Document Detail

Smokestack leak in central serous chorioretinopathy.
MedLine Citation:
PMID:  19830441     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To study the demography, various morphological patterns and fluid dynamics of the smokestack leak by fluorescein angiography (FA) in central serous chorioretinopathy (CSC). METHODS: Part I (clinical): review of the medical records and angiographic documents of 69 consecutive cases of CSC with smokestack leak. Part II (experimental): documentation of the movement of various concentrations of fluorescein dye due to convection currents in a laboratory model that roughly represents a closed chamber similar to that of CSC in human eyes. RESULTS: The clinical study (Part I) revealed that 14.40% of 479 consecutive cases had smokestack leak, of which 70% occurred in first acute episode (p-value: <0.001), 27.14% in acute recurrent episodes (50% fresh leak) and 2.85% in chronic stage. Patients were predominantly male (84.05%) with a median age of 34.00 +/- 8.14 years. The median symptom duration excluding the chronic cases was 15 +/- 34.28 days. This type of leak was mostly (48.57%) seen in medium-sized CSC, and the majority were in the parafoveal superonasal quadrant (31.42%). The ascending type of leak was predominant (94.28%). In four eyes, an atypical pattern and in two eyes more than one smokestack leak were seen within the same detached area. The experimental study (Part II) demonstrated that fluid containing a low concentration of fluorescein ascended due to convection currents, whereas highly concentrated dye descended. CONCLUSIONS: The clinical study revealed smokestack leaks to be significantly more common in a primary acute episode, and they usually develop in the early part of the acute phase of the disease (average duration 15 +/- 34.28 days). Rarely, this type of leak can occur in the chronic stage, and multiple leaks may develop in the same detached space. The various patterns of dye movement due to convection currents in the experimental model resembled the dye movement in certain cases of CSC of the present series. The experimental study also hinted at the probability of drainage of unbound fluorescein molecules along with protein-laden heavy fluid in downward spread of the leak.
Dhiren Bujarborua; Pran N Nagpal; Manab Deka
Publication Detail:
Type:  Journal Article     Date:  2009-10-15
Journal Detail:
Title:  Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv f?r klinische und experimentelle Ophthalmologie     Volume:  248     ISSN:  1435-702X     ISO Abbreviation:  Graefes Arch. Clin. Exp. Ophthalmol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8205248     Medline TA:  Graefes Arch Clin Exp Ophthalmol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  339-51     Citation Subset:  IM    
Pragjyoti Eye Care & Research Centre, 29, Mother Teresa Road, 781 021, Guwahati, Assam, India.
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MeSH Terms
Acute Disease
Capillary Permeability
Central Serous Chorioretinopathy / diagnosis*
Chronic Disease
Fluorescein Angiography*
Middle Aged
Retinal Vessels / pathology*
Risk Factors
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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