Uvea: COMS trial: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Uvea: COMS trial

Sample item

In the Collaborative Ocular Melanoma Study of medium-sized choroidal melanoma, what did the trial show comparing iodine-125 plaque brachytherapy and enucleation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. No difference in survival between the two treatments

COMS found no survival difference at 5 and 12 years between plaque brachytherapy and enucleation for medium tumours, supporting eye-preserving treatment. For large tumours, pre-enucleation radiation gave no benefit. Brachytherapy retains the eye with some visual loss.

Option by option

  • A. Plaque brachytherapy doubled mortality

    Brachytherapy did not increase mortality.

  • B. Enucleation gave much better survival

    Enucleation was not superior in survival.

  • C. Observation was better than both

    Observation was not compared as better.

  • D. No difference in survival between the two treatments (correct)

    Correct. Survival was equivalent.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, No difference in survival between the two treatments. COMS found no survival difference at 5 and 12 years between plaque brachytherapy and enucleation for medium tumours, supporting eye-preserving treatment.

Why is "Plaque brachytherapy doubled mortality" not the answer?

Brachytherapy did not increase mortality.

Why is "Enucleation gave much better survival" not the answer?

Enucleation was not superior in survival.

Why is "Observation was better than both" not the answer?

Observation was not compared as better.

What concept does this question test?

It tests Uvea: COMS trial in Ophthalmology. For large tumours, pre-enucleation radiation gave no benefit. Brachytherapy retains the eye with some visual loss.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Uvea: COMS trial?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.