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Picture quiz.

The following FREE Visual Recognition Test (VRT) should be completed online by clicking on the VRT button at www.otcet.co.uk. Respondents should use the 12 images/photos to answer the 12 associated Multiple Choice Questions (MCQ). Please note that there is only one correct answer for each MCQ. Successful completion of the VRT will result in two CET points.

Posterior Pathology Course Code: C-9912

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1. Which of the following best describes the condition displayed in this image?

a. Retinitis pigmentosa: Diffuse bilateral retinal dystrophy, with a 'bone spicule' pattern of pigmentation. A congenital condition associated with night blindness as the rods are predominantly affected

b. Congenital hypertrophy of the retinal pigment epithelium: Small, darkly pigmented 'boar-track' lesions with well-defined borders and a central area of de-pigmentation

c. Stargardt disease: Associated with diffuse fundus changes and macular atrophy with a characteristic 'bronze-beaten' reflex surrounded by yellow-white flocks

d. Pigmented lattice degeneration: Localized traction along borders with risk of retinal breaks and detachment

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2. This 68-year-old patient attended for an eye examination complaining of a painless reduction of vision in one eye. Which of the following statements is false, relating his ocular condition

a. This is a central retinal vein occlusion

b. This condition is commonly associated with hypertension

c. This is a branch retinal vein occlusion

d. This condition is caused by a retinal artery compressing a vein which leads to vessel rupture and leakage of blood and serum

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3. A 35-year-old patient attended for an eye examination complaining of a recent grey spot in his central vision and occasional micropsia. Ignoring the central white artefact in this image, which of the following is the correct description of this macular condition?

a. Cystoid macular oedema: Accumulation of fluid around the fovea

b. Choroidal neovascularisation: Proliferation of fibrovascular tissue combine to form a subretinal neovascular membrane

c. Myopic degeneration: The elongation of the globe in this condition can lead to islands of chorioretinal degeneration, progressing to retinal pigment epithelium atrophy

d. Central serous chorioretinopathy: Breaks in the retinal pigment epithelium allow build up of serum, detaching the macula

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4. Which of the following diagnosis is the most likely cause of the condition displayed in this image?

a. Exudative retinal detachment: Damage to the RPE via inflammation or a tumour allows fluid into the subretinal space

b. Rhegmatogenous retinal detachment: A retinal tear allows vitreous fluid to enter the subretinal space. This is the most common cause of retinal detachment

c. Cyclodialysis: An opening between the anterior chamber and subarachnoid space, which allows passage of intra ocular fluid and reduces intra ocular pressure

d. Retinosehisis: Where the sensory retinal is split into two layers

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5. Which of the following statements best describes the condition displayed in this image?

a. Choroidal naevus: Mildly elevated lesion with a feathery margin and consistent pigmentation, which disappears with a red-free filter

b. Choroidal haemangioma: Dome-shaped lesion often located in the peripheral retina

c. Congenital hypertrophy of the retinal pigment epithelium: Distinct margin and mainly dark in colour

d. Melanecytoma: Rare elevated pigmented lesion

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6. This patient attended for a routine eye examination with no complaints. Given this optic nerve appearance, which of the following ocular conditions is the likely diagnosis?

a. Normal tension glaucoma

b. Adverse effects of oral contraceptive use

c. Hypertension

d. Branch retinal vein occlusion

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7. Which of the following statements is false relating to this congenital condition?

a. This condition is commonly bilateral

b. It involves elevated optic discs with irregular margins

c. It occurs in approximately 1% of the population, and is due to the retention of

hyaline bodies in the optic nerve

d. Visual fields are commonly used to diagnose this condition

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8. A 62-year-old male with a history of posterior vitreous detachment presents with complaints of decreased vision and metamorphopsia. His vision has shown a progressive decrease from 6/6 to 6/24 over six months. Which of the following would be the most effective way to beat these macular changes?

a. Focal laser photocoagulation

b. Retinopexy with membrane peel

c. Topical NSAID (Voltaren) to reduce edema

d. Pars plana vitrectomy

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9. An 80-year-old patient attended for a routine eye examination with a general reduction in vision, especially when reading. Considering the photograph only, what is the most appropriate descriptor of her condition?

a. Multifocal chorioretinitis

b. Cystoid macular edema

c. Cotton wool spots

d. Stage 3 Dry AMD

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10. What is the optic nerve head condition displayed in this image?

a. Disc oedema

b. Optic disc pit

c. Myelinated nerve fibres

d. Optic disc coloboma

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11. The inferior branch of the central retinal artery (CRA) shows a marked deposit. What is the most likely cause?

a. Hollenhorst plaque: A cholesterol-based material originating from an atheromateus plaque

b. Calcific plaque: Commonly singular, bright and white emboli, which may result in permanent vessel occlusion

c. Rbrinoplatelet emboli: Multiple emboli aligned over a length of vessel Temporary vessel occlusion may result

d. Arteriolarsclerotic changes: Copper and/or silver wiring from chronic elevations of cholesterol

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12. Which of the following is a false description of this image?

a. The image displays malignant choroidal melanoma, which is the most common primary intraocular tumour in adults

b. This image displays wet AMD, which has formed an epimacular membrane

c. This image displays a retinal detachment, which has spread to the macular area

d. This image displays the result of laser photocoagulation in the treatment of wet AMD

NOTE: There is a central white light artefact in each of the following images, which is associated with the camera that was used.

R Peterson PhD MCOptom and C Lisa Prokopich, OD, MSc

University of Waterloo School of Optometry, Canada
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Author:Peterson, R.; Prokopich, C. Lisa
Publication:Optometry Today
Date:Oct 17, 2008
Words:968
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