Diabetic retinopathy: severe NPDR: 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 · Diabetic retinopathy: severe NPDR

Sample item

Which findings define severe non-proliferative diabetic retinopathy under the 4-2-1 rule?

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

The answer and the reasoning

C. Haemorrhages in 4 quadrants, venous beading in 2 quadrants or IRMA in 1 quadrant

The 4-2-1 rule identifies high risk of progression to proliferative disease, with any one feature qualifying. Such patients need close follow-up and may be considered for early laser.

Option by option

  • A. Macular oedema alone

    Macular oedema is classified separately.

  • B. Vitreous haemorrhage

    Vitreous haemorrhage is a complication of PDR.

  • C. Haemorrhages in 4 quadrants, venous beading in 2 quadrants or IRMA in 1 quadrant (correct)

    Correct. Any one of the three features defines severe NPDR.

  • D. Neovascularisation of the disc

    Neovascularisation defines proliferative disease.

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 C, Haemorrhages in 4 quadrants, venous beading in 2 quadrants or IRMA in 1 quadrant. The 4-2-1 rule identifies high risk of progression to proliferative disease, with any one feature qualifying.

Why is "Macular oedema alone" not the answer?

Macular oedema is classified separately.

Why is "Vitreous haemorrhage" not the answer?

Vitreous haemorrhage is a complication of PDR.

Why is "Neovascularisation of the disc" not the answer?

Neovascularisation defines proliferative disease.

What concept does this question test?

It tests Diabetic retinopathy: severe NPDR in Ophthalmology. Such patients need close follow-up and may be considered for early laser.

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 Diabetic retinopathy: severe NPDR?

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.