Test 38
(Matching Paper: Retina)

In response to considerable discussion the Examinations Committee of the College has decided to update the format of the Part 3 MRCOphth Examination from April, 2003.

An extended matching paper will replace the existing MCQs and they will be no negative marking. The test will probably be easier than the previous format. To familiarize the candidates with the new formats, test 34 and onward will follow the new style as described below by the College.
 

40 questions over a 3-hour period. The questions will be divided as follows. 5 pathology questions 5 microbiology questions 15 general ophthalmology questions 15 Medicine and Neurology in relation to ophthalmology Extended matching questions are multiple choice items organized into sets that use one list of items in the set. The extended matching set includes four components  1. a theme  2. an option list  3. a lead in statement  4. at least four item stems, as illustrated below  This will involve 40 questions (probably 200 stems) over a period of 3 hours.

1. Match the OCT (optical coherence topography a-d ) with the most likely options 
    (A-N) listed below:
 

A. macular oedema B. macular pucker C. macular pseudohole D. stage 1 macular hole E.  stage 2 macular hole F.  stage 3 macular hole G. stage 4 macular hole

H. angioma I.  macular drusen J.  choroidal naevus K. subhyaloid haemorrhage L.  vitreous haemorrhage M. pigment epithelium detachment N.  retinoschisis

 

a.	Answer A. Macular oedema. The scan shows multiple cystic spaces within the retina. This patient has diabetic maculopathy.
b.	Answer D. Stage 1 macular hole. The scan shows vitreoretinal traction and elevated fovea.
c.	Answer M. Pigment epithelium detachment. The OCT shows elevations of  the retina and the retinal pigment epithelium suggesting the presence  of fluid under the retinal pigment epithelium layer. This patient has  choroidal neovascularization due to age-related macular degeneration.
d.	Answer F. Stage 3 macular hole. The OCT shows a full thickness macular  hole with an overlying operculum attached to the vitreous phase.

2. Match the following findings (a-d) with the studies (A-L) listed below. 
 

A. DCCT B. BVOS C. CVOS D. UKPDS E. MPS F.  TAP

G.  ETDRS H.  DRVS I.   AERDS J.   VIP K.  DRS L.  EVS

 

a.	This study recommended early vitrectomy for vitreous haemorrhage in  type I diabetes mellitus. Answer H. DRVS (Diabetic Retinopathy Vitrectomy Study) assessed the effect of early vitrectomy on advanced proliferative diabetic retinopathy and vitreous haemorrhage.
b.	This study showed that tight diabetic control reduced the incidence of visual loss  in type II diabetic mellitus. Answer D. UKPDS (United Kingdom Prospective Diabetes Study) looked at the effect of tight glucose and hypertension control on diabetic eye  disease and macrovascular diseases in type II diabetes mellitus.
c.	This study recommended early pan-retina photocoagulation for high-risk proliferative  diabetic retinopathy. Answer K. DRS (Diabetic Retinopathy Study) assessed the effect of pan-retina  photocoagulation proliferative diabetic retinopathy.
d.	This study showed that laser is beneficial in all forms of classic choroidal neovascularization. Answer E. MPS (Macular Photocoagulation Study) assessed if argon laser can prevent  significant visual loss in patients with extrafoveal, juxtafoveal and subfoveal subretinal neovascular membrane.

 

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