Godani Kanika, Prabhu Vishma, Hande Prathiba, Gandhi Priyanka, Kathare Rupal, Venkatesh Ramesh
Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India.
BMC Ophthalmol. 2025 Apr 4;25(1):171. doi: 10.1186/s12886-025-03999-9.
BACKGROUND/AIM: This case report aims to describe an unusual angiographic finding of smoke-stack leakage (SSL) in a vitrectomised eye of a patient with proliferative diabetic retinopathy (PDR).
A 59-year-old male with a 17-year history of type 2 diabetes mellitus underwent fundus fluorescein angiography (FA) following vitrectomy for vitreous hemorrhage secondary to PDR. His visual acuity at the time of FA was 6/6 in both eyes. The examination focused on identifying neovascularization elsewhere (NVE) and analysing leakage patterns. FA revealed active NVEs in the left eye with late-phase leakage nasally and inferiorly to the optic disc, while the right eye exhibited a distinctive SSL pattern from residual proliferation. Interestingly, the leakage subsided in the late phase, leaving only staining of the residual fibrous tissue.
The observed SSL in this vitrectomised eye underscores unique post-surgical dynamics of fluorescein diffusion. This case highlights the importance of recognizing altered leakage patterns in vitrectomised patients, which can impact the evaluation and management of retinal neovascularization in PDR.
背景/目的：本病例报告旨在描述增殖性糖尿病视网膜病变（PDR）患者玻璃体切除术后眼中出现的烟囱样渗漏（SSL）这一不寻常的血管造影表现。
一名患有2型糖尿病17年的59岁男性，因PDR继发玻璃体出血接受玻璃体切除术后进行了眼底荧光血管造影（FA）检查。FA检查时他双眼视力均为6/6。检查重点是识别其他部位的新生血管（NVE）并分析渗漏模式。FA显示左眼有活跃的NVE，视盘鼻侧和下方有晚期渗漏，而右眼呈现出残余增殖的独特SSL模式。有趣的是，渗漏在晚期消退，仅留下残余纤维组织的染色。
在这只玻璃体切除术后的眼中观察到的SSL强调了荧光素扩散独特的术后动态变化。本病例突出了认识玻璃体切除术后患者渗漏模式改变的重要性，这可能会影响PDR中视网膜新生血管的评估和管理。
