Retina: angiography in central serous chorioretinopathy: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Retina: angiography in central serous chorioretinopathy

Sample item

A 34-year-old man with sudden blurring and micropsia in one eye has a shallow neurosensory detachment at the macula. Fluorescein angiography is done to find the source of the subretinal fluid. Which pattern is typical?

ABeaded capillary dropout with large areas of non-perfusionBA focal point of dye leak at the RPE that spreads upward in the subretinal spaceCBlocked fluorescence under a dense subretinal haemorrhageDEarly lacy hyperfluorescence of a well-defined membrane with late leakage

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. A focal point of dye leak at the RPE that spreads upward in the subretinal space

Central serous chorioretinopathy results from focal RPE decompensation with leakage from the choroid. On fluorescein angiography an expanding point of leakage appears, which may rise like a smokestack or spread like an ink blot. Most cases settle without treatment within a few months.

Option by option

A. Beaded capillary dropout with large areas of non-perfusion
Capillary dropout with non-perfusion is the angiographic picture of ischaemic retinal vascular disease.
B. A focal point of dye leak at the RPE that spreads upward in the subretinal space (correct)
Correct. A focal RPE leak that expands in the subretinal space is the classic angiographic pattern.
C. Blocked fluorescence under a dense subretinal haemorrhage
Blocked fluorescence occurs when blood hides the underlying dye and would not explain a serous detachment.
D. Early lacy hyperfluorescence of a well-defined membrane with late leakage
Early lacy hyperfluorescence with late leakage describes a classic choroidal neovascular membrane, as in wet macular degeneration.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is B, A focal point of dye leak at the RPE that spreads upward in the subretinal space. Central serous chorioretinopathy results from focal RPE decompensation with leakage from the choroid.

Why is "Beaded capillary dropout with large areas of non-perfusion" not the answer?

Capillary dropout with non-perfusion is the angiographic picture of ischaemic retinal vascular disease.

Why is "Blocked fluorescence under a dense subretinal haemorrhage" not the answer?

Blocked fluorescence occurs when blood hides the underlying dye and would not explain a serous detachment.

Why is "Early lacy hyperfluorescence of a well-defined membrane with late lea…" not the answer?

Early lacy hyperfluorescence with late leakage describes a classic choroidal neovascular membrane, as in wet macular degeneration.

What concept does this question test?

It tests Retina: angiography in central serous chorioretinopathy in Ophthalmology. On fluorescein angiography an expanding point of leakage appears, which may rise like a smokestack or spread like an ink blot. Most cases settle without treatment within a few months.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Retina: angiography in central serous chorioretinopathy?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.