A 40-year-old man presents with a branch retinal artery occlusion (BRAO) in the inferior temporal territory. On OCT, the involved area shows marked inner retinal thickening acutely. What is the characteristic appearance on fluorescein angiography (FFA) in the first 24 hours?
- A Massive dye leakage from the occluded arteriole
- B Delayed arterial filling and non-perfusion of the involved sector with masking of background choroidal fluorescence by the swollen, opaque retina ✓
- C Window defect corresponding to the infarcted area
- D Strong hyperfluorescence of the disc due to neovascularisation
Correct answer: B. Delayed arterial filling and non-perfusion of the involved sector with masking of background choroidal fluorescence by the swollen, opaque retina
Explanation
In branch retinal artery occlusion (BRAO), fluorescein angiography shows delayed or absent filling of the affected arteriole in the early phase, followed by stagnant or segmented (box-carring) arterial flow. The ischemic edematous inner retina appears as a white opacity on fundoscopy and masks the underlying choroidal fluorescence (hypofluorescence or masking effect) on FFA. There is no dye leakage in the acute phase; leakage from disc or neovascularisation occurs later in the course if retinal ischemia is extensive.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.