A patient presented with peripheral field loss and fundus examination shows waxy exudates & pale disc with pigmentation around retinal vessels, diagnosis is –
**Core Concept**
The patient's presentation suggests a diagnosis related to retinal degeneration, specifically a condition characterized by peripheral field loss, waxy exudates, and characteristic changes in the optic disc and retinal vessels. This condition is associated with a specific type of retinal degeneration that affects the peripheral retina.
**Why the Correct Answer is Right**
The patient's symptoms are consistent with retinitis pigmentosa (RP), a group of genetic disorders that lead to progressive retinal degeneration. The characteristic waxy exudates, also known as bone spicules, are formed due to the accumulation of pigment in the retinal pigment epithelium. The pale optic disc and pigmentation around the retinal vessels are also hallmarks of RP. The peripheral field loss is due to the degeneration of the rod photoreceptors in the peripheral retina.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not match the patient's presentation. Diabetic retinopathy typically presents with microaneurysms, hemorrhages, and exudates in the macula, not waxy exudates and peripheral field loss.
**Option B:** This option is incorrect because it is a condition that presents with central vision loss, not peripheral field loss. Macular degeneration is characterized by the degeneration of the macula, leading to central vision loss and metamorphopsia.
**Option C:** This option is incorrect because it is a condition that presents with sudden vision loss, not progressive peripheral field loss. Central retinal artery occlusion is a medical emergency that requires prompt treatment.
**Clinical Pearl / High-Yield Fact**
Retinitis pigmentosa is a genetic disorder that affects approximately 1 in 4,000 people worldwide. It is often associated with other systemic abnormalities, such as hearing loss and kidney disease.
**Correct Answer: C. Central retinal vein occlusion.**