Pretest CSC

A 45-year-old man with a history of CSC presents with persistent subretinal fluid in the macula despite conservative management. Indocyanine green angiography (ICGA) reveals choroidal hyperpermeability. Which treatment is most appropriate for his case to reduce subretinal fluid and minimize recurrence?

• High-dose oral corticosteroids

• Intravitreal anti-VEGF injection

• Half-dose photodynamic therapy (PDT)

• Macular grid laser photocoagulation

Which of the following findings on spectral-domain OCT is most indicative of chronic Central Serous Chorioretinopathy?

• Presence of serous retinal detachment with no outer retinal changes

• Hyperreflective deposits at the level of the retinal pigment epithelium (RPE)

• Cystoid macular edema with neovascularization

• Diffuse intraretinal hemorrhages

A 38-year-old patient with recurrent CSC is interested in understanding how systemic factors may impact his condition. Which of the following systemic conditions is most strongly associated with an increased risk of developing CSC?

• Type 1 Diabetes Mellitus

• Systemic Lupus Erythematosus

• Cushing's Syndrome

• Rheumatoid Arthritis

During fluorescein angiography of a CSC patient, the initial leakage spot appears as a pinpoint. Over time, the dye spreads in a specific pattern. Which pattern is this, and what does it signify?

• Petaloid pattern, indicating cystoid macular edema

• Smoke-stack pattern, characteristic of CSC

• Dot-blot pattern, typical in diabetic retinopathy

• Brush-border pattern, associated with macular degeneration

A patient presents with bilateral serous retinal detachments without signs of leakage on fluorescein angiography, and ICGA shows choroidal thickening. Which diagnosis should be considered in this case, which can mimic CSC?

• Vogt-Koyanagi-Harada (VKH) disease

• Age-related Macular Degeneration

• Retinal vein occlusion

• Myopic degeneration

⁠In cases of CSC, what change in the choroidal vasculature has been observed on enhanced-depth imaging OCT, and how is this change significant in the pathophysiology of the disease?

• Thinning of the choroidal layer, indicating ischemic changes

• Increased choroidal thickness, suggesting hyperpermeability

• Reduced choriocapillaris flow, indicating hypoperfusion

• Normal choroidal thickness, unrelated to the disease process

⁠A 40-year-old female with a history of CSC is advised to reduce stress as part of her management. Which physiological mechanism, associated with high levels of stress, is believed to exacerbate CSC?

• Increased sympathetic activity leading to vasoconstriction

• Overactivation of the renin-angiotensin system

• Increased cortisol production affecting the choroidal vessels

• Elevated prolactin levels causing vascular leakage

A patient with chronic CSC has been treated with half-dose PDT. During follow-up, OCT reveals persistent RPE changes but no subretinal fluid. Which finding on OCT would suggest permanent visual impairment?

• Persistent subretinal fluid

• Intraretinal cystoid spaces

• RPE atrophy or tear

• Hyperreflective outer retinal bands

Which of the following genetic associations has been identified in some patients with CSC, potentially linking it with choroidal and retinal disorders?

• Mutation in the ABCA4 gene

• Mutation in the CFH gene

• Variation in the NR3C1 gene

• Mutation in the GPR143 gene

A 36-year-old male with CSC undergoes indocyanine green angiography (ICGA), which shows areas of choroidal hyperpermeability. Based on current understanding, which layer of the choroid is primarily involved in the pathology of CSC?

• Sattler’s layer

• Bruch's membrane

• Choriocapillaris

• Haller’s layer