Ocular Therapeutics Conference 2020
MCQs for the Ocular Therapeutics Conference 2020
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1. Persistent epithelial defects should be treated within what period to avoid secondary complications?
2. Which of the following treatments is NOT appropriate for PED?
Bandage soft contact lenses (BCL)
Hourly preservative free antibiotic
Botulinum toxin A
3. What is the current (2016-2020) epithelium-off corneal collagen cross-linking protocol being utilised in the ADHB?
Traditional epithelium-off corneal collagen cross-linking, 30 minute riboflavin soak, 30 minute continuous ultra-violet light exposure (3mW/cm2 for 30 minutes = total energy of 5.4 J/cm2)
Accelerated (high intensity), high energy, epithelium-off corneal collagen cross-linking, 10 minute riboflavin soak, 3 minute continuous ultra-violet light exposure (30mW/cm2 for 4 minutes = total energy of 7.2 J/cm2)
Accelerated (high intensity), high energy, epithelium-off corneal collagen cross-linking, 10 minute riboflavin soak, 8 minute pulsed ultra-violet light exposure (30mW/cm2 for 8 minutes = total energy of 7.2 J/cm2)
Accelerated (high intensity), traditional energy, epithelium-off corneal collagen cross-linking, 10 minute riboflavin soak, 3 minute continuous ultra-violet light exposure (30mW/cm2 for 3 minutes = total energy of 5.4 J/cm2)
Accelerated (high intensity), high energy, transepithelial corneal collagen cross-linking, 10 minute riboflavin soak, 2 minutes 40 seconds pulsed ultra-violet light exposure (45mW/cm2 for 2 minutes 40 seconds = total energy of 7.2 J/cm2)
4. Microbial keratitis is the most severe and likely complication of epithelium-off corneal collagen cross-linking. Approximately what percentage of eyes has it occurred in within the ADHB service over the last 5 years?
5. Which dose of atropine for the treatment of myopia progression has the highest rebound effect?
6. What is considered the safest atropine dose to start treatment for myopia progression to date?
7. A dry eye diagnosis can be made from a patient having symptomology from the OSDI questionnaire, plus ONE of the following homeostasis markers:
NITBUT 12 s
Osmolarity 290 mOsm/L
3 corneal spots
5 conjunctival spots
Lid margin staining 5 mm in length
8. Treatments for evaporative dry eye caused by MGD include all of the following EXCEPT:
9. Which of the following statements about preservatives is INCORRECT?
All preservatives disrupt the ocular surface
All preservatives aggravate pre-existing ocular surface disease
Benzalkonium chloride (BAK) is the most common preservative used in dry eye drops
BAK is the active ingredient in toilet cleaner
BAK increases the rate of cataract development
10. Which of the following is NOT a preservative used in dry eye drops?
11. With respect to stem cell transplantation, which of the following would be identified as TOTIPOTENT?
Adult stem cell
Embryonic stem cell
Umbilical stem cell
Induced pluripotent stem cell
12. Which of the following statements is INCORRECT of induced pluripotent stem cells?
Can be induced from a patient’s own cells
Have significant ethical issues around use
Can form teratomas
Are similar in potency to embryonic stem cells
13. What is the most important step in the management of ocular chemical injury?
Topical ascorbate and citrate
Irrigation with a commercial eye wash pack, plus pH testing
Immediate copious irrigation with water or saline
14. Which of the following statements is INCORRECT?
Topical ascorbate speeds collagen synthesis and healing
Topical steroids are contraindicated in the first week
Doxycycline reduces the risk of ulceration
Debridement of necrotic tissue reduces ulceration
Topical citrate drops reduce the risk of ulceration
15. In relation to the Rho-Kinase pathway which of the following statements is CORRECT?
ROCK-inhibitors are available in Japan and China for treatment of glaucoma
More than 150 possible ROCK-inhibitors have been developed to date
ROCK-inhibitors can improve motility and health of corneal endothelial cells
In glaucoma treatment the most common side-effect of ROCK-inhibitors is hyperaemia
All of the above statements are correct
16. In relation to the human corneal endothelium which of the following statements is INCORRECT?
The human corneal endothelium is normally a highly metabolic, non-dividing, monolayer
Corneal endothelial density falls from 3500 to 2500 cells/mm2 between 15 and 65 years
The current, definitive treatment for advanced endothelial disease is transplantation
Rho-kinase inhibitors have largely made endothelial transplantation obsolete
The most common cause of corneal transplant failure remains endothelial rejection
17. In autosomal dominant aniridia, what is the chance any child of an affected individual is also being affected?
Not at all
18. What is the preferred primary method of treatment for stage 3 aniridia associated keratopathy?
Limbal stem cell transplant
19. In relation to Terrien’s Marginal Corneal Degeneration which of the following statements is INCORRECT?
The corneal epithelium is typically intact
The peripheral thinning is usually separated from the central cornea by a grey/white lipid line
Fine blood vessels usually extend from the limbus over the area of thinning
The majority of cases go on to require surgical intervention
It is an uncommon but slowly progressive corneal disease
20. Which of the following statements is CORRECT in relation to Peripheral Ulcerative Keratitis (PUK)?
PUK is often associated with life-threatening systemic disease
PUK may rapidly lead to corneal perforation
PUK requires intensive systemic and topical treatment
PUK usually presents with a peripheral, painful, corneal melt
All of the above statements are correct
21. Microbial keratitis should be treated with
Steroids in all cases
Broad spectrum topical antibacterials
22. Name a cause of progressive keratitis?
Toxicity from therapy
All of the above
23. Which of the following is the definitive host for toxoplasmosis?
24. In which of the following circumstances would you consider long-term prophylaxis for toxoplasmosis?
Congenital toxoplasmosis for first year of life
All of the above
25. Which of the following is NOT a risk factor for Acanthamoeba keratitis?
Extended wear of contact lenses
Exposure to tank water
Cosmetic contact lens wear
26. Early cases of Acanthamoeba keratitis can be mistaken for any of the following EXCEPT:
Healing corneal abrasion
Stromal herpes simplex keratitis
Herpes zoster keratitis
27. Which of the following is NOT a herpes virus?
Epstein Barr virus
Herpes simplex virus
Varicella zoster virus
28. When should oral and topical antivirals be given in HSV keratitis?
In all of the below cases
In children if there are difficulties with compliance
Co-existent bacterial infection
29. The observational FRB! Project is a database that provides “real world” patient outcomes. What does “FRB” stand for?
Forget retinal blindness
Forecasting retinal blood disorders
Fight retinal blindness
FRB! Professor Gillies
Find (cures for) retinal blindness
30. When an individual has significant vision loss/blindness which of the following statements is CORRECT?
It can result in depression and anxiety
It has been linked to falls, injuries, hospitalisation and need for rehabilitation
It has a negative economic impact including loss of productivity
It can cause a loss of independence for the individual, and result in the need for residential care or home care
All of the above statements are correct
31. Which anti-VEGF agent binds VEGF like a trap?
32. In real world studies, how many letters of VA improvement did patients with diabetic macular oedema gain from anti-VEGF treatment over 12 months?
33. Which of the following statements about anti-VEGF biosimilars is INCORRECT?
They are marketed by the same company as the original product
They must have the same efficacy as the original product
They must have the same safety as the original product
They increase market competition and potentially reduce costs
They can only be marketed once the patent of the original product has expired
34. Which of the following statements about currently approved anti-VEGF agents is CORRECT?
Lucentis can only be used off-label
The smaller their molecular weight, the longer their half-life in the vitreous
Avastin is a monoclonal antibody fragment
The smaller the dissociation constant for VEGF165, the stronger the binding
The larger their molecular weight, the more molecules fit into one dose
35. Two inflammatory pathways that offer novel and promising therapeutic approaches for chronic retinal disease treatment are:
p38 Map Kinase pathway and JACK/STAT pathways
p13 Kinase and Hippo pathways
Complement (C3 inhibition) and Inflammasome pathways
Hippo and JACK/STAT pathways
JACK/STAT pathway and steroids
36. Which of the following statements is CORRECT? Inhibition of the inflammasome:
Reduces VEGF expression but no that of other cytokines
Increases metabolic activity in the retina to reduce VEGF levels
Is limited because it increases conversion to wet AMD
Is upstream of anti-VEGF treatments and shuts down the release of multiple inflammatory cytokines, targeting the underlying disease process
Can only be achieved with intraocular injections
37. Which of the following statements about astaxanthin is INCORRECT?
It is a marine carotenoid
It is related to lutein and zeaxanthin
It is water soluble but not fat soluble
It is extracted from a marine microalgae
It is found in krill oil
38. Which of the following is INCORRECT? Existing uses of astaxanthin include the following EXCEPT:
Skin protection from UV light
Improving mitochondrial function
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