Retina: arteriovenous crossing changes: 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: arteriovenous crossing changes

Sample item

In a long-standing hypertensive patient, the fundus shows a retinal vein that appears tapered where an arteriole crosses it. Why does the vein look compressed?

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

The answer and the reasoning

C. Artery and vein share a common adventitial sheath

At crossings the artery and vein share an adventitial sheath, so thickening of the arteriolar wall compresses the vein, producing arteriovenous nipping. The sign reflects chronic arteriolar sclerosis. It also predisposes to branch vein occlusion at that site.

Option by option

  • A. The vein itself is in spasm

    The vein is not in spasm, and spasm is a feature of arterial narrowing.

  • B. The artery crosses in front of the retina

    Both vessels lie within the inner retina and the crossing is not a depth issue.

  • C. Artery and vein share a common adventitial sheath (correct)

    Correct. The shared sheath lets a sclerotic arteriole compress the vein.

  • D. The vein is thrombosed

    A thrombosed vein would be dilated with haemorrhages, not tapered.

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, Artery and vein share a common adventitial sheath. At crossings the artery and vein share an adventitial sheath, so thickening of the arteriolar wall compresses the vein, producing arteriovenous nipping.

Why is "The vein itself is in spasm" not the answer?

The vein is not in spasm, and spasm is a feature of arterial narrowing.

Why is "The artery crosses in front of the retina" not the answer?

Both vessels lie within the inner retina and the crossing is not a depth issue.

Why is "The vein is thrombosed" not the answer?

A thrombosed vein would be dilated with haemorrhages, not tapered.

What concept does this question test?

It tests Retina: arteriovenous crossing changes in Ophthalmology. The sign reflects chronic arteriolar sclerosis. It also predisposes to branch vein occlusion at that site.

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: arteriovenous crossing changes?

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.