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Results for “Choroidal Effusions”

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PubMedDate not supplied

Clinicopathologic features in two cases of multiple myeloma.

Multiple myeloma is a serious and fatal condition with various ocular manifestations. In two of these cases, pathologic findings included opaque ciliary body cysts, a ciliochoroidal effusion, retinal microaneurysms and hemorrhages, and detachment of both the sensory retina and the retinal pigment epithelium. In one case, a recanalized thrombus within a retrolaminar vein and direct continuity of a superonasal retinal detachment with a large pars plana cyst was observed. The proteinaceous material in the anterior chamber, ciliary body cysts, choroid and ciliary body, subretinal, and subretinal pigment epithelial areas was identified as immunoprotein using an immunoperoxidase technique.

Aneurysm↗

PubMed2004

[Ciliochoroidal effusion after remission of lens-induced glaucoma detected by ultrasound biomicroscopy].

PURPOSE: To report the results of ultrasound biomicroscopy(UBM) cases of ciliochoroidal effusion after a lens-induced glaucoma attack. CASES: Case 1 was an 83-year-old female. She had shallow anterior chamber with expanded cataract with exfoliation in her right eye. Intraocular pressure(IOP) of the right eye was 64 mmHg. On the next day, IOP was reduced to 16 mmHg by conservative therapy. UBM showed circumference ciliochoroidal effusion in the right eye. On the 5th day, IOP increased to 38 mmHg. UBM was repeated and showed the disappearance of ciliochoroidal effusion. On the 9th day, phacoemulsification was done to treat the lens induced glaucoma attack. Two weeks after operation, IOP of the right eye was 6 mmHg and UBM showed ciliochoroidal effusion. Case 2 was an 85-year-old female. She had been diagnosed by an ophthalmologist as having an attack of lens-induced glaucoma in her left eye. IOP was 46 mmHg. When she was referred to us, IOP was decreased to 24 mmHg and ciliochoroidal effusion was observed in her left eye by UBM. CONCLUSION: We report two cases of ciliochoroidal effusion associated with lens-induced glaucoma attack. UBM is useful to observe changes in the ciliary body after lens-induced glaucoma attack.

Aged↗

PubMed2003

Acute posterior multifocal placoid pigment epitheliopathy associated with a systemic necrotizing vasculitis.

PURPOSE: The authors present a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with a systemic necrotizing vasculitis with mixed features of Wegener granulomatosis and polyarteritis nodosa (PAN). METHODS: Case report. RESULTS: A 29-year-old woman developed a severe nosebleed, followed by a low-grade fever, night sweats, and a productive cough. One month later, she began experiencing high fevers, headache, myalgia, neck stiffness, and abdominal pain as well as bilateral blurred vision from APMPPE. Systemic evaluation revealed nasal ulcerations, bilateral pleural effusions, and a bilateral maxillary and ethmoid sinusitis, consistent with Wegener granulomatosis. However, ANCA testing was negative, and a renal and mesenteric angiogram showed aneurysmal dilatations suggestive of PAN. Her ocular and systemic symptoms markedly improved with systemic corticosteroids. CONCLUSIONS: The cause of APMPPE is unknown. This case of APMPPE associated with systemic necrotizing vasculitis provides support for the choroid as being primarily involved by a diffuse vasculitic process that interrupts choroidal perfusion and causes the characteristic fundus findings in APMPPE.

Adult↗

PubMed1982

Central serous choroidopathy with exudative retinal detachment.

An exudative retinal detachment that may be a severe type of central serous choroidopathy (CSC) developed in ten patients. These patients were all middle-aged, all but one were men, and all had a tendency of bilateral involvement. The retinal detachment was associated with doughnut-shaped exudative flecks, and the shifting of subretinal fluid with head position was observed in some cases. Fluorescein angiography revealed wide-ranged retinal pigment epithelial disturbances and effusive dye leakages, especially descending leakage. Treatment with steroids and antibiotics was ineffective, and photocoagulation resolved these conditions rapidly, otherwise spontaneous improvement occurred. The final visual outcomes were variable, and in some cases permanent visual loss occurred.

Adult↗

PubMed1989

Secondary intraocular lens implantation in eyes that experienced suprachoroidal hemorrhage during primary cataract surgery.

Six eyes that experienced acute intraoperative suprachoroidal hemorrhage or effusion (AISHE) during primary extracapsular cataract surgery have had secondary lens implantation. All secondary procedures were without recurrent AISHE and uneventful. The six patients achieved 20/30 or better corrected visual acuity. The key to these good results was the maintenance of an intact posterior capsule at the time of original surgery. This was accomplished with early rapid wound closure and no choroidal drainage.

Aged↗

PubMed1988

Ciliochoroidal effusion as precursor of suprachoroidal hemorrhage: a pathologic study.

Ciliochoroidal effusion and suprachoroidal (expulsive) hemorrhage both occur in hypotonic eyes and may be serious complications of intraocular surgery or other ocular perforations. Clinical observations have given rise to the suspicion that ciliochoroidal effusion may be a precursor of suprachoroidal hemorrhage, which has resulted in a change of recommended surgical management of the complications. In the present pathologic study, typical ciliochoroidal effusion is demonstrated at the stage at which rupture of stretched posterior ciliary arteries makes suprachoroidal hemorrhage imminent. Our observations morphologically support the clinical conclusions of Maumenee and Schwartz.

Aged↗

PubMed1998

Papillomas and carcinomas of the choroid plexus in children.

OBJECT: Choroid plexus tumors are rare intraventricular tumors (1% of all intracranial tumors) that occur mainly in children. The pathophysiological characteristics of associated hydrocephalus, surgical management, and oncological issues related to these tumors remain a matter of debate. To understand more about these tumors, the authors have reviewed their experience with the management of 38 children with choroid plexus tumors. METHODS: There were 25 cases of papilloma and 13 of carcinoma. The mean age of the patients at presentation was 22.5 months, and one-half of the patients were younger than 2 years of age. Hydrocephalus was present in 33 patients and poorly correlated with the size, site, and pathological characteristics of the tumor. In nine children, a ventriculoperitoneal shunt was required after tumor excision, calling into question the notion that cerebrospinal fluid oversecretion is the only cause of hydrocephalus. Complete excision was achieved in 96% of the cases of papilloma and 61.5% of the cases of carcinoma. These surgical procedures were complicated by the risks of intraoperative hemorrhage, which proved to be fatal in two cases, and postoperative brain collapse, which led to subdural fluid collections requiring subdural shunt placement in six patients. Preoperative embolization was partially successful in four cases and significantly assisted surgery. Preoperative controlled drainage of excessively dilated ventricles and intraoperative gluing of the cortical incision have been used to address the problem of postoperative brain collapse. Patients with carcinomas were treated postoperatively by chemotherapy alone (seven cases), radiotherapy (one case), or chemotherapy plus radiotherapy (one case). The overall 5-year survival rate was 100% for patients with papillomas and 40% for those with carcinomas. CONCLUSIONS: Total surgical excision is curative in cases of papillomas. For carcinomas, the most effective treatment remains total surgical excision; however, adjuvant treatment in the form of chemotherapy in patients younger than age 3 years, supplemented by radiation therapy in older children, can moderately reduce the risk of recurrence.

Adolescent↗

PubMed1982

Syphilitic retinal detachment and uveal effusion.

A 32-year-old man developed a recurrent nonrhegmatogenous retinal detachment, uveal effusion, and visual loss as a result of latent secondary syphilis. Treponemes were found in the subretinal fluid and the Treponema pallidum hemagglutination test demonstrated substantially higher titers in the subretinal fluid than in the serum (1: 2,569 vs 1: 16). Despite scleral dissection and a scleral implant and treatment with penicillin, the patient's visual loss persisted and the last examination showed a thickened choroid, a flat nonrhegmatogenous retinal detachment, and reaccumulation of subretinal fluid.

Adult↗

PubMed2005

Microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach.

BACKGROUND: Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications. METHODS: Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen, the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed. RESULTS: Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%). CONCLUSIONS: Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.

Adolescent↗

PubMed2002

Ultrasound biomicroscopy in eyes with anterior chamber flattening after trabeculectomy.

BACKGROUND: Information about changes in the trabeculectomy ostium and adjacent structures related to flattening of the anterior chamber in the early postoperative period may be important for management. We assessed the ostium and adjacent structures by means of ultrasound biomicroscopy (UBM) in order to identify common patterns related to postoperative flattening of the anterior chamber. METHODS: We studied 15 eyes of 15 consecutive patients. A first UBM examination was performed when the patient was referred. Changes in the ostium (evidence of tissue adhesions to the ostium) were evaluated with UBM after the chamber flattening resolved, at least 60 days after the first examination. The following features were noted: depth of the anterior chamber, size and patency of the ostium, rotation of ciliary processes, presence of uveal effusion and ultrasound functioning of the bleb. RESULTS: All the patients had ring-shaped ciliochoroidal effusions; in nine eyes the effusions were found only with UBM. In four eyes an anterior-posterior deformation of the ostium was found. Synechiae in the ostium were identified in the three eyes in which iris remnants had been recognized at the site on the initial UBM examination. INTERPRETATION: Our observations confirm the presumed pathophysiology of flat anterior chamber without bleb leak. Ring-shaped effusions were detected on UBM even in cases in which conventional ultrasonography showed no positive results. UBM is a helpful tool in the diagnosis and management of flattening of the anterior chamber after trabeculectomy.

Anterior Chamber↗

PubMed1999

Ultrasound biomicroscopy in the diagnosis of supraciliochoroidal fluid after trabeculectomy.

PURPOSE: To report supraciliochoroidal effusion after trabeculectomy with the use of ultrasound biomicroscopy. METHODS: In a prospective study, 28 eyes of 19 patients with primary open-angle glaucoma that underwent trabeculectomy were evaluated preoperatively and postoperatively by ultrasound biomicroscopy. RESULTS: Four eyes showed a hypoechogenic suprachoroidal space that remained stable for 6 months postoperatively. These four eyes had intraocular pressures of 11 mm Hg or less on no antiglaucoma medications and without signs of choroidal detachment. CONCLUSION: Ultrasound biomicroscopy proved to be a useful method of detecting, after trabeculectomy, supraciliochoroidal fluid without clinically detectable choroidal detachment. This fluid may signify an iatrogenic cyclodialysis during surgery or, less likely, subclinical ciliochoroidal detachment.

Anterior Chamber↗

PubMed1983

Uveal effusion syndrome. A new hypothesis concerning pathogenesis and technique of surgical treatment.

It is hypothesized that the primary underlying cause of the idiopathic uveal effusion syndrome is a congenital anomaly of the sclera, and in some cases, the vortex veins. Superimposed aging and hormonal changes in the sclera and its emmissary channels impair its permeability to protein and predispose the eye to vortex vein obstruction. The inability of the eye to transport extravascular protein across the abnormal sclera is probably the cause of prolonged exudative detachment of the uvea and retina in these patients. Partial thickness sclerectomies and sclerostomies without choroidal puncture in each quadrant near the equator caused prompt resolution of long-standing uveal and bullous retinal detachment in two eyes.

Choroid↗

PubMed1983

Uveal effusion syndrome: a new hypothesis concerning pathogenesis and technique of surgical treatment.

It is hypothesized that the primary underlying cause of the idiopathic uveal effusion syndrome is a congenital anomaly of the sclera, and in some cases, the vortex veins. Superimposed aging and hormonal changes in the sclera and its emissary channels impair its permeability to protein and predispose the eye to vortex vein obstruction. The inability of the eye to transport extravascular protein across the abnormal sclera is probably the cause of prolonged exudative detachment of the uvea and retina in these patients. Partial thickness sclerectomies and sclerostomies without choroidal puncture in each quadrant near the equator caused prompt resolution of long-standing uveal and bullous retinal detachment in two eyes.

Choroid↗

PubMed2001

Uveal effusion after cataract surgery: an echographic study.

PURPOSE: To determine the incidence of uveal effusion after cataract surgery and to relate its presence to selected preoperative, intraoperative, and postoperative variables. DESIGN: Prospective consecutive observational case series. PARTICIPANTS: Two hundred seven eyes of 205 subjects undergoing cataract surgery. METHODS: Several preoperative, intraoperative, and postoperative variables of potential significance in uveal effusion after cataract surgery were studied. On the first postoperative day and within 2 weeks after the surgery, subjects were examined clinically and echographically with B-scan for evidence of suprachoroidal (uveal) effusion. When effusion was present, follow-up examinations were performed until complete resolution was documented. MAIN OUTCOME MEASURES: Echographic presence of uveal effusion in the postoperative period. RESULTS: Uveal effusion was documented echographically in 12 patients (5.8%). Only one of these cases was clinically evident. All effusions were small and resolved with no intervention. The presence of postoperative hypotony related to wound leak (intraocular pressure <10 mmHg) was significantly correlated with uveal effusion after cataract surgery (P<0.0001). The combination of oral acetazolamide and topical pilocarpine gel given after the surgery also correlated with effusion (P<0.02). Intraoperative complications and prolonged phacoemulsification time were not shown to be risk factors for effusion. CONCLUSIONS: Uveal effusion is rarely seen after modern, small-incision, closed-system cataract surgery. It is correlated with postoperative hypotony related to wound leak and with the administration of both oral acetazolamide and topical pilocarpine after surgery.

Acetazolamide↗

PubMed2002

Posterior segment changes associated with posterior microphthalmos.

PURPOSE: To characterize and analyze the posterior segment ocular involvement in patients with posterior microphthalmos. DESIGN: Retrospective observational case series. PARTICIPANTS: Eighteen patients (8 sporadic cases and 10 siblings from 5 different families) between the age of 4 and 36 years with posterior microphthalmos. METHODS: Records of patients with posterior microphthalmos over a 5-year-period were reviewed, including clinical, fundus photographic, fluorescein angiographic, and ultrasonographic findings, and management. RESULTS: All patients had bilateral foreshortening of the posterior ocular segment (range, 7--11.2 mm) with associated high hyperopia (range, +12.00--+19.00 diopters) and normal or slightly smaller than normal anterior segment dimensions. Visual acuity ranged from 20/200 to 20/40. Inheritance of this syndrome was compatible with an autosomal recessive pattern. Posterior segment changes included bilateral elevated papillomacular retinal fold (13 patients, 72.2%); fine retinal folds (6 patients, 33.3%); chorioretinal folds (11 patients, 61.1%); uveal effusion syndrome (3 patients, 16.7%); pigmentary retinopathy (4 patients, 22.2%), including retinitis punctata albescens in 1 patient; absence or marked reduction of the capillary-free zone (18 patients, 100%); crowded optic discs (18 patients, 100%); and sclerochoroidal thickening on ultrasonography (18 patients, 100%). Two patients with uveal effusion were successfully treated with scleral surgery. CONCLUSION: A wide variety of congenital or acquired posterior segment changes may be encountered in patients with posterior microphthalmos. Although high hyperopia and elevated papillomacular retinal fold are the main causes of visual impairment, other chorioretinal changes, such as pigmentary retinopathy, chorioretinal folds and uveal effusion syndrome, should be considered as causes of visual disturbance in patients with posterior microphthalmos. Early ultrasonographic diagnosis, close follow-up, and appropriate management are mandatory to improve or maintain visual function in such patients.

Adolescent↗

PubMed1991

[Serous retinal detachment in O2 therapy of primary pulmonary hypertension].

Primary pulmonary hypertension (PPH) is a rare disease, which almost inevitably leads to right-sided heart failure and death. This is to our knowledge the first report of ophthalmological complications. A 43-year-old woman in the late stage of PPH who had been continuously treated with oxygen developed an uveal effusion syndrome, which manifested as bilateral central serous retinal detachment and ciliochoroidal swelling. The serous detachment improved promptly after interruption of the oxygen therapy and again worsened when it was resumed because of massive dyspnea. Systemic blood pressure was 115/95. Right-sided cardiac catheterization revealed a systolic pulmonary arterial pressure of 110 mmHg. Pulmonary function tests showed a normal PO2 with oxygen and a light hypoxia without therapy. We came to the following conclusions: First, the central serous retinal detachment and peripheral choroidal swelling were induced by the striking increase in pulmonary arterial pressure, which almost equaled the systemic arterial pressure. Although the same ophthalmological findings have been reported in experimental animals after exposure to pure oxygen, pulmonary function tests disproved high oxygen concentration as the causative agent in our patient. Second, the improvement of pigment epithelial function after the interruption of oxygen therapy could be explained by the following hypotheses. Hypoxia induced a dilation of the choroidal arteries, followed by an improved supply of nutritive material for the pigment epithelium. There is experimental evidence that glucose might be the limiting metabolite of pigment epithelial function.

Adult↗

PubMed1996

Risk factors for ciliochoroidal effusion after panretinal photocoagulation.

PURPOSE: To determine the incidence, duration, and risk factors for ciliochoroidal effusion after panretinal photocoagulation. METHODS: Thirty-nine consecutive patients with diabetic retinopathy underwent ultrasound biomicroscopy of both eyes to image the ciliochoroidal space immediately before and 1 day after unilateral argon-green panretinal photocoagulation. Imaging was repeated on days 3, 7, and 14 in patients in whom ciliochoroidal effusion developed. RESULTS: Low-lying ciliochoroidal effusions were imaged in 23 (59%) of 39 eyes. Of 23 eyes, effusions resolved in 6 (26%), 12 (52%), and 5 (22%) eyes by 3, 7, and 14 days respectively. The number of laser applications (P = 0.02), shorter axial length (P = 0.01), and percentage of retinal surface area treated (P = 0.02) were associated with systemic hypertension, location of treatment, previous panretinal photocoagulation of cataract surgery, retinal surface area treated, and mean blood pressure before photocoagulation were not associated with effusion. All fellow, untreated eyes remained effusion-free. CONCLUSION: Ciliochoroidal effusion develops commonly after panretinal photocoagulation. Limiting the number of laser applications and the percentage of retinal surface area treated reduces the likelihood of this complication. Eyes with shorter axial lengths are at higher risk

Adult↗

PubMedDate not supplied

Delayed suprachoroidal hemorrhage following viscocanalostomy.

Delayed suprachoroidal hemorrhage is a rare complication of conventional glaucoma surgery. Viscocanalostomy is one of the new surgical techniques used in glaucoma surgery that may theoretically protect against suprachoroidal effusion and hemorrhage due to the nonpenetrating nature of the procedure. Delayed suprachoroidal hemorrhage developed in a 92-year-old white woman following viscocanalostomy. This case demonstrates that the risk of suprachoroidal hemorrhage may not be completely eliminated after a nonpenetrating glaucoma procedure such as viscocanalostomy.

Aged↗