Continuing Professional Development


RANZCO Fellows can claim CPD points by reading the following two articles that appear in this issue and answering the five questions. One point is awarded for each set of five questions answered. Please remember to claim your points.

Burdon KP. Genome-wide association studies in the hunt for genes causing primary open-angle glaucoma: a review (pp. 358–63).

  • 1In conducting genome-wide association studies (GWAS), how is linkage disequilibrium considered (a) useful and (b) a hindrance?
  • 2Which of the options below are requirements for a successful genome-wide association study?
    • (a) Clearly defined homogeneous phenotype
    • (b) Ethnically matched cohort
    • (c) Multiple hypothesis testing correction
    • (d) Additional cohorts for replication
  • 3In which subgroups of patients do the CAV1/CAV2 single-nucleotide polymorphisms appear to be most strongly associated with primary open-angle glaucoma (POAG)?
  • 4Which genes have been reproducibly associated with POAG from GWAS of POAG itself?
  • 5Which endophenotypes have so far identified loci also associated with POAG?

Faridi O, Park SC, Liebmann JM, Ritch R. Glaucoma and obstructive sleep apnoea syndrome (pp. 408–19).

  • 1Obstructive sleep apnoea syndrome (OSAS) is associated with all of the following except …
    • (a) hypertension
    • (b) floppy eyelid syndrome
    • (c) renal calculi
    • (d) obesity
  • 2During sleep, which physiological change occurs?
    • (a) Decrease in intraocular pressure (IOP)
    • (b) Decrease in blood pressure
    • (c) Increase in aqueous humour secretion
    • (d) Increase in sympathetic tone
  • 3Which of the following statements is correct?
    • (a) Continuous positive airway pressure (CPAP) lowers IOP
    • (b) OSAS increases the amount of time in slow-wave sleep
    • (c) OSAS can lead to a lower intracranial pressure
    • (d) IOP is highest during slow-wave sleep
  • 4Postulated mechanisms for glaucoma development in OSAS include all of the following except …
    • (a) ischaemia
    • (b) elevated IOP
    • (c) autonomic dysfunction
    • (d) inflammation
  • 5Which of the following statements is false?
    • (a) Low ocular perfusion pressure is associated with glaucoma.
    • (b) Non-dipping of nocturnal blood pressure increases the risk of cardiovascular abnormalities.
    • (c) Silent cerebral infarcts have been associated in glaucoma.
    • (d) OSAS reduces endothelin production.

Answers to questions published in previous issue

Marchini G, Pedrotti E, Pedrotti M et al. Long-term effectiveness of autologous cultured limbal stem cell grafts in patients with limbal stem cell deficiency due to chemical burns (pp. 255–67)

  • 1Q: Limbal stem cell transplantation represents the treatment of choice for corneal pathologies or acquired factors causing …
    • (a) loss of corneal transparency
    • (b) limbal stem cell deficiency
    • (c) inflammation of the anterior segment
    • (d) increase of the intraocular pressure
  • A: (b) limbal stem cell deficiency

  • 2Q: When limbal stem cell deficiency occurs …
    • (a) the epithelium of the bulbar conjunctiva migrates over the cornea causing conjunctivalization, patient discomfort and eventually vision loss
    • (b) the epithelium of the bulbar conjunctiva migrates over the cornea causing conjunctivalization
    • (c) the epithelium of the bulbar conjunctiva migrates over the cornea causing patient discomfort
    • (d) the epithelium of the bulbar conjunctiva migrates over the cornea causing changes in corneal curvature
  • A: (a) the epithelium of the bulbar conjunctiva migrates over the cornea causing conjunctivalization, patient discomfort and eventually vision loss

  • 3Q: In limbal stem cell deficiency, conventional penetrating keratoplasty is unlikely to succeed because …
    • (a) immunological rejection occurs frequently
    • (b) late graft failure occurs frequently
    • (c) disease recurrence occurs frequently
    • (d) success is dependent on the gradual replacement of the donor's corneal epithelium with the recipient's
  • A: (d) success is dependent on the gradual replacement of the donor's corneal epithelium with the recipient's

  • 4Q: In cases of bilateral limbal stem cell deficiency …
    • (a) Limbal tissue should be taken from a living relative donor
    • (b) Limbal tissue should be taken from a living relative or a cadaver donor, without the need of long-term immunosuppression in the recipient
    • (c) Limbal tissue should be taken from a living relative or a cadaver donor, with the recipient requiring long-term immunosuppression
    • (d) Limbal tissue should be taken from a cadaver donor
  • A: (c) Limbal tissue should be taken from a living relative or a cadaver donor, with the recipient requiring long-term immunosuppression

  • 5Q: To confirm the clinical diagnosis of limbal stem cell deficiency, impression cytology specimen must be immunostained with …
    • (a) Markers of corneal keratocytes
    • (b) Markers of corneal endothelium
    • (c) Markers of corneal epithelium
    • (d) Markers of corneal and conjunctival epithelium
  • A: (d) Markers of corneal and conjunctival epithelium

Forward H, Hewitt AW, Mackey DA. Missing X and Y: a review of participant ages in population-based eye studies (pp. 305–19).

  • 1Q: What is the largest population-based study of eye disease conducted worldwide?
    • A: China Nine-Province survey (examined 45747 participants)

  • 2Q: What were the youngest ages of the participants in the Melbourne Visual Impairment Project and Blue Mountains Eye Study?
    • A: Melbourne VIP included participants over 40 years of age; Blue Mountains included participants over 49 years of age

  • 3Q: What percentage of blindness in the Nigerian National Blindness and Visual Impairment Study was due to avoidable causes?
    • (a) 24%
    • (b) 54%
    • (c) 84%
  • A: (c) 84%

  • 4Q: What are the risk factors for myopia identified by the Sydney Myopia Study?
    • A: Near work, low levels of outdoor activity, urban environment and schooling

  • 5Q: What ages of participants are mostly excluded from population eye studies?
    • A: Young adults (age 18–40)

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