Retina: retinal changes in toxaemia of pregnancy: 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: retinal changes in toxaemia of pregnancy

Sample item

A 27-year-old woman with eclampsia has bilateral blurred vision. Examination shows bilateral serous retinal detachments and yellowish patches at the level of the pigment epithelium that later turn into pigmented spots. What is the underlying mechanism?

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

The answer and the reasoning

C. Choroidal vasoconstriction with ischaemia of the overlying pigment epithelium

Severe pregnancy-induced hypertension causes marked choroidal vasoconstriction and fibrinoid necrosis of choroidal vessels. The overlying pigment epithelium becomes ischaemic, producing Elschnig spots and a serous detachment. These changes usually resolve after delivery and blood pressure control.

Option by option

  • A. Venous thrombosis of the central retinal vein

    Central vein thrombosis causes diffuse flame-shaped haemorrhages and disc swelling, not RPE patches.

  • B. Embolic blockage of a cilioretinal artery

    Cilioretinal artery embolism would cause a sectoral retinal whitening.

  • C. Choroidal vasoconstriction with ischaemia of the overlying pigment epithelium (correct)

    Correct. Choroidal vasoconstriction with RPE ischaemia produces the serous detachment and Elschnig spots.

  • D. Traction by a vitreous membrane

    Vitreous traction does not cause bilateral serous detachment with pigment epithelial 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 C, Choroidal vasoconstriction with ischaemia of the overlying pigment epithelium. Severe pregnancy-induced hypertension causes marked choroidal vasoconstriction and fibrinoid necrosis of choroidal vessels.

Why is "Venous thrombosis of the central retinal vein" not the answer?

Central vein thrombosis causes diffuse flame-shaped haemorrhages and disc swelling, not RPE patches.

Why is "Embolic blockage of a cilioretinal artery" not the answer?

Cilioretinal artery embolism would cause a sectoral retinal whitening.

Why is "Traction by a vitreous membrane" not the answer?

Vitreous traction does not cause bilateral serous detachment with pigment epithelial spots.

What concept does this question test?

It tests Retina: retinal changes in toxaemia of pregnancy in Ophthalmology. The overlying pigment epithelium becomes ischaemic, producing Elschnig spots and a serous detachment. These changes usually resolve after delivery and blood pressure control.

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: retinal changes in toxaemia of pregnancy?

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.