What alteration in tapetal reflectivity may indicate fundic disease?

• A. Altered tapetal reflectivity leading to hypo- or hyperreflective
• B. No change in tapetal reflectivity
• C. Tapetum reflects only in bright light
• D. Tapetum absent

Answer: (A)

In a fundic exam, how the tapetum lucidem reflects light is a sensitive clue to retinal and choroidal health. When disease affects the back of the eye, the way light travels through and reflects off retinal tissues changes, so you can see areas that are hypo- or hyperreflective. Hyporeflective regions often correspond to problems like edema, retinal detachment, or necrosis, where the normal reflective structure is disrupted. Hyperreflective areas can indicate inflammatory changes, exudates, scar tissue, or mineralization that alter how light is reflected back to the observer. Because these reflectivity changes directly point to underlying fundic pathology, they are a strong indicator of fundic disease.

Normal findings, where there is no change in tapetal reflectivity, do not suggest disease. The idea that the tapetum reflects only in bright light doesn’t provide a diagnostic signal of disease. An absent tapetum would be a separate structural anomaly and not a typical sign used to indicate common fundic disease.