A 58-year-old man with multiple hard drusen at the posterior pole undergoes FFA. The drusen appear hyperfluorescent in the early arteriovenous phase, increase slightly in intensity through the mid phase, but show sharp margins and no increase in size or blur in late frames. This finding represents:

• A Pooling of dye in a serous detachment
• B Window defect due to RPE atrophy over the drusen ✓
• C Staining of the drusen material
• D Leakage from occult choroidal neovascularization

Explanation

Drusen cause thinning or loss of overlying RPE, so background choroidal fluorescence shows through early and intensifies modestly as background rises, without leakage, blurring or enlargement. This is a transmission or window defect. Pooling fills a defined space and enlarges with blurred margins, staining increases gradually into late frames with ill-defined borders, and CNV leaks progressively with fuzzy edges, none of which matches the described sharply marginated non-expanding hyperfluorescence.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

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Written and medically reviewed by the StethoPrep medical team.