Retina: retinal arterial macroaneurysm: 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 arterial macroaneurysm

Sample item

A 70-year-old hypertensive woman has sudden painless vision loss, with haemorrhages in the subretinal, intraretinal and pre-retinal planes around a round lesion on an arteriole at its second bifurcation. What is the diagnosis?

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

The answer and the reasoning

D. Retinal arterial macroaneurysm

Macroaneurysms occur in elderly hypertensive women on a major arteriole and can bleed at several levels. Branch vein occlusion gives a wedge of haemorrhage at an arteriovenous crossing. Coats disease affects young males, and neovascular macular degeneration has a subretinal membrane.

Option by option

  • A. Branch retinal vein occlusion

    Branch vein occlusion shows a sector of flame haemorrhages and venous tortuosity.

  • B. Coats disease

    Coats disease affects young boys with telangiectasia and exudate.

  • C. Neovascular age-related macular degeneration

    Neovascular macular degeneration shows a subretinal membrane and drusen, not an arteriolar lesion.

  • D. Retinal arterial macroaneurysm (correct)

    Correct. A saccular dilatation on an arteriole with multilevel bleeding fits a macroaneurysm.

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 D, Retinal arterial macroaneurysm. Macroaneurysms occur in elderly hypertensive women on a major arteriole and can bleed at several levels.

Why is "Branch retinal vein occlusion" not the answer?

Branch vein occlusion shows a sector of flame haemorrhages and venous tortuosity.

Why is "Coats disease" not the answer?

Coats disease affects young boys with telangiectasia and exudate.

Why is "Neovascular age-related macular degeneration" not the answer?

Neovascular macular degeneration shows a subretinal membrane and drusen, not an arteriolar lesion.

What concept does this question test?

It tests Retina: retinal arterial macroaneurysm in Ophthalmology. Branch vein occlusion gives a wedge of haemorrhage at an arteriovenous crossing. Coats disease affects young males, and neovascular macular degeneration has a subretinal membrane.

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 arterial macroaneurysm?

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.