Retina: management of central serous chorioretinopathy: 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: management of central serous chorioretinopathy

Sample item

A 38-year-old man has been taking oral prednisolone for asthma. He now has painless blurring and micropsia in the right eye with a serous macular detachment on OCT and 6/9 vision. What is the most appropriate initial step?

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

The answer and the reasoning

C. Stop or taper the corticosteroid if possible and observe for resolution

Corticosteroid exposure is a strong risk factor for central serous chorioretinopathy. Most acute episodes resolve spontaneously over about three months, so withdrawing the steroid and observing is the first step. Laser or photodynamic therapy is kept for persistent or recurrent fluid.

Option by option

  • A. Perform pars plana vitrectomy with membrane peeling

    Vitrectomy is for tractional and vitreous problems and is not used for serous detachment from RPE leakage.

  • B. Start panretinal photocoagulation of the whole retina

    Panretinal photocoagulation treats retinal ischaemia and neovascularisation and has no role in a serous macular detachment.

  • C. Stop or taper the corticosteroid if possible and observe for resolution (correct)

    Correct. Removing the steroid trigger and observing is the standard first step because most acute cases resolve.

  • D. Give repeated intravitreal anti-VEGF injections

    Anti-VEGF injections are used for choroidal neovascularisation and macular oedema and are not first-line here.

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 C, Stop or taper the corticosteroid if possible and observe for resolution. Corticosteroid exposure is a strong risk factor for central serous chorioretinopathy.

Why is "Perform pars plana vitrectomy with membrane peeling" not the answer?

Vitrectomy is for tractional and vitreous problems and is not used for serous detachment from RPE leakage.

Why is "Start panretinal photocoagulation of the whole retina" not the answer?

Panretinal photocoagulation treats retinal ischaemia and neovascularisation and has no role in a serous macular detachment.

Why is "Give repeated intravitreal anti-VEGF injections" not the answer?

Anti-VEGF injections are used for choroidal neovascularisation and macular oedema and are not first-line here.

What concept does this question test?

It tests Retina: management of central serous chorioretinopathy in Ophthalmology. Most acute episodes resolve spontaneously over about three months, so withdrawing the steroid and observing is the first step. Laser or photodynamic therapy is kept for persistent or recurrent fluid.

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: management of central serous chorioretinopathy?

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.