Retina: pathological myopia macular complication: 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: pathological myopia macular complication

Sample item

A 40-year-old woman with a refractive error of -14 D has sudden central distortion. The macula shows a small, round, dark pigmented lesion with a surrounding haemorrhage. What is this lesion?

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

The answer and the reasoning

B. Fuchs spot from choroidal neovascularisation

In pathological myopia, breaks in Bruch's membrane (lacquer cracks) allow choroidal neovascularisation. The scarred membrane appears as a dark pigmented macular lesion known as Fuchs spot. Treatment of the active neovascular membrane is with intravitreal anti-VEGF.

Option by option

  • A. Dalen-Fuchs nodule of sympathetic ophthalmia

    Dalen-Fuchs nodules are small yellow-white lesions beneath the RPE in granulomatous uveitis.

  • B. Fuchs spot from choroidal neovascularisation (correct)

    Correct. Fuchs spot is a pigmented scar after myopic choroidal neovascularisation.

  • C. Roth spot of infective endocarditis

    Roth spots are pale-centred haemorrhages linked to endocarditis and are not pigmented lesions at the macula.

  • D. Cotton wool spot

    Cotton wool spots are white fluffy patches of nerve fibre layer infarction, not dark pigmented spots.

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, Fuchs spot from choroidal neovascularisation. In pathological myopia, breaks in Bruch's membrane (lacquer cracks) allow choroidal neovascularisation.

Why is "Dalen-Fuchs nodule of sympathetic ophthalmia" not the answer?

Dalen-Fuchs nodules are small yellow-white lesions beneath the RPE in granulomatous uveitis.

Why is "Roth spot of infective endocarditis" not the answer?

Roth spots are pale-centred haemorrhages linked to endocarditis and are not pigmented lesions at the macula.

Why is "Cotton wool spot" not the answer?

Cotton wool spots are white fluffy patches of nerve fibre layer infarction, not dark pigmented spots.

What concept does this question test?

It tests Retina: pathological myopia macular complication in Ophthalmology. The scarred membrane appears as a dark pigmented macular lesion known as Fuchs spot. Treatment of the active neovascular membrane is with intravitreal anti-VEGF.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: pathological myopia macular complication?

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.