Retina: retinoblastoma spread and treatment: 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 · Retina: retinoblastoma spread and treatment

Sample item

A child with advanced unilateral retinoblastoma has a tumour that fills the globe and shows invasion of the post-laminar optic nerve on histopathology. What is appropriate?

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

The answer and the reasoning

B. Enucleation with a long optic nerve stump and adjuvant chemotherapy

Retinoblastoma spreads along the optic nerve to the brain, so enucleation with at least 10 mm of optic nerve is performed for advanced disease. High-risk histology (post-laminar invasion) requires adjuvant chemotherapy. Small tumours are treated with chemoreduction and focal therapy.

Option by option

  • A. Cryotherapy alone

    Cryotherapy only treats small peripheral tumours.

  • B. Enucleation with a long optic nerve stump and adjuvant chemotherapy (correct)

    Correct. Enucleation with chemotherapy treats high-risk disease.

  • C. Observation

    Observation would permit spread.

  • D. Topical chemotherapy

    Topical drops cannot treat intraocular tumours.

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 B, Enucleation with a long optic nerve stump and adjuvant chemotherapy. Retinoblastoma spreads along the optic nerve to the brain, so enucleation with at least 10 mm of optic nerve is performed for advanced disease.

Why is "Cryotherapy alone" not the answer?

Cryotherapy only treats small peripheral tumours.

Why is "Observation" not the answer?

Observation would permit spread.

Why is "Topical chemotherapy" not the answer?

Topical drops cannot treat intraocular tumours.

What concept does this question test?

It tests Retina: retinoblastoma spread and treatment in Ophthalmology. High-risk histology (post-laminar invasion) requires adjuvant chemotherapy. Small tumours are treated with chemoreduction and focal therapy.

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 Retina: retinoblastoma spread and treatment?

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.