RCM QuizWise answers
1. Retinal capillary microaneurysms are found in which conditions ?
A. Diabetic retinopathy
B. Retinal Vein occlusion
C. Old age patients
D. All of the above
Answer: D. All of the above
Microaneurysms are commonly found in patients with diabetes or veno-occlusive disease but may occur in older individuals without these diseases.
Spaide RF, Barquet LA. RETINAL CAPILLARY MACROANEURYSMS. Retina. 2019 Oct;39(10):1889-1895. doi: 10.1097/IAE.0000000000002406. PMID: 30489449.
2. Typical size of a retinal capillary macroaneurysm is –
A. Less than 50 microns
B. 50 to 100 microns
C. 100 to 200 microns
D. More than 200 microns
Answer: More than 200 microns.
Spaide RF, Barquet LA. RETINAL CAPILLARY MACROANEURYSMS. Retina. 2019 Oct;39(10):1889-1895. doi: 10.1097/IAE.0000000000002406. PMID: 30489449.
3. Aneurysms of the retinal vasculature includes ?
A. Retinal Artery Macroaneurysm
B. Capillary Microaneurysms
C. Retinal Capillary Macroaneurysms
D. All of the above
Answer: D. All of the above
The aneurysms affecting arterioles generally are larger and consequently are called retinalarterial macroaneurysms while those involving the capillaries are smaller and are called microaneurysms (with the word “capillary” being understood). Retinal arterial macroaneurysms1–3 typically involve the first few orders of the branching arterioles. They can cause subretinal, intraretinal, and preretinal hemorrhage and exudation and are associated with hypertension. Microaneurysms are commonly found in patients with diabetes or veno-occlusive disease but may occur in older individuals without these diseases.
Lewis RA, Norton EW, Gass JD. Acquired arterial macroaneurysms of the retina. Br J Ophthalmol 1976;60:21–30.
4. Which one of the following is true about Retinal Capillary Macroaneurysms-
A. Good response to anti VEGF injections
B. Inadequate response to anti VEGF Injections
C. Poor response to laser photocoagulation
D. No response to either laser or anti VEGF injections
Answer: B Inadequate response to anti VEGF injections
Microaneurysms have been shown to respond well to anti VEGF injections, but Spaide et. al showed a series of cases which showed inconsistent response of RCMs to anti VEGF injections but a good response to focal laser photocoagulation.
Spaide RF, Barquet LA. RETINAL CAPILLARY MACROANEURYSMS. Retina. 2019 Oct;39(10):1889-1895. doi: 10.1097/IAE.0000000000002406. PMID: 30489449.
5. Which of the following is false related to micro aneurysms ?
A. Small micro aneurysms contain type III collagen
B. Larger ones have increased expression of MMP-9
C. Larger ones have lesser pericyte coverage
D. Larger ones have more pericyte coverage
Answer:D. Larger ones have more pericyte coverage.
Small microaneurysms were found to have Type III collagen, which is a type not ordinarily found in retinal capillaries. This was believed to represent a compensatory mechanism to reinforce the vascular wall. In larger microaneurysms, there was increased expression of matrix-metalloproteinase (MMP)-9, which functions to break down basement membrane proteins.
López-Luppo M, Nacher V, Ramos D, et al. Blood vessel basement membrane alterations in human retinal microaneurysms during aging. Invest Ophthalmol Vis Sci 2017;58:1116–1131