Retinal vascular disease: 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 · Retinal vascular disease

Sample item

A 65-year-old hypertensive man has sudden painless visual loss in one eye. The fundus shows widespread flame-shaped haemorrhages in all quadrants, dilated tortuous veins and disc swelling, with large areas of capillary non-perfusion on fluorescein angiography. Three months later he returns with a painful red eye, a high intraocular pressure and iris neovascularisation. What is this complication and the best preventive measure?

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

The answer and the reasoning

B. Neovascular glaucoma, prevented by panretinal photocoagulation or anti-VEGF therapy

Central retinal vein occlusion, especially the ischaemic type, can cause rubeosis iridis and neovascular glaucoma about three months later (the 100-day glaucoma). Ischaemic retina releases VEGF, so panretinal photocoagulation and intravitreal anti-VEGF agents reduce the angiogenic drive.

Option by option

  • A. Acute angle-closure glaucoma, prevented by peripheral iridotomy

    Angle-closure from pupillary block is treated by iridotomy but is not the mechanism here.

  • B. Neovascular glaucoma, prevented by panretinal photocoagulation or anti-VEGF therapy (correct)

    Correct. Retinal ischaemia and VEGF lead to new vessels in the angle.

  • C. Phacolytic glaucoma, prevented by cataract extraction

    Phacolytic glaucoma is linked to a hypermature cataract.

  • D. Steroid-induced glaucoma, prevented by stopping steroids

    There is no steroid exposure in this history.

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.

More Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is B, Neovascular glaucoma, prevented by panretinal photocoagulation or anti-VEGF therapy. Central retinal vein occlusion, especially the ischaemic type, can cause rubeosis iridis and neovascular glaucoma about three months later (the 100-day glaucoma).

Why is "Acute angle-closure glaucoma, prevented by peripheral iridotomy" not the answer?

Angle-closure from pupillary block is treated by iridotomy but is not the mechanism here.

Why is "Phacolytic glaucoma, prevented by cataract extraction" not the answer?

Phacolytic glaucoma is linked to a hypermature cataract.

Why is "Steroid-induced glaucoma, prevented by stopping steroids" not the answer?

There is no steroid exposure in this history.

What concept does this question test?

It tests Retinal vascular disease in Ophthalmology. Ischaemic retina releases VEGF, so panretinal photocoagulation and intravitreal anti-VEGF agents reduce the angiogenic drive.

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 Retinal vascular disease?

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.