Uvea: vitreoretinal lymphoma masquerade: 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: vitreoretinal lymphoma masquerade

Sample item

A 68-year-old has bilateral vitritis with yellow-white sub-retinal pigment epithelial infiltrates that do not respond to corticosteroids. MRI later shows a periventricular lesion. What is the most likely diagnosis?

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

The answer and the reasoning

A. Primary vitreoretinal lymphoma

Vitreoretinal lymphoma, usually a large B-cell tumour, masquerades as steroid-resistant uveitis in older adults and is associated with central nervous system lymphoma. Vitreous biopsy with cytology confirms it.

Option by option

  • A. Primary vitreoretinal lymphoma (correct)

    Correct. Steroid-resistant vitritis with sub-RPE infiltrates and a brain lesion in an older adult suggests lymphoma.

  • B. Intermediate uveitis

    Intermediate uveitis affects younger patients and responds to steroid therapy.

  • C. Birdshot chorioretinopathy

    Birdshot chorioretinopathy shows cream-coloured choroidal spots, not sub-RPE infiltrates, and does not form a brain mass.

  • D. Sarcoid panuveitis

    Sarcoid panuveitis usually responds to steroids and does not give a brain mass of this kind.

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 A, Primary vitreoretinal lymphoma. Vitreoretinal lymphoma, usually a large B-cell tumour, masquerades as steroid-resistant uveitis in older adults and is associated with central nervous system lymphoma.

Why is "Intermediate uveitis" not the answer?

Intermediate uveitis affects younger patients and responds to steroid therapy.

Why is "Birdshot chorioretinopathy" not the answer?

Birdshot chorioretinopathy shows cream-coloured choroidal spots, not sub-RPE infiltrates, and does not form a brain mass.

Why is "Sarcoid panuveitis" not the answer?

Sarcoid panuveitis usually responds to steroids and does not give a brain mass of this kind.

What concept does this question test?

It tests Uvea: vitreoretinal lymphoma masquerade in Ophthalmology. Vitreous biopsy with cytology confirms it.

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: vitreoretinal lymphoma masquerade?

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.