Fluorescein angiography (FFA) shows a 'smokestack' leakage pattern in one eye of a 35-year-old male. This pattern is pathognomonic of:

• A Choroidal neovascularization membrane (CNVM)
• B Central serous chorioretinopathy (CSCR) ✓
• C Cystoid macular edema (CME)
• D Polypoidal choroidal vasculopathy (PCV)

Explanation

The 'smokestack' pattern on FFA — a focal hyperfluorescent point in early frames that rises vertically and then spreads laterally under the detached neurosensory retina like a mushroom cloud — is pathognomonic of active CSCR. It is seen in approximately 10-15% of CSCR cases; the more common pattern is an 'inkblot' of expanding hyperfluorescence. CNVM shows feeder vessels and early lacy hyperfluorescence. CME produces petaloid late staining. PCV requires ICGA for diagnosis of polypoidal dilations.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.