Ocular Therapeutics Conference 2020

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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? *

1 point

1 day

2 days

5 days

7 days

14 days

2. Which of the following treatments is NOT appropriate for PED? *

1 point

Punctal plug

Bandage soft contact lenses (BCL)

Hourly preservative free antibiotic

Tetracycline

Botulinum toxin A

3. What is the current (2016-2020) epithelium-off corneal collagen cross-linking protocol being utilised in the ADHB? *

1 point

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? *

1 point

0.5-1%

10%

50%

0.001%

5. Which dose of atropine for the treatment of myopia progression has the highest rebound effect? *

1 point

0.025%

0.01%

0.05%

1.5%

6. What is considered the safest atropine dose to start treatment for myopia progression to date? *

1 point

0.05%

0.01%

0.025%

0.5%

7. A dry eye diagnosis can be made from a patient having symptomology from the OSDI questionnaire, plus ONE of the following homeostasis markers: *

1 point

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: *

1 point

BlephEx

Blephasteam goggles

Gland expression

IPL

Lipiflow

9. Which of the following statements about preservatives is INCORRECT? *

1 point

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? *

1 point

Polyquad

Purite

Benzalkonium chloride

Hydrogen peroxide

Sodium perborate

11. With respect to stem cell transplantation, which of the following would be identified as TOTIPOTENT? *

1 point

Adult stem cell

Embryonic stem cell

Umbilical stem cell

Fertilised egg

Induced pluripotent stem cell

12. Which of the following statements is INCORRECT of induced pluripotent stem cells? *

1 point

Can be induced from a patient’s own cells

Are pluripotent

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? *

1 point

Ocular lubricants

Topical ascorbate and citrate

Irrigation with a commercial eye wash pack, plus pH testing

Immediate copious irrigation with water or saline

Topical steroids

14. Which of the following statements is INCORRECT? *

1 point

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? *

1 point

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? *

1 point

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? *

1 point

100%

75%

50%

25%

Not at all

18. What is the preferred primary method of treatment for stage 3 aniridia associated keratopathy? *

1 point

Punctual occlusion

Penetrating keratoplasty

Topical lubricants

Limbal stem cell transplant

Boston keratoprosthesis

19. In relation to Terrien’s Marginal Corneal Degeneration which of the following statements is INCORRECT? *

1 point

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)? *

1 point

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 *

1 point

Steroids in all cases

Topical NSAIDS

Broad spectrum topical antibacterials

Oral antibiotics

Oral antivirals

22. Name a cause of progressive keratitis? *

1 point

Acanthamoeba

Fungal keratitis

Toxicity from therapy

Mycobacteria

All of the above

23. Which of the following is the definitive host for toxoplasmosis? *

1 point

Bats

Cats

Cows

Humans

Mice

24. In which of the following circumstances would you consider long-term prophylaxis for toxoplasmosis? *

1 point

Multiple recurrences

Macular toxoplasmosis

Immunosuppression

Congenital toxoplasmosis for first year of life

All of the above

25. Which of the following is NOT a risk factor for Acanthamoeba keratitis? *

1 point

Extended wear of contact lenses

Exposure to tank water

Chronic blepharitis

Corneal abrasion

Cosmetic contact lens wear

26. Early cases of Acanthamoeba keratitis can be mistaken for any of the following EXCEPT: *

1 point

Healing corneal abrasion

Stromal herpes simplex keratitis

Neurotrophic keratopathy

Toxic epitheliopathy

Herpes zoster keratitis

27. Which of the following is NOT a herpes virus? *

1 point

Cytomegalovirus

Epstein Barr virus

Herpes simplex virus

Varicella zoster virus

Adenovirus

28. When should oral and topical antivirals be given in HSV keratitis? *

1 point

In all of the below cases

In children if there are difficulties with compliance

Dendritic keratitis

Disciform keratitis

Co-existent bacterial infection

29. The observational FRB! Project is a database that provides “real world” patient outcomes. What does “FRB” stand for? *

1 point

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? *

1 point

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? *

1 point

Macugen

Avastin

Lucentis

Eylea

Beovu

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? *

1 point

3 letters

5 letters

8 letters

11 letters

15 letters

33. Which of the following statements about anti-VEGF biosimilars is INCORRECT? *

1 point

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? *

1 point

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: *

1 point

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: *

1 point

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? *

1 point

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: *

1 point

Skin protection from UV light

Exercise recovery

Hair restoration

Neuroprotection

Improving mitochondrial function

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