QuizWise 26

Q 1. What is the correction factor of  Volk 78D lens while assessing the size of optic disc  on slit lamp bio microscopy?
a. 1
b. 1.2
c. 0.88
d. 1.63

Q 2. Which of the following is not a trial associated with multiple sclerosis or optic neuritis?
a. CHAMPS
b. ONTT
c. PRISMS
d. BENEFIT
e. EVEREST

Q 3. The treatment dose of steroid treatment as per Optic neuritis treatment trial is?
a. Oral prednisone (1 mg/kg/day) for 14 days.
b. Intravenous methylprednisolone (250 mg every 6 hours) for 3 days, followed by oral prednisone (1 mg/kg/day) in tapering dose for 11 days.
c. Intravenous methylprednisolone (250 mg every 6 hours) for 3 days, followed by oral prednisone (1 mg/kg/day) for 11 days.
d. Intravenous methylprednisolone (250 mg every 6 hours) for 3 days

Q 4. About Para-central acute middle maculopathy (PAMM) all are true except.
a. It is due to ischemia of retina
b. Deep and/ or superficial capillary plexus of retina is involved
c. PAMM is associate with use of sympathomimetics 
d. None of the above

Q 5. Which of the following is the best functional parameter for the assessment of permanent dysfunction due to optic neuritis?
a. Visual field defects
b. Colour vision
c. Contrast sensitivity
d. Visual acuity

ANSWERS

  1. b – 1.2 
    The slit lamp graticule measurement of the disc size needs to be corrected as the size of the image would depend on the magnification properties of the eye and the instruments. Correction factors are:
    Volk
    60 D –  0.88 
    78 D – 1.2 
    90 D – 1.33
    Super field
    NC – 1.5  
    Nikon
    60 D – 1.03
    90 D – 1.63 

Reference: Gandhi M, Dubey S. Evaluation of the Optic Nerve Head in Glaucoma. J Curr Glaucoma Pract. 2013;7(3):106‐114.

 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741153/)

2. e – EVEREST
The Controlled High-Risk Subjects Avonex Multiple Sclerosis Prevention Study (CHAMPS)
The Prevention of Relapses and Disability by Interferon β-1a Subcutaneously in Multiple Sclerosis (PRISMS) Trial
The Betaferon in Newly Emerging Multiple Sclerosis for Initial Treatment (BENEFIT)
The Optic Neuritis Treat Trial (ONTT)
EVEREST Study: Efficacy and Safety of Verteporfin Photodynamic Therapy in Combination With Ranibizumab or Alone Versus Ranibizumab

Reference: Menon V, Saxena R, Misra R, Phuljhele S. Management of optic neuritis. Indian J Ophthalmol. 2011;59(2):117‐122. doi:10.4103/0301-4738.77020 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116540/)

3. c – Intravenous methylprednisolone (250 mg every 6 hours) for 3 days, followed by oral prednisone (1 mg/kg/day) for 11 days

Reference: Menon V, Saxena R, Misra R, Phuljhele S. Management of optic neuritis. Indian J Ophthalmol. 2011;59(2):117‐122. doi:10.4103/0301-4738.77020 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116540/)

4. d – None of the above
It is well known that AMN is a disorder associated with various pressor agents or vasoconstrictors, including sympathomimetics, such as epinephrine, norepinephrine,  ephedrine or caffeine 

Retinal capillary ischemia affecting either the superficial capillary plexus (SCP) or the DCP may explain the development of either lesion, and we have classified each as either a type 1 (above the OPL) or type 2 (below the OPL) SD-OCT finding. 

Reference – Sarraf D, Rahimy E, Fawzi AA, et al. Paracentral acute middle maculopathy: a new variant of acute macular neuroretinopathy associated with retinal capillary ischemia. JAMA Ophthalmol. 2013;131(10):1275‐1287 (https://pubmed.ncbi.nlm.nih.gov/23929382/)

5. c – Contrast sensitivity
Although the visual acuity, fields, and colour perception generally revert to normal, visual contrast often remains markedly impaired and is thus the best functional parameter to use for the assessment of permanent dysfunction due to optic neuritis.

Reference – Wilhelm H, Schabet M. The Diagnosis and Treatment of Optic Neuritis. Dtsch Arztebl Int. 2015;112(37):616‐626. doi:10.3238/arztebl.2015.0616 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581115/)

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