Board Certified Ophthalmologist Board Certified Ophthalmologist Retina and Vitreous Diseases Questions and Answers 2 — Questions and Answers
Question 1: A 62-year-old patient presents with sudden painless vision loss and a cherry-red spot on fundoscopy. What is the most likely diagnosis?
- Central retinal artery occlusion (Correct answer)
- Central retinal vein occlusion
- Vitreous hemorrhage
- Retinal detachment
Correct answer: Central retinal artery occlusion
A cherry-red spot with surrounding retinal whitening is the classic fundoscopic finding in central retinal artery occlusion due to ischemia of the inner retina.
Question 2: Which imaging modality is considered the gold standard for detecting choroidal neovascularization in age-related macular degeneration?
- Fluorescein angiography (Correct answer)
- Optical coherence tomography
- B-scan ultrasonography
- Fundus autofluorescence
Correct answer: Fluorescein angiography
Fluorescein angiography remains the gold standard for identifying and classifying choroidal neovascular membranes by demonstrating dye leakage patterns.
Question 3: A patient with proliferative diabetic retinopathy develops tractional retinal detachment involving the macula. What is the most appropriate management?
- Pars plana vitrectomy (Correct answer)
- Panretinal photocoagulation
- Intravitreal anti-VEGF injection alone
- Observation with serial imaging
Correct answer: Pars plana vitrectomy
Tractional retinal detachment involving the macula requires pars plana vitrectomy to relieve traction and reattach the retina to preserve central vision.
Question 4: What is the most common cause of vitreous hemorrhage in adults in the United States?
- Proliferative diabetic retinopathy (Correct answer)
- Posterior vitreous detachment
- Retinal tear
- Trauma
Correct answer: Proliferative diabetic retinopathy
Proliferative diabetic retinopathy is the leading cause of vitreous hemorrhage in US adults due to bleeding from fragile neovascular vessels.
Question 5: In Eales disease, what is the primary pathologic finding affecting the retinal vasculature?
- Peripheral retinal vasculitis with nonperfusion (Correct answer)
- Central retinal artery embolism
- Choroidal granuloma formation
- Optic disc drusen
Correct answer: Peripheral retinal vasculitis with nonperfusion
Eales disease is characterized by idiopathic peripheral retinal vasculitis leading to nonperfusion, neovascularization, and recurrent vitreous hemorrhage.
Question 6: Which gene mutation is most commonly associated with Best vitelliform macular dystrophy?
- BEST1 (bestrophin-1) (Correct answer)
- ABCA4
- RHO
- RPE65
Correct answer: BEST1 (bestrophin-1)
Best vitelliform macular dystrophy is caused by mutations in the BEST1 gene encoding bestrophin-1, a chloride channel protein in the retinal pigment epithelium.
Board Certified Ophthalmologist Board Certified Ophthalmologist Retina and Vitreous Diseases Questions and Answers 2
A 62-year-old patient presents with sudden painless vision loss and a cherry-red spot on fundoscopy.
What is the most likely diagnosis?