Uveal Effusion

Shah, Parth; Yohendran, Jayshan; Hunyor, Alex P.; Grigg, John; McCluskey, Peter

doi:10.1097/ijg.0000000000000329

Cited by 15 publications

(4 citation statements)

References 21 publications

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“…There has been one large case series studying medical management for uveal effusion, in 12 patients from a glaucoma center, in which 8 (67%) had angle closure and 6 (50%) had serous retinal detachment. [ 21 ] However, this case series did not represent true idiopathic UES as 3 (25%) had scleritis, 2 (17%) were drug-induced, 1 (8%) was related to Vogt–Koyanagi–Harada syndrome, and 1 (8%) had scleral amyloidosis. The authors indicated that only three patients had idiopathic UES.…”

Section: Discussionmentioning

confidence: 92%

“…The three eyes with idiopathic UES were all treated with surgical sclerectomy. [ 21 ] They indicated that management of uveal effusion should consider the underlying cause, whether it be inflammatory that might respond to systemic corticosteroids, drug-induced that relies on cessation of the causative drug, or abnormal sclera-related effusion that necessitates surgical scleral thinning procedures. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 4 10 11 12 13 14 15 16 17 18 19 20 ] There is very little information on the role of systemic or periocular corticosteroids (PCS) for UES and PubMed search for keywords “uvea,” “choroid,” “effusion,” and “steroid” yielded one case series in the English literature. [ 21 ] A major survey on UES indicated that “treatment with systemic steroids does not appear to be effective.”[ 4 ] The mechanism of corticosteroids for UES is unclear, but some speculate that there could be generalized reduction in inflammatory factors or control of transudation and edema by membrane stabilization. Herein, we evaluate the largest published cohort of UES cases ( n = 104 eyes), mostly referred for suspicion of uveal tumor, and we specifically investigate the role of local and systemic corticosteroids as a primary therapy for this rare condition.…”

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confidence: 99%

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Uveal effusion syndrome in 104 eyes: Response to corticosteroids – The 2017 Axel C. Hansen lecture

Shields

Roelofs

Nicola

et al. 2017

Indian J Ophthalmol

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Purpose:The purpose of the study was to investigate the corticosteroids for uveal effusion syndrome (UES).Methods:Retrospective series of 104 eyes with UES treated with oral corticosteroids (OCS), periocular corticosteroids (PCS), topical corticosteroids (TCS), or observation (OBS). Main outcome measure was UES resolution.Results:Of 104 eyes, treatment included OCS (n = 27), PCS (n = 12), TCS (n = 11), and OBS (n = 54). A comparison of the four groups (OCS vs. PCS vs. TCS vs. OBS) revealed differences in those managed with OCS versus OBS as younger (66 vs. 72 years, P = 0.049), PCS versus OBS as male (100% vs. 54%, P = 0.002), PCS versus OBS with decreased visual acuity (VA)/visual field (91% vs. 51%, P = 0.018), and OBS versus OCS as asymptomatic (28% vs. 0%, P = 0.001). Of the 59 with follow-up information, management included OCS (n = 21), PCS (n = 12), TCS (n = 6), and OBS (n = 20). There were differences in initial VA <20/400 in PCS versus OBS (42% vs. 5%, P = 0.018), effusion thickness in TCS versus OCS (7 vs. 3 mm, P = 0.004), and serous retinal detachment in PCS versus OBS (100% vs. 30%, P < 0.001) and PCS versus OCS (100% vs. 57%, P = 0.012). Regarding outcomes, VA showed less worsening in OCS versus OBS (0% vs. 30%, P = 0.008) and OCS versus PCS (0% vs. 33%, P = 0.012). There was no difference in rate of effusion resolution or effusion recurrence. Overall, using combination of corticosteroid therapies, effusion resolution was achieved in 56/59 (95%) cases and the need for surgical management with scleral windows was necessary in only 3/59 (5%) cases. Complications included cataract (n = 9) and no instance of steroid-induced glaucoma.Conclusion:Management of UES is complex and depends on disease severity. Using various corticosteroid delivery routes, UES control was achieved in 95%, and scleral window surgery was required in only 5%. A trial of corticosteroids can benefit patients with UES.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Uveal effusion syndrome in 104 eyes: Response to corticosteroids – The 2017 Axel C. Hansen lecture

Shields

Roelofs

Nicola

et al. 2017

Indian J Ophthalmol

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“…Surgical drainage should be considered for choroidal effusions that persist despite conservative treatment. Chronic non-resolving choroidal effusions cause failure of the pump mechanism of the retinal pigment epithelium, which may cause subsequent serous retinal detachment [12]. As the duration of choroidal effusion increases, the viscosity and amount of suprachoroidal fluid may also increase, making it more difficult for the fluid to be absorbed.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution of long-standing choroidal effusion after glaucoma drainage implant surgery without significant visual deterioration : a case report

Sung,

Lee,

et al. 2023

BMC Ophthalmol

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Background Choroidal effusion is a common complication of glaucoma surgery. Although most cases of choroidal effusions resolve spontaneously with observation or medical management alone as intraocular pressure normalizes, surgical drainage might be needed in severe or persistent cases. Herein, we report a case of spontaneous resolution of long-standing severe choroidal effusion after Ahmed glaucoma valve implantation. Case presentation An 85-year-old man with uncontrolled primary open-angle glaucoma and medical history of chronic kidney disease underwent uneventful Ahmed glaucoma valve implantation. On postoperative day 8, transient hypotony occurred, and large 360° peripheral choroidal detachments developed. Although the intraocular pressure increased to normal levels on postoperative day 15, choroidal effusion did not resolve. Fundus examination over 8 months showed that the large choroidal effusion persisted despite a well-controlled intraocular pressure. Laboratory test performed at preoperatively and follow-up period revealed persistently elevated potassium and creatinine levels. On postoperative 9 months, the lesion resolved spontaneously without any surgical intervention. We found that the patient’s creatinine level was normalized, pre-existing hyperkalemia was corrected, and accordingly his general condition was improved. Conclusions Considering the underlying medical condition may be helpful in patients with persistent choroidal effusion of an unclear etiology following glaucoma filtering surgery.

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Choroidal Effusions and Detachments

Waheed

Mendonça

Young

2022

Albert and Jakobiec's Principles and Practice of Ophthalmology

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Uveal Effusion

Abstract: Uveal effusion is a complex and poorly understood clinical entity with significant visual morbidity and is caused by a range of ocular and systemic diseases. Effective management is critically dependent on the underlying cause.

Cited by 15 publications

References 21 publications

Uveal effusion syndrome in 104 eyes: Response to corticosteroids – The 2017 Axel C. Hansen lecture

Uveal effusion syndrome in 104 eyes: Response to corticosteroids – The 2017 Axel C. Hansen lecture

Spontaneous resolution of long-standing choroidal effusion after glaucoma drainage implant surgery without significant visual deterioration : a case report

Choroidal Effusions and Detachments

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