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Results for “Choroidal Effusions”

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At least 73 records · Page 4Linked to original sources

PubMed2006

Two cases of uveal effusion syndrome.

PURPOSE: To report a case of uveal effusion syndrome associated with hypotony and a case of uveal effusion syndrome in nanophthalmos. METHODS: The first case was a 25-year-old man who presented with decreased visual acuity in the left eye and hypotony. Fundus examination revealed choroidal effusion and retinal detachment with a thickened eyeball. Partial thickness sclerotomy and sclerectomy were performed. The second case was a 13-year-old boy who had uveal effusion syndrome with a nanophthalmic eye. RESULTS: In the patient with hypotony, intraocular pressure was well maintained following partial thickness sclerotomy and sclerectomy, and choroidal effusion and retinal detachment were reduced. The visual acuity of the nanophthalmic patient was well maintained during a 3-year follow-up period without treatment. CONCLUSIONS: appropriate treatment modalities should be considered depending on the ophthalmic condition of the individual patient.

Adolescent↗

PubMed1988

Choroidal hematoma and effusion: evaluation with MR imaging.

To evaluate the usefulness of magnetic resonance (MR) imagining in the evaluation of choroidal pathologic conditions, the authors studied 15 patients with either choroidal hematoma or choroidal effusion with a 1.5-T MR imager. These two lesions were reliably distinguished from each other on the basis of MR findings. Choroidal hematomas appeared as lenticular-shaped masses in the wall of the eyeball, and signal intensity depended on the age of the hematoma. Choroidal effusions appeared as crescentic or ring-shaped areas of increased signal on both T1- and T2-weighted images in an anatomic distribution corresponding to the choroidal and suprachoroidal spaces.

Adult↗

PubMed1982

Nanophthalmos with uveal effusion: clinical and embryologic considerations.

Three brothers were found to have nanophthalmos as evidenced by marked hyperopia, decreased global axial length, and shallow anterior chambers. The thickness of the lens, measured with A-scan ultrasound biometry in two cases, was much greater than normal. Choroidal thickening with shallow retinal detachments without breaks was found in those patients. Fluorescein angioscopy demonstrated leaks beneath the serous retinal detachments in one. The spontaneous presence of choroidal effusions and retinal detachments in nanophthalmic patients has been reported only rarely. The present findings emphasize that careful examination of the posterior segment should be done prior to anterior segment surgery in these patients to alert the surgeon to the possibility of serious intra- and post-operative choroidal effusions and retinal detachments. An attempt is made to explain some of the clinical findings in nanophthalmos by extrapolating from results obtained on experimental animals. It is postulated that the increased lens size in nanophthalmos may be due to the abnormal accumulation of a factor influencing lens fiber differentiation. The overall small size of the eye may be the result of the formation of a smaller than usual optic vesicle anlage.

Aged↗

PubMedDate not supplied

A case of acute angle-closure glaucoma secondary to posterior scleritis in patient with Sturge-Weber syndrome.

BACKGROUND: Sturge-Weber syndrome has been known to be frequently associated with facial cutaneous angioma and ipsilateral glaucoma. However, as far as we know, no cases accompanied by acute angle-closure glaucoma have been reported in patients with Sturge-Weber syndrome. CASE: A 14-year-old boy with unilateral acute angle-closure glaucoma secondary to posterior scleritis associated with Sturge-Weber syndrome is described. OBSERVATIONS: Slit-lamp examination revealed diffuse episcleral venous hemangioma in the right eye. With ultrasound biomicroscopy, a forward shift of the lens-iris diaphragm, a swelling of the ciliary body, and an anterior rotation of the ciliary processes with annular choroidal effusion were detected. The patient responded well to treatment with systemic corticosteroids and cycloplegics. CONCLUSIONS: In our patient, inflammatory changes of the sclera, including swelling of the ciliary body, choroidal effusion, an anterior rotation of the ciliary processes at the scleral spur, and swelling of the lens, leading to closure of the anterior chamber angle, were suggested to be the major mechanisms of intraocular pressure elevation.

Acute Disease↗

PubMed1999

Ciliary body detachment caused by capsule contraction.

A 74-year-old woman developed capsule contraction associated with hypotony and choroidal effusion 18 months after uneventful phacoemulsification with 3-piece poly(methyl methacrylate) intraocular lens implantation. Ultrasound biomicroscopy revealed ciliary body detachment and stretched zonules. A radial neodymium: YAG anterior capsulotomy was performed, resulting in the resolution of the ciliary body detachment and choroidal effusion as well as in normal intraocular pressure over 4 days.

Aged↗

PubMed2001

Angle-closure glaucoma in association with orbital pseudotumor.

PURPOSE: To describe the pathophysiology of angle-closure glaucoma secondary to idiopathic inflammatory orbital pseudotumor. DESIGN: Retrospective, small noncomparative case series. PARTICIPANTS: Three patients with angle-closure glaucoma and orbital pseudotumor. METHODS: The pathophysiology of this entity was investigated using magnetic resonant imaging (MRI) and ultrasound biomicroscopy (UBM). MAIN OUTCOMES MEASURES: Clinical features, anterior chamber angle configuration, and intraocular pressure. RESULTS: Angle closure from anterior rotation of the ciliary body caused by choroidal effusions secondary to pseudotumor was demonstrated using MRI and UBM. Two of the three cases resolved after treatment for orbital pseudotumor. CONCLUSIONS: Idiopathic orbital pseudotumor is a cause of secondary angle-closure glaucoma. The mechanism of angle closure is anterior rotation of the ciliary body secondary to choroidal effusions resulting from the orbital inflammation.

Adult↗

PubMed2003

Malignant glaucoma due to drug-related angioedema.

PURPOSE: To report postsurgery angioedema resulting in malignant glaucoma. Interventional case report. METHODS: Three hours after uncomplicated cataract surgery on the right eye, a 61-year-old woman developed angioedema with swelling of the parapharyngeal tissue. Visual acuity deteriorated, and tonometry revealed an intraocular pressure of 60 mm Hg, with shallow anterior chambers, in both eyes. RESULTS: Ultrasound showed choroidal effusion on both eyes. Intraocular pressure could only be controlled surgically by procedure to deepen the anterior chamber. The angioedema regressed after withdrawal of candesartan, an angiotensin II antagonist that the patient had taken for 1 year. CONCLUSIONS: Angioedema without urticaria is well documented in patients receiving angiotensine-converting enzyme inhibitors or angiotensin II antagonists. Drug-related angioedema may lead to a choroidal effusion syndrome with malignant glaucoma. Surgical intervention may trigger angioedema. Most important in treatment is withdrawal from the implicated medication and control of intraocular pressure.

Angioedema↗

PubMed1996

Venous obstruction as the cause of retinal/choroidal dysfunction associated with arteriovenous shunts in the cavernous sinus.

OBJECTIVE: To determine the hemodynamic abnormalities that result in visual acuity loss because of retinal or choroidal dysfunction associated with arteriovenous shunts (AVS) that involve the cavernous sinus. METHODS: Retrospective study of the records of 250 patients with either a carotid cavernous fistula or dural arteriovenous malformation revealed a total of 10 patients with vision loss secondary to retinopathy (group I) or choroidal effusion (group II). The cerebral angiograms of these 10 patients and 10 additional patients with visual dysfunction due to elevated intraocular pressure (group III) were evaluated to determine whether the three groups could be distinguished by a specific vasculopathic pattern. Particular attention was given to the extent of thrombosis in the ophthalmic venous system and cavernous sinus. RESULTS: There were angiographic signs of severe thrombosis in the ophthalmic vein in nine patients and in the cavernous sinus in seven patients ipsilateral to the retinal or choroidal lesion. In contrast, in group III, severe thrombosis in the ipsilateral ophthalmic vein and in the cavernous sinus occurred in one and two patients, respectively. Closure of the AVS improved the visual acuity in 1 of 4 patients in group I and in 4 of 5 patients in group II, and normalized the intraocular pressure in all patients. CONCLUSIONS: Ophthalmic vein thrombosis, rather than arterialization of the venous system or an arterial "steal, " is the principal cause of retinal or choroidal dysfunction associated with AVS to the cavernous sinus. Following AVS closure, visual recovery is more frequent with choroidal effusion or detachment rather than with retinopathy.

Adult↗

PubMed1996

Retinal complications after aqueous shunt surgical procedures for glaucoma.

OBJECTIVES: To assess retinal complications and to identify risk factors for retinal complications following aqueous shunt procedures. MATERIALS AND METHODS: Records of 38 consecutive aqueous shunt procedures that were performed on 36 patients at the Eye Institute of the Medical College of Wisconsin, Milwaukee, from June 1993 to March 1995 (minimum follow-up, 6 months) were reviewed. The mean +/- SD follow-up was 11.4 +/- 5.2 months (median, 10.5 months). RESULTS: Twelve patients (32%) had the following retinal complications: 4 serous choroidal effusions (10%) that required drainage, 3 suprachoroidal hemorrhages (8%), 2 vitreous hemorrhages (5%), 1 rhegmatogenous retinal detachment (3%), 1 endophthalmitis (3%), and 1 scleral buckling extrusion (3%). Surgical procedures for retinal complications were required in 8 (67%) of these 12 patients. Visual acuity decreased 2 lines or more in 9 (75%) of these 12 patients. The median onset of a postoperative retinal complication was 12.5 days, with 10 patients (83%) experiencing complications within 35 days. Serous choroidal effusions developed in 10 other patients (26%), and these effusions resolved spontaneously. Visual acuity decreased 2 lines or more in 2 (20%) of these additional 10 patients. Patients who experienced serious retinal complications were significantly older, had a higher rate of hypertension, and postoperative ocular hypotony. Serious retinal complications were distributed evenly among patients with Krupin valves with discs and Molteno and Baerveldt devices. Experience with the Ahmed glaucoma valve implant was limited. CONCLUSION: Aqueous shunt procedures may be associated with significant retinal complications and subsequent visual loss.

Adult↗

PubMed2002

Cavernous sinus dural arteriovenous malformations: patterns of venous drainage are related to clinical signs and symptoms.

OBJECTIVE: To provide evidence that venous congestion and drainage patterns are responsible for the manifestations of cavernous sinus area dural arteriovenous malformations (CSdAVMs). DESIGN: Retrospective observational case series. PARTICIPANTS: Records of 85 patients with complete clinical and angiographic evaluations of CSdAVMs were evaluated for the clinical features of the disorder. A neuroradiologist analyzed patterns of venous drainage to and from the cavernous sinus without knowledge of the clinical features. Four venous drainage patterns (reversal of flow from the CSdAVMs into the anterior cavernous sinus, ophthalmic vein thrombosis, drainage into the inferior petrosal sinus or drainage into the superior petrosal sinus) were statistically tested for their predictive value of signs and symptoms using logistic regression. MAIN OUTCOME MEASURES: The power of prediction of orbital congestion, elevated IOP, extraocular muscle dysfunction, optic neuropathy, venous-stasis retinopathy, choroidal effusion, anterior chamber shallowing, bruits, cranial nerve paresis, and central nervous system dysfunction from four patterns of venous drainage. RESULTS: Reversal of drainage into the anterior cavernous sinus and ophthalmic veins was highly predictive (P = 0) of orbital congestion, which was seen in 77 (91%) patients. In contrast, eight (9%) patients without orbital congestion had shunts that did not drain into the anterior cavernous sinus and ophthalmic veins. Cavernous sinus dural arteriovenous malformation drainage into the anterior cavernous sinus and ophthalmic veins also predicted elevated IOP (P = 0.0023) and optic neuropathy (P = 0.047). Ophthalmic vein thrombosis significantly predicted cases with choroidal effusion (P = 0.002) and anterior chamber shallowing (P = 0.01). Third nerve paresis could be predicted from flow toward the inferior petrosal sinuses (P = 0.017). Central nervous system symptoms or dysfunction, occurring in 7 (8%) patients, was predicted by venous drainage into the superior petrosal sinus (P = 0.0008). CONCLUSIONS: The clinical features found in patients with CSdVAMs are related to the abnormal venous drainage and can be predicted by these venous drainage patterns. Venous congestion and hypertension seem to cause the clinical dysfunction in this disorder.

Aged↗

PubMed2004

Uveal effusion following laser in situ keratomileusis (LASIK) for hypermetropia.

PURPOSE: To describe the first reported cases of uveal effusion syndrome following laser in situ keratomileusis (LASIK). DESIGN: Interventional case reports. METHODS: A 50-year-old woman developed bilateral submacular choroidal folds with subtle fluid elevation of the macula on the first day following uneventful LASIK for hypermetropia. A 48-year-old man developed right, prominent, 360-degree, peripheral choroidal effusions and submacular choroidal and retinal folds several months following LASIK for hypermetropia. RESULTS: Case 1 was treated with systemic diclofenac and case 2 with systemic prednisolone. Both cases showed gradual improvement in vision over several weeks, returning to best-corrected visual acuity of 6/6. CONCLUSIONS: Uveal effusion syndrome is a previously unreported complication that may occur following LASIK for hypermetropia.

Choroid Diseases↗

PubMed1999

Glaucoma in Sturge-Weber syndrome.

BACKGROUND: In glaucoma associated with Sturge-Weber syndrome (SWS), medical treatment often fails to control intraocular pressure, thus requiring surgical intervention that may result in serious complications. METHODS: Eighteen consecutive patients with SWS were reviewed retrospectively at the King Khaled Eye Specialist Hospital. An intraocular pressure less than 20 mm Hg, plus stable optic nerve cup-to-disc ratio and corneal diameter (or visual fields where appropriate), were parameters chosen to indicate that the glaucoma was being controlled. RESULTS: Glaucoma was found in 15 of 18 patients (22 eyes). The mean follow-up time was 62 months (range, 12 to 148 months). Medical treatment alone was successful in 5 patients (7 eyes); the remainder required surgical intervention. The initial surgical procedures included cyclocryotherapy, YAG laser goniotomy, surgical goniotomy, and trabeculotomy or trabeculectomy. Eight eyes required subsequent surgery, 5 with Molteno or Ahmed implants. Early postoperative choroidal effusion and hemorrhage occurred in 4 eyes and resolved spontaneously. Hemorrhagic choroidal detachment with total retinal detachment developed in 2 patients 3 to 5 months after surgery. In 1 patient a recurrent serous choroidal detachment after suture lysis was associated with total optic atrophy. CONCLUSIONS: Glaucoma in SWS is common. Control of glaucoma was successfully achieved with medical treatment in 7 of 22 eyes of our 15 SWS-glaucoma patients, and we consider it the initial treatment of choice. Of the 15 eyes that required surgery, late postoperative complications resulted in loss of vision as a result of persistent postoperative hypotony in 3 eyes that underwent surgical procedures.

Adolescent↗

PubMed1998

High-resolution ultrasound biomicroscopy of the pars plana and peripheral retina.

OBJECTIVE: This study aimed to evaluate the ability and role of ultrasound biomicroscopy in imaging the peripheral retina, pars plana, and anterior choroid. DESIGN: The study design was a case series. PARTICIPANTS: Seventeen eyes of 17 patients with a variety of clinical diagnoses involving the anterior portion of the posterior segment were studied. INTERVENTION: High-frequency (50 MHz), high-resolution (50 microns) ultrasound biomicroscopy was performed. RESULTS: Ultrasound biomicroscopy was capable of imaging the peripheral retina, pars plana, and anterior choroid. Images had features consistent with known histopathology. Retinoschisis consisted of one thin hyper-reflective echo and could be differentiated from a retinal detachment, which was thicker and formed a bilayered echo. A choroidal effusion could be identified as an echolucent space within the suprachoroidea, whereas a choroidal hemorrhage was moderately echodense. Inflammatory diseases, such as a sarcoid granuloma, pars planitis, and Harada's disease, were characterized by different forms of uveal thickening. A ciliochoroidal nevus was internally hyporeflective and could be measured accurately and localized. CONCLUSIONS: Imaging of the peripheral retina, pars plana, and anterior choroid is possible with ultrasound biomicroscopy and may aid in the diagnosis and management of pathology involving this region.

Adolescent↗

PubMed1990

Retinal detachment adherent to posterior chamber IOL after Molteno implant surgery.

A patient with refractory glaucoma 1 year after cataract extraction and trabeculectomy had Molteno implant surgery. Three days after surgery a kissing choroidal effusion and retinal detachment adherent to the posterior chamber IOL were detected. Repeated choroidal taps were unsuccessful. Removal of the Molteno implant, vitrectomy, and silicone oil injection were required to reattach the retina.

Cataract Extraction↗

PubMed1989

Silicone tubes in glaucoma surgery: the effect of technical modifications on early postoperative intraocular pressures and complications.

One hundred and nineteen eyes with glaucoma were treated by implantation of silicone rubber tubes draining either to encircling inverted gutters (92 eyes) or to integral plates sutured at the equator of the globe. The occurrence of persistent choroidal effusion was related significantly (S less than 0.01) to post-operative hypotony and choroidal haemorrhage appeared to occur during periods of ocular hypotony. This paper describes our surgical modifications to overcome these problems. A one-piece integral tube and plate with a slit-valve mechanism designed to regulate post-operative intraocular pressure had a very variable response in 27 eyes, with mean pressures similar to those after unligated tube and gutters. Ligation of the tube in 34 eyes caused significantly higher mean intraocular pressures on the first two days after surgery than that in 43 eyes without ligation and the incidence of ocular hypotony (less than 7 mmHg) was significantly lower after ligation. However, five eyes with ligated tubes required operative release of the suture because of uncontrollably raised intraocular pressures. Venting of the drainage tube on the anterior chamber side of the occlusive ligation in 15 eyes caused fewer cases of raised post-operative intraocular pressures, but also a moderate increase in the frequency of ocular hypotony. At present a combination of occlusive ligation and a venting stab into the drainage tube in a one-piece tube and plate system appears to be the best design for avoiding short-term ocular hypotony whilst achieving long-term pressure control.

Adolescent↗

PubMed1981

Two cases of suspected familial erythrophagocytic lymphohistiocytosis.

We studied two children who died of suspected familial erythrophagic lymphohistiocytosis. The first child, a 7-year-old boy, had fever, diffuse pulmonary infiltrates, bilateral choroidal effusions, diabetes insipidus, and marked meningitis with increased cerebrospinal fluid protein. Ocular histologic studies disclosed diffuse choroidal infiltrates consisting of atypical mononuclear cells with foamy cytoplasm. Similar histologic changes were seen in the lungs, liver, brain, and kidneys. The second child, the 5-year-old male cousin of Patient 1, had fever, hepatosplenomegaly, pulmonary infiltrates, and cerebrospinal fluid pleocytosis. Histologic changes were similar to those in the first case, but viral particles of the herpes simplex virus group were noted in brain tissue as well. The findings of virus particles in this histiocytic proliferative disease suggested a defect in the inflammatory response in these patients.

Child↗

PubMed1996

Transvitreal endocyclophotocoagulation.

PURPOSE: Transvitreal endophotocoagulation of the ciliary processes is a little-used option for eyes with refractory glaucoma. No histopathologic studies of animals or humans have described its effects. We sought to characterize this cilioablative procedure in an animal model, examine its effects in human eyes histopathologically, and evaluate its clinical safety and efficacy in a large series of patients with long-term follow-up. METHODS: ANIMAL MODEL: Rabbit eyes were treated with lensectomy, vitrectomy, and transvitreal photocoagulation of the ciliary processes. Eyes were enucleated immediately after surgery and at weekly intervals up to 1 month. Light and electron microscopic evaluation of histopathologic changes was performed. Human Eyes: The pathology laboratory files were searched for cases with a history of endocyclophotocoagulation prior to enucleation, and three eyes were identified. Histopathologic sections were retrieved and examined. Clinical Series: A retrospective clinical review was performed of a single surgeon's experience with endolaser to the ciliary processes, including all cases with adequate data on ocular history, preoperative and postoperative visual acuity, intraocular pressure (IOP), and glaucoma medications, and details of surgery. Only eyes with at least 6 months' follow-up were included. RESULTS: ANIMAL MODEL: Histopathologic examination of rabbit eyes treated with endocyclophotocoagulation demonstrated acute changes of ciliary process destruction, proteinaceous exudate, stromal edema, nuclear pyknosis, and pigment dispersion. Vascular congestion was seen with some hemorrhage. Later, replacement by fibrous or fibrovascular scar developed with loss of the pigmented and nonpigmented ciliary epithelia, absence of ciliary architectural elements, and pigment rounding and clumping. Human Eyes: Histopathologic examination of enucleated human eyes revealed total ablation of the ciliary processes with fibrosis and pigment clumping in areas of treatment. Abrupt transitions between treated and untreated regions could be identified. In some areas fibrocellular membrane proliferation was found extending over the scars that replaced the ciliary processes. Clinical series: Seventy-three patients were identified ranging in age from 2 to 85 years (mean, 57.7), with follow-up of 6 to 130 months (mean, 28.6). Mean number of previous operations was 3.5; mean number of previous glaucoma operations was 1.3. Preoperative mean IOP was 38 mmHg (range, 19 to 75), postoperative mean IOP was 16 mmHg (range, 1 to 50). At 6 months, 58 of 72 eyes (81%) with available IOP data had IOP greater than 5 mmHg and less than 22. At 12 months 48 of 55 (87.3%) were successfully controlled by these criteria, and at last follow-up 50 of 73 (68%). Fifty-six of 73 eyes (77%) were considered clinically stable at the last follow-up in terms of visual acuity, anatomic integrity, and IOP < or = 23 off all glaucoma medications. Visual acuity was stable or improved in 53 of 73 eyes (73%). Complications developed in 9 eyes (12%), including IOP < or = 6 mmHg in 6 eyes (8.2%), peripheral choroidal effusion in 4 (5.5%), fibrinous anterior chamber reaction in 3 (4.1%), phthisis in 2 (2.7%), and choroidal hemorrhage in 1. Thirty-five eyes had penetrating keratoplasty performed before or at the same time as endolaser (an average of 2.14 grafts each), Graft rejection occurred in 4 eyes (11%), and long-term failure of grafts occurred in 11 of 35 (31%). In 31 eyes, additional surgical procedures were performed at the time of endocyclophotocoagulation. CONCLUSIONS: Endocyclophotocoagulation successfully ablates the ciliary processes, which are replaced with fibrous scar. Surgical results compare favorably with other methods of glaucoma therapy in complicated eyes in terms of IOP control, visual preservation, and complication rate. Endolaser to the ciliary body was especially successful in glaucomatous eyes after keratoplasty, although corneal graft prognosis

Adolescent↗

PubMedDate not supplied

Suprachoroidal septic effusion leading to panophthalmitis following strabismus surgery.

We describe a case of endophthalmitis following strabismus surgery. Drainage of the suprachoroidal effusion with injection of antibiotics was unsuccessful in salvaging vision. Endophthalmitis following strabismus surgery may present with findings simulating a choroidal effusion or hemorrhage. Treating physicians should be alert to signs and symptoms of this severe complication of strabismus surgery in preverbal children.

Anti-Bacterial Agents↗