RESUMEN
PURPOSE: This study aimed to describe the clinical findings and management of eyes affected by uveal effusion syndrome. METHODS: We retrospectively evaluated the charts of 13 eyes of 8 consecutive patients diagnosed with uveal effusion syndrome attending the Ophthalmology Unit of the University Hospitals Leuven, Belgium, between 2007 and 2018. The presenting features, investigations, management, and outcomes were analyzed for each case. RESULTS: Cataract surgery was the predisposing factor for uveal effusion in 6 eyes, 2 bilateral uveal effusions (4 eyes) were considered to be medication-induced, and in 3 eyes, the uveal effusion was described as idiopathic. Fundus examination of 5 of 13 eyes showed bullous choroidal detachment, treated with pars plana vitrectomy with superotemporal sclerectomy or transscleral punction. Fundoscopy showed uveal effusion without serous retinal detachment in 3 eyes. Serous retinal detachment accompanied by uveal swelling was observed in 3 eyes and the 2 remaining eyes presented with uveal swelling only. The 8 nonbullous choroidal detachments were treated in a conservative way. A rapid resolution of subretinal fluid and uveal effusion was observed in all cases. CONCLUSIONS: A conservative approach with acetazolamide treatment or just observation was used in our case series in choroidal detachment without substantial visual loss if, over time, slow improvement was documented. However, further studies are needed to verify the effectiveness of the reported therapy.
Asunto(s)
Efusiones Coroideas/cirugía , Presión Intraocular/fisiología , Esclerótica/cirugía , Esclerostomía/métodos , Síndrome de Efusión Uveal/diagnóstico , Vitrectomía/métodos , Adulto , Efusiones Coroideas/complicaciones , Efusiones Coroideas/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oftalmoscopía , Estudios Retrospectivos , Ultrasonografía , Síndrome de Efusión Uveal/fisiopatología , Síndrome de Efusión Uveal/terapiaAsunto(s)
Enfermedades de la Coroides/etiología , Síndrome de Efusión Uveal/complicaciones , Anciano , Enfermedades de la Coroides/diagnóstico , Enfermedades de la Coroides/fisiopatología , Angiografía con Fluoresceína , Humanos , Masculino , Líquido Subretiniano/diagnóstico por imagen , Tomografía de Coherencia Óptica , Síndrome de Efusión Uveal/diagnóstico , Síndrome de Efusión Uveal/fisiopatología , Agudeza Visual/fisiologíaRESUMEN
AIM: To describe an extensive scleral excision technique to treat uveal effusion in nanophthalmic eyes. METHODS: This prospective, interventional series of eight eyes of five consecutive patients with nanophthalmos underwent scleral window surgeries. Ninety per cent of the scleral thickness, extending from immediately behind the extraocular muscle insertions to the vortex veins for 3 and 1/4 quadrants, was removed. The main outcome measure was resolution of the uveal effusions. RESULTS: Eight eyes of five patients (one female and four male) with a mean age of 46 years were studied. The mean (range) axial length was 16.1 mm (14.6-17.6 mm), and the mean refractive error was +13.6 dioptres (+10.75 to +16.00 dioptres). Following scleral excision surgery, all uveal effusions resolved within an average (±SD) of 13.9 (±8.7) days. The uveal effusion recurred in only one eye that had a vasoproliferative retinal tumour. The mean best corrected visual acuity improved from 0.69 logarithm of the minimum angle of resolution (logMAR) (Snellen equivalent: 20/97) at baseline to 0.51 logMAR (Snellen equivalent: 20/64; Wilcoxon paired t-test: p=0.016) after a mean follow-up of 35.6 months. CONCLUSION: The circumferential scleral window technique produces rapid resolution of uveal effusion in nanophthalmic eyes. No adverse effects were noted after surgery and the clinical effect was durable through 1 year. TRIAL REGISTRATION NUMBER: NCT03748732.