Central Serous Chorioretinopathy

A 38-year-old man presents with acute-onset, painless blurred central vision and metamorphopsia for 2 weeks. He reports objects appearing smaller than usual and a central scotoma. He is a high-stress investment banker on inhaled corticosteroids for asthma. Fundoscopy reveals a well-circumscribed dome-shaped lesion at the posterior pole with loss of the foveal reflex. OCT confirms a dome-shaped serous detachment of the neurosensory retina with elongated photoreceptor outer segments, as marked **A** in the diagram. Which of the following best describes the pathophysiological basis of the structure marked **A**?

A 38-year-old male marketing executive presents with central grey blur and micropsia in the right eye for two weeks. Best-corrected acuity is 6/12 with a hypermetropic shift. Dilated fundoscopy reveals a dome-shaped serous detachment at the posterior pole with loss of foveal reflex. Fluorescein angiography demonstrates a single focal hyperfluorescent spot at the superotemporal edge of the detachment that progressively expands upward and then spreads laterally in a classic smokestack pattern (marked **A** in the diagram). This pattern of leakage originates from which of the following?