OSLI Retina

May/June 2013

Issue link: http://osliretina.healio.com/i/129075

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■ T E C H N I Q U E ■ A Novel Technique for Choroidal Fluid Drainage in Uveal Effusion Syndrome Juliane Matlach, MD; Johannes Nowak, MD; Winfried Göbel, MD INTRODUCTION BACKGROUND AND OBJECTIVE: Uveal effusion syndrome (UES) is a rare disorder associated with thickening of the choroid and secondary retinal detachment as a possible serious complication. UES occurs in hypermetropic or nanophthalmic eyes or can be idiopathic and is a diagnosis of exclusion. Vortex vein decompression, sclerectomy or sclerotomy, and drainage of choroidal fluid are surgical treatment options. PATIENTS AND METHODS: The authors describe a novel surgical technique for drainage of serous choroidal detachment using a penetrating diathermy probe in two patients with UES. The procedure involves drainage of choroidal fluid by using a penetrating diathermy probe (2 mm tip length) after placing a 20-gauge infusion line in the anterior chamber. RESULTS: Choroidal fluid drainage was successful in both patients, with satisfactory outcome on follow-up. CONCLUSION: The proposed simple and feasible surgical drainage technique may improve the management of patients with UES. [Ophthalmic Surg Lasers Imaging Retina. 2013;44:274-277.] Uveal effusion describes an exudative fluid escape from the choriocapillaris into the suprachoroidal space causing choroidal detachment and secondary serous retinal detachment. Uveal effusion is a clinical sign rather than a diagnosis. Causes of uveal effusion include inflammation such as scleritis or uveitis, trauma or ocular surgery, as well as hypotony. If a choroidal detachment occurs in hypermetropic or nanophthalmic eyes, the term uveal effusion syndrome (UES) should be used. The term "idiopathic UES" is reserved for nonhyperopic and non-nanophthalmic eyes and should only be used after exclusion of the above-mentioned causes of uveal effusion.1 Early clinical features of uveal effusion are engorgement of the choroid, choroidal detachment, and secondary serous retinal detachment. Typical late signs include changes in the retinal pigment epithelium ("leopard spots") or choroid.1-3 Several studies have recommended sclerectomy as the surgical treatment of choice, although some patients have poor visual recovery despite anatomic success.1,4-6 Here, we describe a novel technique for drainage of choroidal fluid using a penetrating diathermy probe in two patients with UES. Case 1 A 72-year-old generally healthy woman was referred to the University of Würzburg Department of Ophthalmology in July 2012 complaining of blurred vision and the impression of a moving dense shadow in her left eye. On initial examination, best corrected visual acuity (BCVA) was 20/25 and intraocu- From the Department of Ophthalmology (JM, WG) and the Institute of Radiology, Division of Neuroradiology (JN), University of Würzburg, Germany. Originally submitted September 25, 2012. Accepted for publication March 20, 2013. The authors have no financial or proprietary interest in the material presented herein. Address correspondence to Juliane Matlach, MD, Department of Ophthalmology, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; +49-(0)931-201-0; Email: j.matlach@augenklinik.uni-wuerzburg.de. doi: 10.3928/23258160-20130503-11 274 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina

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