neovascularization should be performed prior to focal laser for the macular edema.
Vitrectomy should be performed for patients with non-clearing vitreous hemorrhage and tractional retinal detachment that threatens vision.
The “classic” presenting symptoms in a diabetic patient consists of which of the following?
Polydipsia, polyphagia, and polyuria.
Lean body mass.
Young age.
Family history of diabetes.
Which statement regarding branch retinal vein occlusions (BRVO) is true?
Retinal arteries and veins share a common adventitial sheath and mechanical compression leads to thrombotic obstruction of the vein.
Non-ischemic events have much greater clinical findings and severity.
There are three types of BRVOs: primary, minor, and complicated.
Most BRVOs occur in the inferior retina.
A silent choroid on fluorescein angiography.
All of the answers listed here are correct.
Which of the following is an incorrect statement regarding the etiology of central retinal vein occlusions (CRVO)?
Hypertension, diabetes, and hyperlipidemia are the leading causes of CRVOs in those > 50 years of age.
Glaucoma is very uncommon ocular etiology of CRVO.
Papilledema, optic disc drusen, and optic nerve compression are ocular etiologies of CRVOs.
Hyperviscosity syndromes should be considered in people of all ages with CRVO.
Birth control pills should be considered as an etiology in young females with CRVOs.
The Central Vein Occlusion Study (CVOS) stated which of the following results?
Scatter laser photocoagulation should be initiated in all ischemic central retinal vein occlusions as prophylactic therapy for neovascularization.
Those of older age, visual acuity < 20/400, nonperfusion > 10 disc areas, and smoking were at low risk for the development of neovascularization.
Iris and angle neovascularization (neovascular glaucoma) occur more frequently after 6 months.
All answers listed here are true.
Focal grid laser for macular edema reduced angiographic macular edema, but did not improve visual acuity.
Which of the following is a correct statement regarding cotton wool spots of the retina?
Cotton wool spots are infarcts in the nerve fiber layer.
Visual field loss, i.e. scotoma can occur with cotton wool spots.
Typically cotton wool spots will fade over a 5-6 week period.
Any cotton wool spot warrants a work-up for diabetes, hypertension, carotid, vasculitic disease, collagen-vascular disease, and more.
All of the above are correct.
Which of the following is an incorrect statement regarding Retinal Macroaneurysms, RAM?
Typically found in older males with hypertension.
May exhibit sub, intra, and pre-retinal hemorrhage.
Focal laser treatment is applied to the leaking area if vision is threatened.
Retinal obstruction/occlusions can occur distal to the RAM.
Frequently bilateral.
Which of the following is incorrect with respect to “wet” macular degeneration, AMD?
Wet AMD comprises 10%-15% of macular degeneration.
90% of patients with wet AMD have vision < 20/200.
The fellow eye of a patient with wet AMD has only a 10% chance of developing a choroidal neovascular membrane.
Subretinal Fluid, hemorrhage, and lipid are the major clinical findings present when a choroidal neovascular has formed.
Which of the following pertains to the Age Related Eye Disease Study, AREDS?
The AREDS showed that high doses of certain vitamins reduced the risk of vision loss in advanced AMD.
The AREDS showed that high doses of certain vitamins reduced the progression of cataracts.
The AREDS formulation was vitamins D, B12, and Folic acid.
The AREDS formulation should be given prophylaxis to patients without AMD, but have a family history of AMD.
Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICG) are two tests used to diagnose and manage wet AMD. Which of the following statements is true regarding these techniques.
FFA images the choroidal vasculature and is useful to image through subretinal blood and fluid, while ICG images the retinal vasculature.
Choroidal neovascularization, CNVM, appear as dark, hypofluorescent lesions on FFA that do not increase in intensity of size.
Fluorescein angiography never has any side effects.
None are correct.
ICG is a large molecular weight dye that does not leak from the large choroidal lobules.
Which of the following is a correct statement pertaining to presumed ocular histoplasmosis syndrome, POHS?
Rarely is the disease bilateral.
Surgical management is considered first line therapy for CNVM.
Histoplasmosis is a bacteria from dogs that is ingested and disseminated via the bloodstream.
The major clinical findings are; punched out chorioretinal lesions, peripapillary atrophy, no vitritis, and possible choroidal neovascular membranes,CNVM.
Patients are typically very symptomatic even without a CNVM.
Which of the following is a correct statement pertaining to Angioid Streaks?
Angioid streaks are associated with the following conditions; Paget’s Disease, Sickle Cell, Pseudoxanthoma Elasticum, and Ehler’s-Danlos Syndrome.
Typically angioid streaks are bilateral
Up to 70% will develop vision threatening complications to choroidal neovascular membranes, CNVM.
All of the above are correct.
Typically irregular, jagged, curvilinear lines are seen radiating from the optic nerve head.
Which of the following is incorrect in the management of central serous chorioretinopathy, CSCR?
Most patients are observed and followed with fundus photography.
Focal laser improves visual prognosis, however lengthens the course of the disease.
Laser should be considered in persistence of serous detachment > 4 months.
Only 5%-10% of patients fail to regain 20/30 vision or better.
80%-90% of CSCR cases resolve spontaneously within 3-4 months.
Which of the following is a correct statement regarding epiretinal membrane, ERM?
ERM is not associated with the formation of a posterior vitreous detachment, PVD.
Clinical characteristics of ERM may include; retinal folds, parafoveal telangectasias, CME, and pseudohole formation.
Typical management of ERM is to perform an immediate pars plana vitrectomy and peel.
95% of patients with ERM undergo surgery.
60% of ERM is bilateral.
Which of the following is incorrect in the comparison of macular holes vs pseudomacular holes?
Macular holes vs Pseudoholes visual acuity: 20/70 to 20/400 vs 20/25 to 20/70
Macular holes vs Pseudoholes Associated ERM: very little ERM vs high association
Macular holes vs Pseudoholes Scotoma: central scotoma vs small to no scotoma
Macular holes vs Pseudoholes Watzke Allen sign: negative vs positive
Macular holes vs Pseudoholes deposits: xanthophyl deposits vs no deposits
Which of the following is a correct statement regarding pigmented retinal lesions?
Bear tracking may be a sign of intestinal cancer: Gardener’s Syndrome.
A choroidal melanoma is typically < 10 disc diameters in size, flat, and avascular.
A choroidal nevus is typically > 5 disc diameters in size, elevated, and vasculized.
Retinal pigment epithelium, RPE, hyperplasia is a round, dark, acquired hypertrophy of the RPE that occurs due to aging and degeneration.
With red free light an RPE hypertrophy will disappear while a choroidal nevus will remain visible.
Which of the following is incorrect regarding lattice degeneration?
The lattice lesions are typically at or anterior to the equator.
Lattice degeneration has a < 2% association with retinal detachment, RD.
The majority of retinal detachments, RD, that occur with lattice start at the edge of the lesion.
Lattice lesions are a localized thinning of the inner retinal layers with condensation of vitreous fibrils attached to the borders of the lesion.
30% to 50% of eyes with lattice have lesions bilaterally.