Uvea: progressive outer retinal necrosis: 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 · Uvea: progressive outer retinal necrosis

Sample item

A man with advanced HIV has rapid loss of vision with multifocal deep outer retinal whitening from the periphery, minimal vitritis and no haemorrhage. He had herpes zoster last year. What is the diagnosis?

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

The answer and the reasoning

D. Progressive outer retinal necrosis

Progressive outer retinal necrosis is a varicella zoster infection of profoundly immunosuppressed patients, with rapid outer retinal whitening and little inflammation. CMV retinitis is slower and shows haemorrhage. Toxoplasmosis gives a focal lesion with vitritis.

Option by option

  • A. Cytomegalovirus retinitis

    CMV retinitis is slower and has haemorrhage with granular borders.

  • B. Toxoplasma retinochoroiditis

    Toxoplasma gives a focal necrotising retinitis with marked vitritis.

  • C. Candida chorioretinitis

    Candida produces fluffy white lesions with vitreous balls in a bloodstream infection.

  • D. Progressive outer retinal necrosis (correct)

    Correct. Rapid peripheral outer retinal necrosis with little vitritis in advanced HIV fits PORN.

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, Progressive outer retinal necrosis. Progressive outer retinal necrosis is a varicella zoster infection of profoundly immunosuppressed patients, with rapid outer retinal whitening and little inflammation.

Why is "Cytomegalovirus retinitis" not the answer?

CMV retinitis is slower and has haemorrhage with granular borders.

Why is "Toxoplasma retinochoroiditis" not the answer?

Toxoplasma gives a focal necrotising retinitis with marked vitritis.

Why is "Candida chorioretinitis" not the answer?

Candida produces fluffy white lesions with vitreous balls in a bloodstream infection.

What concept does this question test?

It tests Uvea: progressive outer retinal necrosis in Ophthalmology. CMV retinitis is slower and shows haemorrhage. Toxoplasmosis gives a focal lesion with vitritis.

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 Uvea: progressive outer retinal necrosis?

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.