Uveal Effusion Syndrome

Jd, Gass

doi:10.1097/00006982-198300330-00003

Cited by 101 publications

(16 citation statements)

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“…The diagnosis of uveal effusion syndrome (UES) was made based on these considerations, along with clinical features of combined choroidal and retinal detachments, leopard-spot pigmentation on FA, and exclusion of rhegmatogenous detachment, malignant conditions, and inflammatory disease, to the extent possible. In UES, abnormal transscleral protein outflow hypothetically results in extravascular choroidal protein accumulation, 1 which leads to exudative retinal and choroidal detachments. 2 With long-term fluid accumulation, retinal pigment epithelium hypertrophy and hyperplasia can occur, causing a leopard-spot pattern visible by FA.…”

Section: Discussionmentioning

confidence: 99%

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Intermittent Temporal Visual Field Loss in a Middle-aged Man

Al-Khersan

Villate²,

Davis

2019

JAMA Ophthalmol

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A 45-year-old man presented with floaters in his left eye and headaches for 2 months. He experienced left temporal field loss when lifting heavy objects. He took no medications and denied prior surgery, eye trauma, or pain. His best-corrected visual acuity was 20/25 OD and 20/30 OS. The only abnormalities on bilateral eye examination were 1+ levels of anterior vitreous cells and trace levels of posterior vitreous cells in the left eye, without vitreous haze, and a left retinal detachment extending from 1:30 to 10:00 o'clock, with macular involvement and without visible retinal tears. There were 360°left choroidal detachments.Optical coherence tomography showed choroidal thickening in both maculae. Fluorescein angiography (FA) of the right eye gave normal results. Figure 1A depicts the FA image of the left eye. On B-scan ultrasonography, there was a subclinical choroidal detachment superonasally in the right eye. An ultrasonographic image confirmed the detachments in the left eye (Figure 1B). The findings of a prior magnetic resonance image of the brain, chest radiographic image, and computed tomographic image of the chest were unremarkable. Test results for syphilis, tuberculosis, bartonella, and toxoplasma were negative, as were test results for inflammatory markers, quantitative serum proteins, and immunoglobulins.The patient started receiving 60 mg of oral prednisone daily. Three weeks later, his bestcorrected visual acuity worsened to 20/50 OS. A posterior sub-Tenon injection of 40 mg of triamcinolone acetonide was given, along with tapering doses of oral prednisone for 6 more weeks. There was further decline in visual acuity to 20/60 OS and worsening subretinal fluid.

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Section: Discussionmentioning

confidence: 99%

“…Surgery for UES was initially conceptualized as a decompression of the vortex veins. 1,6 Surgical technique has recently been reviewed. 7 Scleral thinning appears to be the essential intervention.…”

Section: Discussionmentioning

confidence: 99%

Intermittent Temporal Visual Field Loss in a Middle-aged Man

Al-Khersan

Villate²,

Davis

2019

JAMA Ophthalmol

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“…There is no known cause of UES, but many theories have been postulated. These include vortex vein compression, increased choroidal permeability, abnormal scleral collagen or decreased scleral permeability [3][4][5][6]. UES is classified into three types [7].…”

Section: Introductionmentioning

confidence: 99%

Comparing the Results of Vitrectomy and Sclerectomy in a Patient with Nanophthalmic Uveal Effusion Syndrome

2021

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Nanophthalmic uveal effusion syndrome (UES) is an extremely rare idiopathic disease characterized by a short axial length of the eye, extremely thick sclera and choroid. These structural changes can lead to spontaneous serous detachment of the retina and peripheral choroid. There are many other causes of UES such as trauma, inflammation, cataract surgery, glaucoma, or retinal detachment. UES is classified into three types. All are characterized by a relapsing-remitting clinical course. The loss of visual acuity ranges from mild to very severe, depending on macular involvement. Changes of the retinal pigment epithelium develop secondary after long-standing choroidal effusion and retinal detachment. Subretinal exudates could be seen and mistakenly diagnosed as chorioretinitis. UES can be very difficult to treat. The most commonly used treatment is surgery involving the creation of surgical sclerostomies (scleral window surgery) or partial thickness sclerectomies to support transscleral drainage. In our case, we present a bilateral nanophthalmic UES, which was misdiagnosed as bilateral ocular Vogt−Koyanagi−Harada disease. We documented the course of the disease and the results of the different surgical approaches in both eyes. A pars plana vitrectomy was performed in the right eye and a sclerectomy with sclerostomies in the left eye. In the left eye, even long lasting loss of visual acuity due to a serous retinal detachment was partially reversed.

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“…Impaired vascular drainage associated with scleral thickening is assumed to be the primary etiology. 6 Possible obstruction of the vortex veins and reduced transscleral drainage of protein rich fluid from the suprachoroidal space due to the thickened sclera is believed to be the major coverted cause. 3,7 The association between UES and nanophthalmic eyes was first established by Brockhurst.…”

Section: Introductionmentioning

confidence: 99%

“…UES could arise due to various ocular pathological states like postoperative hypotony, post scleral buckling surgery or posterior scleritis. 6 Medical management have been tried with oral acetazolamide and oral/topical prostaglandin analogues but the success is limited, and yet to be fully validated. 8 The management of these type of small eye phenotype represents a major surgical challenge to regulate the intraocular pressure (IOP)…”

Section: Introductionmentioning

confidence: 99%

Partial Thickness Sclerectomy for Uveal Effusion Syndrome in nanophthalmic eyes

et al. 2021

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Introduction: Nanophthalmos characterized by short axial length, high lens-to-eye ratio and thick sclera, is more prone to develop uveal effusion syndrome (UES). This rare entity can result in idiopathic exudative detachment of the choroid, ciliary body and retina. Abnormality in the scleral thickness with resultant obstruction of the vortex veins and reduced trans-scleral drainage of fluid is responsible for exudative retinal detachment (ERD). Methods: A retrospective study of UES in nanophthalmic patients treated with partial thickness sclerectomy in tertiary eye care centre from January 2015 to June 2019. Five eyes of five patients (four males and one female) with a diagnosis of nanophthalmos suffered from angle closure glaucoma associated with ERD. Raised intra-ocular pressure (IOP) not amenable to conservative medical management were subjected to surgery. Lamellar sclerectomy was performed in two or more quadrants without drainage which was judged on the basis of maximum amount of exudative fluid present in the subsequent quadrants. Results: The average age at surgery was 39.2 years and the mean follow-up duration was 9.2 months (6 to 18 months). Revision sclerectomy was required in 2/5 (60%) eyes. The serous fluid gradually resolved and retina remained reattached at the end of final follow up. The useful vision was preserved and IOP was normalized. Conclusion: Nanophthalmic UES remains a challenging clinical entity. Partial thickness sclerectomy may be an effective option in the treatment of nanophthalmic UES, not amenable to the conventional medical management in a low resource setup.

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Uveal Effusion Syndrome

Cited by 101 publications

References 0 publications

Intermittent Temporal Visual Field Loss in a Middle-aged Man

Intermittent Temporal Visual Field Loss in a Middle-aged Man

Comparing the Results of Vitrectomy and Sclerectomy in a Patient with Nanophthalmic Uveal Effusion Syndrome

Partial Thickness Sclerectomy for Uveal Effusion Syndrome in nanophthalmic eyes

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