Board Certified Ophthalmologist FREE Board Certified Ophthalmologist Retina and Vitreous Diseases Questions and Answers 2 — Questions and Answers
Question 1: A 62-year-old diabetic patient presents with tractional retinal detachment involving the macula. What is the most appropriate surgical intervention?
- Pars plana vitrectomy with membrane peeling (Correct answer)
- Scleral buckle alone
- Intravitreal anti-VEGF injection only
- Pneumatic retinopexy
Correct answer: Pars plana vitrectomy with membrane peeling
Tractional retinal detachment involving the macula in proliferative diabetic retinopathy requires pars plana vitrectomy with membrane peeling to relieve traction and reattach the retina.
Question 2: Which finding on OCT is most characteristic of central serous chorioretinopathy?
- Neurosensory retinal detachment with subretinal fluid (Correct answer)
- Intraretinal cystoid spaces with hard exudates
- Full-thickness macular hole with operculum
- Epiretinal membrane with retinal folds
Correct answer: Neurosensory retinal detachment with subretinal fluid
Central serous chorioretinopathy classically presents on OCT as a dome-shaped neurosensory retinal detachment with an optically clear space of subretinal fluid.
Question 3: A patient with acute retinal necrosis syndrome should be treated initially with which antiviral agent?
- Intravenous acyclovir (Correct answer)
- Oral valacyclovir alone
- Topical ganciclovir
- Intravitreal foscarnet alone
Correct answer: Intravenous acyclovir
Acute retinal necrosis requires aggressive treatment with intravenous acyclovir to control the viral infection and prevent fellow eye involvement.
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 with retinal tear
- Retinal vein occlusion
- Trauma
Correct answer: Proliferative diabetic retinopathy
Proliferative diabetic retinopathy is the most common cause of vitreous hemorrhage in adults in the US due to rupture of fragile neovascular vessels.
Question 5: Which visual field defect is classically associated with a branch retinal artery occlusion affecting the superior temporal arcade?
- Inferior nasal scotoma (Correct answer)
- Superior altitudinal defect
- Homonymous hemianopia
- Central scotoma
Correct answer: Inferior nasal scotoma
A branch retinal artery occlusion of the superior temporal arcade causes ischemia to the corresponding retinal area, resulting in an inferior nasal visual field defect.
Question 6: In a patient with retinitis pigmentosa, which electroretinography finding is expected?
- Markedly reduced or extinguished rod and cone responses (Correct answer)
- Normal a-wave with reduced b-wave
- Supranormal b-wave amplitude
- Electronegative ERG with preserved a-wave
Correct answer: Markedly reduced or extinguished rod and cone responses
Retinitis pigmentosa causes progressive photoreceptor degeneration leading to markedly reduced or extinguished rod responses followed by cone responses on full-field ERG.
Board Certified Ophthalmologist FREE Board Certified Ophthalmologist Retina and Vitreous Diseases Questions and Answers 2
A 62-year-old diabetic patient presents with tractional retinal detachment involving the macula.
What is the most appropriate surgical intervention?