Retina: early lesion in diabetic microangiopathy: 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: early lesion in diabetic microangiopathy

Sample item

In a patient with long-standing diabetes, which early change in the retinal capillary wall is thought to lead to microaneurysm formation?

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

The answer and the reasoning

D. Selective loss of pericytes

Chronic hyperglycaemia damages the supporting pericytes of retinal capillaries early. The weakened wall bulges as microaneurysms, and thickened basement membrane and endothelial dysfunction cause leakage and capillary closure. Microaneurysms are the first clinically visible sign.

Option by option

  • A. Loss of retinal ganglion cell axons

    Ganglion cell axon loss causes optic atrophy and field defects, not microaneurysms.

  • B. Proliferation of Muller cells

    Muller cell proliferation is a reactive response and not the initiating vessel wall defect.

  • C. Thickening of the pigment epithelium

    The pigment epithelium is not the site of the primary vascular defect.

  • D. Selective loss of pericytes (correct)

    Correct. Pericyte loss weakens the capillary wall and permits microaneurysm formation.

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, Selective loss of pericytes. Chronic hyperglycaemia damages the supporting pericytes of retinal capillaries early.

Why is "Loss of retinal ganglion cell axons" not the answer?

Ganglion cell axon loss causes optic atrophy and field defects, not microaneurysms.

Why is "Proliferation of Muller cells" not the answer?

Muller cell proliferation is a reactive response and not the initiating vessel wall defect.

Why is "Thickening of the pigment epithelium" not the answer?

The pigment epithelium is not the site of the primary vascular defect.

What concept does this question test?

It tests Retina: early lesion in diabetic microangiopathy in Ophthalmology. The weakened wall bulges as microaneurysms, and thickened basement membrane and endothelial dysfunction cause leakage and capillary closure. Microaneurysms are the first clinically visible sign.

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: early lesion in diabetic microangiopathy?

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.