Podcast
Questions and Answers
A patient presents with sudden, painless vision loss in one eye. Fundoscopy reveals a cloudy retina with a 'cherry-red' spot at the fovea. Which condition is most consistent with these findings?
A patient presents with sudden, painless vision loss in one eye. Fundoscopy reveals a cloudy retina with a 'cherry-red' spot at the fovea. Which condition is most consistent with these findings?
A patient with a history of chronic hypertension presents with visual changes. Fundoscopic exam reveals retinal vessel changes including sclerosis and fibrinoid necrosis. What is the most likely diagnosis?
A patient with a history of chronic hypertension presents with visual changes. Fundoscopic exam reveals retinal vessel changes including sclerosis and fibrinoid necrosis. What is the most likely diagnosis?
Which of the following conditions is most associated with 'blood and thunder' appearance during a fundoscopic exam?
Which of the following conditions is most associated with 'blood and thunder' appearance during a fundoscopic exam?
A patient reports experiencing night blindness and progressive peripheral vision loss. Which retinal disorder is most consistent with these symptoms?
A patient reports experiencing night blindness and progressive peripheral vision loss. Which retinal disorder is most consistent with these symptoms?
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An infant presents with an abnormal white reflection in one eye. Which of the following conditions should be highest in the differential diagnosis?
An infant presents with an abnormal white reflection in one eye. Which of the following conditions should be highest in the differential diagnosis?
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A patient describes a 'dark curtain' moving across their vision, along with floaters and light flashes. Fundoscopy reveals wrinkling of the retina. What is the most likely cause of these symptoms?
A patient describes a 'dark curtain' moving across their vision, along with floaters and light flashes. Fundoscopy reveals wrinkling of the retina. What is the most likely cause of these symptoms?
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Which condition is characterized by optic disc swelling due to increased intracranial pressure?
Which condition is characterized by optic disc swelling due to increased intracranial pressure?
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Which finding is most suggestive of proliferative diabetic retinopathy?
Which finding is most suggestive of proliferative diabetic retinopathy?
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A patient presents with conjunctival redness and pus accumulation in the anterior chamber of the eye. Which condition is most consistent with these findings?
A patient presents with conjunctival redness and pus accumulation in the anterior chamber of the eye. Which condition is most consistent with these findings?
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Distortion of straight lines (metamorphopsia) and rapid decrease in vision are most commonly associated with which form of Age-Related Macular Degeneration?
Distortion of straight lines (metamorphopsia) and rapid decrease in vision are most commonly associated with which form of Age-Related Macular Degeneration?
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What is the primary cause of visual loss in wet age-related macular degeneration?
What is the primary cause of visual loss in wet age-related macular degeneration?
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A patient with acute and painless monocular vision loss most likely has which condition?
A patient with acute and painless monocular vision loss most likely has which condition?
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What is the direct pathology behind a branch retinal vein occlusion?
What is the direct pathology behind a branch retinal vein occlusion?
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Which of the following is a likely consequence of a chronic hypertensive retinopathy?
Which of the following is a likely consequence of a chronic hypertensive retinopathy?
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Which type of retinal detachment is most often caused by a tear in the retina?
Which type of retinal detachment is most often caused by a tear in the retina?
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What specific visual field defect is most commonly associated with retinitis pigmentosa?
What specific visual field defect is most commonly associated with retinitis pigmentosa?
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What is the underlying cause of papilledema?
What is the underlying cause of papilledema?
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Which of the following is NOT a cause of leukocoria?
Which of the following is NOT a cause of leukocoria?
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Why does proliferative diabetic retinopathy lead to neovascularization?
Why does proliferative diabetic retinopathy lead to neovascularization?
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Which gene mutation is directly implicated in the development of retinoblastoma?
Which gene mutation is directly implicated in the development of retinoblastoma?
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Which of the following best describes the pathophysiology of retinal artery occlusion?
Which of the following best describes the pathophysiology of retinal artery occlusion?
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A patient with retinitis pigmentosa would most likely exhibit which finding on fundoscopic examination?
A patient with retinitis pigmentosa would most likely exhibit which finding on fundoscopic examination?
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Which of the following is a key feature of nonproliferative diabetic retinopathy?
Which of the following is a key feature of nonproliferative diabetic retinopathy?
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A patient presenting with a painless monocular vision loss ('dark curtain'), floaters, and light flashes is most likely experiencing which condition?
A patient presenting with a painless monocular vision loss ('dark curtain'), floaters, and light flashes is most likely experiencing which condition?
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A 6-year-old child presents with strabismus and an abnormal white reflection in the left eye. This is most suggestive of which underlying condition?
A 6-year-old child presents with strabismus and an abnormal white reflection in the left eye. This is most suggestive of which underlying condition?
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Which of the following describes the primary pathophysiology of papilledema?
Which of the following describes the primary pathophysiology of papilledema?
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What is the primary cause of the retinal neovascularization seen in proliferative diabetic retinopathy?
What is the primary cause of the retinal neovascularization seen in proliferative diabetic retinopathy?
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A patient with conjunctival redness and hypopyon in the anterior chamber is most likely experiencing:
A patient with conjunctival redness and hypopyon in the anterior chamber is most likely experiencing:
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Which of the following best characterizes the 'blood and thunder' appearance seen on fundoscopy?
Which of the following best characterizes the 'blood and thunder' appearance seen on fundoscopy?
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Which of the following genetic patterns is most closely associated with retinitis pigmentosa?
Which of the following genetic patterns is most closely associated with retinitis pigmentosa?
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Study Notes
Age-Related Macular Degeneration
- Dry (most common): Gradual decrease in vision, subretinal deposits
- Wet: Rapid decrease in vision due to bleeding following choroidal neovascularization, distortion of straight lines (metamorphopsia)
Retinal Artery Occlusion
- Blockage of central or branch retinal artery, due to emboli (carotid artery atherosclerosis), or giant cell arteritis
- Clinical feature: acute and painless monocular vision loss
Retinal Vein Occlusion
- Central retinal vein occlusion due to primary thrombosis
- Branch retinal vein occlusion due to secondary thrombosis at arteriovenous crossings
- Pathophysiology: sclerotic arteriole compresses adjacent venule causing turbulent blood flow
- Fundoscopy: venous engorgement ("blood and thunder" appearance), retinal edema in affected areas, retinal hemorrhage
Retinitis Pigmentosa
- Group of inherited dystrophies causing progressive degeneration of photoreceptors and retinal pigment epithelium
- Due to blood supply loss (hypoxia)
- Associations: abetalipoproteinemia, autosomal recessive, MTTP gene mutation, defective reabsorption of fats
- Clinical features: night blindness (nyctalopia), peripheral vision loss
- Fundoscopy: retinal pigmentation with bone spicule–shaped deposits, retinal vessel attenuation, optic disc pallor
Papilledema
- Optic disc swelling, usually bilateral
- Cause: Increased intracranial pressure (ICP) (e.g., due to mass effect), leading to impaired axoplasmic outflow in the optic nerve
- Fundoscopy: elevated optic disc with blurred margins
Leukocoria
- Abnormal white reflection of light on the eye.
- Signs, not a diagnosis.
- Causes: Congenital cataracts and retinoblastoma.
Diabetic Retinopathy
- Chronic hyperglycemia leading to increased permeability and occlusion of retinal vessels.
- Nonproliferative (most common): retinal hemorrhages, microaneurysms, cotton-wool spots, hard exudates
- Proliferative: chronic hypoxia → retinal neovascularization, abnormal new vessels can cause vitreous hemorrhage and tractional retinal detachment
- Fundoscopy: hard exudates, cotton-wool spots, retinal hemorrhages, microaneurysms
Hypertensive Retinopathy
- Chronic hypertension: spasm → sclerosis → fibrinoid necrosis of retinal vessels
- Clinical features: indicative of hypertensive emergency, warrants immediate lowering of blood pressure
- Fundoscopy: arteriovenous nicking
Retinal Detachment
- Monocular vision loss ("dark curtain")
- Rhegmatogenous (most common): due to traumatic tears of retina.
- Non-Rhegmatogenous: not due to tears: tractional (fluid accumulation) or exudative (fluid accumulation).
- Fundoscopy: wrinkling of detached retina, change in vessel direction, and opacification
Retinoblastoma
- Most common intraocular malignancy in children
- Arises from immature retinal cells.
- Mutation in both RB1 tumor suppressor gene on chromosome 13 (impedes G1 to S phase of cell cycle) appears sporadic (random) or familial (inherited)
- Presentation: leukocoria, strabismus, nystagmus, eye redness
- Fundoscopy: elevated optic disc with blurred margins
Uveitis
- Inflammation of uvea (hypopyon - accumulation of pus in anterior chamber), conjunctiva redness
- Associations with systemic inflammatory disorders (e.g., Crohn's disease), HLA-B27-associated conditions (e.g., juvenile idiopathic arthritis), Behçet syndrome, and sarcoidosis
- Fundoscopy: inflammation of the uveal tract
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Description
Test your knowledge on various retinal disorders including Age-Related Macular Degeneration, Retinal Artery and Vein Occlusion, and Retinitis Pigmentosa. This quiz covers clinical features, pathophysiology, and genetic associations related to these conditions.
