Step 2 UWorld Self-Assessment (UWSA) 2 Practice Exam

Cupping of the optic disc is most characteristic of which condition?

Retinal detachment Macular degeneration Cupping of the optic disc due to loss of retinal ganglion cell axons Cataract

Correct Answer:

Cupping of the optic disc due to loss of retinal ganglion cell axons

Explanation:

Cupping of the optic disc reflects loss of retinal ganglion cell axons with thinning of the neuroretinal rim, causing the optic cup to enlarge relative to the disc. This pattern is most characteristic of glaucomatous optic neuropathy, where damage to the retinal ganglion cells and their axons from elevated intraocular pressure leads to progressive cupping and visual field loss. Retinal detachment affects the retina, macular degeneration targets the macula and central vision, and cataract involves lens opacity—not the optic nerve or cup-to-disc ratio. A normal cup-to-disc ratio is about 0.3; a larger cup suggests glaucomatous damage.

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