Uveal effusion and ultrasonic imaging: a clinical series

Abstract

ABSTRACT.Purpose: To establish the diagnostic role of imaging by ultrasound for the diagnosis of uveal effusion syndrome. Methods: Using ultrasonic imaging features as the main criteria for evaluation, the recorded data from 16 patients with presumed uveal effusion seen between 1994 and 2000 were reviewed and analysed for clinical manifestations and current diagnostic suggestions. Eventually, as cumulating experience suggested that ultrasound is capable of indicating uveal effusion, the study set-up became in part more prospective. Results: The two main ultrasonic features found were: (1) extended multi-layered detachment patterns by B-scan, often kinetically mobile; (2) a spongy oedematous ciliary body region, often with interstitial lacunae, as demonstrated by high-resolution ultrasound biomicroscopy (50 Mhz). Conclusions: In patients with visual loss and ambiguous detachment-like fundus pathology, ultrasonic features are often of practical guidance for diagnosing uveal effusion syndrome.

Viagra-associated serous macular detachment

“…The characteristic findings of Vogt-KoyanagiHarada syndrome (VKH), including anterior uveitis, vitritis, and papillitis, were not present [27,28]. Characteristic findings of posterior scleritis, including mild anterior and posterior inflammatory response, choroidal or retinal folds, choroidal detachment, or scleral thickening with subtenons fluid and T-sign, on B-scan ultrasonography were not present in either patient [2,13,31]. Uveal effusion syndrome is an idiopathic cause of subretinal fluid typified by hyperopia, peripheral subretinal fluid, choroidal folds, and choroidal detachment and resistant to steroid treatment, which is in contradistinction to the findings described herein.…”

Uveal Effusion

“…Uveal effusion is often misdiagnosed at first presentation, with many patients referred for investigation of uveitis, tumor, and masquerade syndromes. 18 In this series, acute angleclosure crisis was initially attributed to pupil block, and retinal detachments were thought to be rhegmatogenous rather than serous. A correct diagnosis including the underlying cause of the uveal effusion is critical to guide effective management.…”

“…UBM allows excellent visualization of the anatomic relationship between the ciliary body, lens, iris, and angle structures. Fledelius et al 18 reported that in more subtle cases the anterior choroid has a thickened, spongy, or cystic appearance. UBM can reliably differentiate between the various causes of angle closure, including large annular uveal effusions which often mimic ciliary block due to aqueous misdirection.…”

Uveal effusion associated with an IgM lambda subtype monoclonal gammopathy

“…Ocular echography evidenced choroidal and retinal detachment and discard the characteristic "T-sign" of posterior scleritis, without showing the typical posterior shadow of melanoma on the internal hyperecogenicity of osteoma or metastasis. 2,5 Fluorescein angiography revealed signs of RPE imbalance with the typical "leopard spots" appearance. 2 Indocyanine green angiography assisted in the differential diagnostic with choroidal hemangioma.…”