Smoke-stack fluorescein leakage in a vitrectomised eye with proliferative diabetic retinopathy: a rare angiographic phenomenon

Abstract 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). Case description A 59-year-old male with a 17-year history of type 2 diabetes mellitus underwent f...

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Main Authors: Kanika Godani, Vishma Prabhu, Prathiba Hande, Priyanka Gandhi, Rupal Kathare, Ramesh Venkatesh
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-03999-9
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Summary:Abstract 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). Case description 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. Conclusion 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.
ISSN:1471-2415