B-scan ultrasonography of the posterior segment in a patient with a dense cataract shows a dome-shaped hyperechoic lesion attached to the optic nerve head that does not move on kinetic B-scan (no aftermovement). The most likely diagnosis is:
- A Posterior vitreous detachment
- B Optic nerve drusen ✓
- C Rhegmatogenous retinal detachment
- D Choroidal melanoma
Correct answer: B. Optic nerve drusen
Explanation
Optic nerve head drusen appear on B-scan as a highly reflective (hyperechoic) nodular opacity at the optic disc that demonstrates pseudo-fluorescence (autofluorescence) and does not move with kinetic ultrasound. Retinal detachments show aftermovement; PVD appears as a faint mobile linear echo; choroidal melanoma has characteristic choroidal excavation and acoustic hollowness.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.