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Results for “Choroidal Effusions”

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PubMedDate not supplied

Ocular findings in Sturge-Weber syndrome.

PURPOSE: We reviewed the rare ocular findings of Sturge-Weber syndrome (SWS) and the results of implantation of the Ahmed valve in cases associated with glaucoma. METHODS: Seven patients (range 18 to 52 years) diagnosed as SWS were reviewed as clinical findings over two years. An anterior chamber maintainer was placed in patients with glaucoma to maintain stable intraocular pressure and minimize the risk of intraocular hemorrhage due to sudden pressure changes during surgery, when an Ahmed valve is implanted. RESULTS: Episcleral venous vessels were prominent in all cases. Diffuse choroidal hemangiomas were seen in three cases. Nevus of Ota was observed in only one case. Three cases had juvenile glaucoma. One also had buphthalmos. No intraocular hemorrhage or choroidal effusion was observed intraoperatively in valve-implant patients. The surgical treatment of the patients with glaucoma gave favorable outcomes. CONCLUSIONS: Rare ocular findings such as choroidal hemangioma and nevus of Ota are sometimes seen in SWS. Drainage valve implantation, with an anterior chamber maintainer, is a good choice for treatment when surgery is done in cases with glaucoma. This method may reduce the risk of intraoperative suprachoroidal effusion and expulsive hemorrhage by stabilizing intraocular pressure within normal limits during the surgery.

Adolescent↗

PubMed1979

Uveal effusion following pan-retinal photocoagulation.

Uveal effusion combined with nonrhegmatogenous retinal detachment is presented as a complication of pan-retinal photocoagulation in diabetic patients. This complication is believed to be a direct effect of photocoagulation on the choroidal vasculature. The mechanism is postulated to be secondary to photocoagulation-induced choroiditis, choroidal vascular occlusion, or a combination of the two. Corticosteroid therapy is recommended as being effective in resolving the choroidal effusion.

Choroid↗

PubMed1990

Choroidal detachment, flat anterior chamber, and hypotony as complications of neodymium: YAG laser cyclophotocoagulation.

Severe hypotony, flat anterior chamber, and serous choroidal detachment after transscleral neodymium: YAG laser cyclophotocoagulation (Nd:YAG-CPC) for three cases of intractable glaucoma are reported. The three patients had failed previous filtering surgery and were receiving maximal medical therapy. The types of glaucomas treated were two cases of primary open-angle and one chronic-angle closure. The complications were noted between 1 and 2 weeks from the time of treatment. One patient improved spontaneously after 1 week of observation. Another patient required drainage of the choroidal effusion and anterior chamber reformation. The last patient remains under observation with a low intraocular pressure (IOP) and a slowly resolving serous choroidal detachment. Though the incidence of shallow anterior chambers is three cases (0.5%) in this series of 750 Nd:YAG-CPCs, it represents a serious problem that had not been reported previously.

Aged↗

PubMed1996

Long-term results of Krupin-Denver valve implants in filtering surgery for neovascular glaucoma.

The long-term results obtained with the Krupin eye short valve shut in 28 eyes with neovascular glaucoma were retrospectively analyzed by means of Kaplan-Meier survival curve. The preoperative intraocular pressures (IOPs) ranged from 28 to 62 mm Hg (mean, 36.8 +/- 5.8 mm Hg). Success was considered an IOP of less than 22 mm Hg and greater than 5 mm Hg without medication (complete success) or with medication (qualified success) without additional glaucoma filtering surgery or devastating complications. Postoperative success was obtained in 10 out of 28 eyes after a mean follow-up period of 58.4 +/- 23.02 months (range, 10-108 months). The 3- and 6-year life table success rates were 66 and 34%, respectively. Early complications were: shallow or flat anterior chamber (15 patients, 53.6%), hypotony (16 patients, 57.1%), hypertony (7 patients, 25%), serous choroidal effusion (7 patients, 25%), fibrinous uveitis (5 patients, 17.9%), blockage of the intracameral portion of the tube by fibrin (5 patients, 17.9%), choroidal hemorrhage (2 patients, 7.1%). Late complications were: external conjunctival bleb failure (12 patients, 42.9%), blockage of the intracameral portion of the tube by fibrovascular tissue (5 patients, 17.9%), cataract (2 patients, 7.1%), bullous keratopathy (2 patients, 7.1%), external erosion of the Silastic valve (2 patients, 7.1%), phthisis bulbi (2 patients, 7.1%). Mortality during long-term follow-up was high in our series. The complications of an underlying diabetes mellitus were the most common cause of death (15 out of 22 patients). The high mortality of patients subjected to valve implantation makes it difficult to interpret the results of long-term studies. However, the valve implant is still today an alternative surgical procedure for controlling IOP in eyes with neovascular glaucoma that have visual potential.

Aged↗

PubMed1987

Magnetic resonance imaging in the evaluation and differentiation of uveal melanoma.

We evaluated 39 patients with intraocular disease by magnetic resonance imaging (MRI). Malignant uveal melanoma was considered the likely diagnosis in 25 patients. Seventeen patients underwent surgery, and the histopathologic diagnosis of melanoma was confirmed. The authors observed that uveal melanomas had characteristic MRI features consisting of a relatively high-signal intensity in T1-weighted images and a relatively low-signal intensity in T2-weighted images. These images reflected their inherently relative short T1 and T2 relaxation times. Choroidal lesions elevated more than 3 mm were well visualized on MRIs. MRI also proved valuable for differentiating uveal melanoma from associated subretinal effusion, choroidal hemangioma, choroidal metastasis, and hemorrhagic and serous choroidal detachments.

Adult↗

PubMed1988

Morbidity following prolonged postoperative hypotony after trabeculectomy.

The postoperative course of a series of 54 patients that had undergone primary trabeculectomy for open-angle glaucoma is reviewed. Almost one third of the eyes had prolonged postoperative hypotony with an intraocular pressure less than 8mm Hg for more than 2 weeks. The possible significance of prolonged hypotony and choroidal effusions is discussed in relation to the final intraocular pressure and the effect on visual acuity.

Choroid↗

PubMed1986

Long-term evaluation of initial filtration surgery.

In a long-term study of 252 eyes that had initial glaucoma filtration surgery, there was an overall success rate of 85%. Rigid criteria for success included an intraocular pressure equal to or less than 19 mmHg, no further visual field loss or disc damage, and no glaucomatous etiology for a decrease in visual acuity. The success rate was evaluated over an extended postoperative period with a range of 2 to 14 years and a mean follow-up of five years (61 months). Full thickness procedures had a higher success rate for a greater length of time, 88% (6 years) than did trabeculectomy, 76% (4 years). If an eye was considered successful at two years, the probability of success at five years was 94.5% for full thickness procedures and only 82% for trabeculectomies. Choroidal effusion associated with hypotony and shallow anterior chamber was the most frequent postoperative complication. There was no difference in the incidence between full thickness procedures and trabeculectomies. Cataract extraction was indicated more often following full thickness procedures, 34%, than trabeculectomies, 21%. However, the performance of a choroidal tap or subsequent cataract extraction did not appear to influence the success of the filtration operation. Bleb leaks and bleb infection occurred only after full thickness operations and were associated with a high 5/8 (62%) rate of bleb failure and loss of glaucoma control. Full thickness filtering operations appeared to insure a lower pressure from a longer period of time than does trabeculectomy.

Adolescent↗

PubMedDate not supplied

Ahmed glaucoma valve implant for childhood glaucoma in Sturge-Weber syndrome with choroidal hemangioma.

We present our experience with implantation of an Ahmed glaucoma valve in a 9-year-old girl with Sturge-Weber syndrome with choroidal hemangioma. In this case of childhood glaucoma, the choice of surgical procedure should be based on the efficacy and elimination of intra-and post-operative complications. An Ahmed glaucoma valve offered safety and efficacy in controlling glaucoma. This technique avoided sudden drops in intraocular pressure and decreases the risk of intraoperative and postoperative choroidal effusion and hemorrhage. The surgical procedure was not complicated: a one-staged implant was satisfactory and a prophylactic sclerostomy was not required.

Child↗

PubMed1990

Fluorosilicone oil in the treatment of retinal detachment.

We evaluated the use of a heavier-than-water fluorinated silicone oil in the treatment of 30 selected cases of complicated retinal detachment from January 1988 to July 1989. Proliferative vitreoretinopathy grade C-2 or greater accounted for 19 cases, proliferative diabetic retinopathy with traction detachment for two cases, giant retinal tears five, ruptured globe with retinal detachment two, massive choroidal effusion with retinal detachment one, and acute retinal necrosis with retinal detachment one. Initial retinal reattachment was achieved in all cases. Complications included redetachment seven (23%), cataract six (75% of phakic patients), raised intraocular pressure four (13%), hypotony four (13%), keratopathy three (10%), uveitis-synechia formation three (10%), phthisis two (3%), choroidal haemorrhage one (3%), and vitreous haemorrhage one (3%). Postoperative visual acuities with at least six months' follow-up range from no light perception to 20/50, with seven patients (23%) 20/400 or better.

Adolescent↗

PubMed2002

Photodynamic therapy for circumscribed choroidal haemangioma.

PURPOSE: To assess the efficacy of photodynamic therapy (PDT) as a new treatment for circumscribed choroidal haemangioma (CCH). METHODS: Eight patients with CCH were treated with PDT using a protocol similar to that used in the standard treatment of neovascular age-related macular degeneration. RESULTS: Visual acuity improved in six of eight eyes, remained unchanged in one eye and deteriorated in one eye after 3-15 months (median 7 months) follow-up. Pre-treatment metamorphopsia disappeared in all but two cases. The thickness of the CCH measured with standardized echography showed marked regression within 1 month after PDT. In six eyes there was no remaining protrusion after PDT and one lesion was barely detectable. One patient experienced a transient choroidal effusion and perifoveal haemorrhage. CONCLUSION: Photodynamic therapy is a promising new treatment for CCH as it restores visual function in most cases without causing apparent ocular or systemic side-effects.

Adult↗

PubMed2006

Escitalopram-induced uveal effusions and bilateral angle closure glaucoma.

PURPOSE: To report the onset of bilateral angle closure glaucoma resulting from ciliochoroidal effusions noted after taking escitalopram. DESIGN: Case report. METHODS: A 41-year-old woman with a medical history of depression was placed on escitalopram and presented with acute bilateral angle closure glaucoma. A medical history and ophthalmic examination (including slit-lamp photography and high-frequency ultrasonography) were performed at the time of diagnosis and at resolution of her symptoms. RESULTS: High-frequency ultrasonography revealed bilateral choroidal effusions with ciliary body detachments and angle closure. Attempts to reduce intraocular pressure with topical ocular antihypertensive drugs and subsequent laser peripheral iridotomy were unsuccessful. Over the course of four days, the use of topical cycloplegics, corticosteroids, and discontinuation of escitalopram resulted in normalization of intraocular pressures, deepening of anterior chamber depths, and resolution of her uveal effusions. CONCLUSIONS: The use of escitalopram resulted in uveal effusions, angle rotation, and acute bilateral angle closure glaucoma. Discontinuation of escitalopram and corticosteroid therapy resulted in normalization of the patient's eyes.

Acute Disease↗

PubMed1997

Adverse side effects associated with latanoprost.

PURPOSE: To report three different adverse reactions after initiating treatment with latanoprost. METHOD: Serial clinical examinations of three patients were performed. RESULTS: Adverse reactions such as ocular hypotony and choroidal effusions, recurrent cystoid macular edema, and facial rash were noted to occur within 1 to 4 weeks after starting topical latanoprost for the treatment of primary open-angle glaucoma. CONCLUSION: Clinicians should be alerted to these possible complications of topical latanoprost therapy.

Aged↗

PubMed1986

Bilateral angle-closure glaucoma in association with the acquired immune deficiency syndrome.

Two homosexual men, 35 and 42 years old, had bilateral acute angle-closure glaucoma in association with the acquired immune deficiency syndrome. In one patient, the angle-closure attack was the initial manifestation of AIDS. Choroidal effusion with secondary anterior rotation of the ciliary body at the scleral spur appeared to be the pathophysiologic mechanism. Pupillary block, angle crowding, and inflammatory synechial angle closure must be differentiated from anterior rotation of the ciliary body as the mechanism of the angle closure to provide optimal treatment. Whereas primary angle closures are treated with miotics and iridectomy, secondary angle closure may be worsened with this treatment. Cycloplegics and, if necessary, drainage of suprachoroidal fluid may be curative in AIDS-related angle closure associated with a choroidal detachment. Both patients died before the long-term efficacy of this treatment could be assessed.

Acquired Immunodeficiency Syndrome↗

PubMed2003

[The role of ultrasound examinations in diagnosis of massive suprachoroidal hemorrhage occurring as a postoperative complication of intraocular surgery ].

This article presents importance of the ultrasound examinations (standard A- and B-scan ultrasonography, Colour Doppler and Power Doppler ultrasonography) in early and late diagnosis of massive intraoperative suprachoroidal hemorrhage. Standardized echography can help establish an accurate diagnosis. Echography can determine the location and extent of expulsive hemorrhage, as well as determine the status of the retina and vitreous. Furthermore, differentiation between hemorrhagic choroidal detachment and serous choroidal effusion can be made only by A- and B-scans. Colour and Power Doppler imagings of orbital vessels are relatively new sonography methods of ocular diagnosis. Using them, we can evaluate all blood flow disturbance, which occur in eye with massive suprachoroidal hemorrhage. These methods are also useful in differentiation of retina from other tissues, especially in the presence of opaque media.

Aged↗

PubMed1978

Molecular sieving in suprachoroidal fluid formation in man.

Suproachoroidal fluid (SCF) obtained at the time of the surgical evacuation of a clinically significant choroidal detachment (CD) was analyzed for its chemical and cellular components in four distinct subgroups: (1) CD following cataract surgery, (2) CD (nonhemorrhagic) following glaucoma surgery, (3) CD (hemorrhagic) following glaucoma surgery, and (4) intraoperative CD during glaucoma surgery in patients with elevated episcleral venous pressure. The fluid obtained in groups 1, 2, and 4 was clear and slightly xanthochromic and contained low-molecular-weight substances in concentrations essentially equal to serum. Proteins and other high-molecular-weight substances were present in lesser amounts than in serum. Albumin, alpha1-antitrypsin, and transferrin were present in amounts approximately equal to those in serum, whereas alpha2-macroglobulin, IgM and IgG were decreased. beta-Lipoprotein and beta-complement were absent. It is postulated that this distribution of serum proteins is a manifestation of molecular sieving and is consistent with the existence of an isoporous membrane between the intravascular and suprachoroidal space with a pore diameter of 144 A. In the intraoperative choroidal effusions, there was evidence for exclusion of more of the lower, as well as all of the higher, molecular weight proteins. This suggested that the degree of molecular sieving increased with increasing filtration rate. In the hemorrhagic SCF, the distinctive character of the fluid and the protein concentrations indicated that the integrity of the capillary membrane was mardkedly disrupted, thereby allowing higher-molecular-weight proteins and cellular elements to enter the space.

Ascorbic Acid↗

PubMed2003

Reversal of blindness after transvenous embolization of a carotid-cavernous fistula: case report.

OBJECTIVE AND IMPORTANCE: Reversal of blindness after the endovascular treatment of a carotid-cavernous fistula (CCF) is exceedingly rare. It has been reported only once in a patient with a direct CCF. We report the first such case in a patient with an indirect CCF. Defining patients whose vision may recover is critical in coordinating the timing of therapy. Mechanisms of reversible visual loss in CCFs are discussed with the intent of elucidating the patients who compose this subgroup. CLINICAL PRESENTATION: A 65-year-old man had a 1-week history of blindness, chemosis, and proptosis of the right eye. Ophthalmoscopy was compromised by diffuse choroidal effusion and corneal edema that obscured visualization of the patient's retina. INTERVENTION: Transvenous embolization through retrograde catheterization of the superior ophthalmic vein allowed complete coil occlusion of the lesion. The patient's visual loss improved rapidly, returning to normal within 50 days. CONCLUSION: Although CCFs frequently are associated with permanent visual loss, a subset of patients demonstrates reversible ocular findings. If the retina of a patient with a CCF seems normal or is obscured, the potential for visual recovery, even from blindness, should prompt emergent treatment.

Aged↗

PubMed1975

The management of glaucoma in nanophthalmos.

Patients with nanophthalmos are prone to develop a chronic painless type of glaucoma in middle age, probably due to the natural increase in the size of the lens which is already relatively too large for the small eye. Although the underlying mechanism is obscure, a slowly progressive "creeping" chronic angle-closure is postulated, but gonioscopic evaluation is difficult due to the shallow anterior chamber, with grade I and slit angles. Response to medical treatment is poor and miotics may even make the condition worse by producing relative pupillary block and by relaxing the lens zonule. Ordinary glaucoma surgery is to be avoided in nanophthalmos because of the fear of postoperative ciliary-block malignant glaucoma. Periopheral iridectomy performed in five eyes at an advanced stage of the chronic angle-closure did not facilitate glaucoma control in three eyes, and in two eyes in which the operation was combined with posterior sclerotomy, the eyes became blind from vitreous hemorrhage. Lenx extraction in five eyes controlled the glaucoma but was followed by choroidal effusion and nonrhegmatogenous retinal detachements in two eyes and blindness in another eye when combined with a posterior sclerotomy. No firm therapeutic recommendations can be made on the basis of the author's experience in the six reported cases. Conventional medical therapy seems ineffectual even when begun early in the glaucoma. Conventional glaucoma surgery must be performed early, before permanent damage to the outflow mechanism occurs but removal of the lens must be anticipated. The surgeon must also remain aware of the high incidence of serious posterior-segment complications which inexplicably follow glaucoma or lens surgery in nanophthalmos, as described by Brockhurst.

Adult↗

PubMed1996

Survey of risk factors for expulsive choroidal hemorrhage: case reports. Substantiation of the risk factors and their incidence.

To evaluate the interaction of risk factors for expulsive hemorrhage, we evaluated 3 cases of expulsive hemorrhage and 2 of acute intraoperative choroidal effusion that occurred at the University of Tsukuba Hospital over a 16-year-period and investigated the common findings in these 5 cases. We also selected randomly 500 cataractous cases operated at the University of Tsukuba Hospital and investigated the probabilities of risk factors for expulsive hemorrhage in these control cases. The 5 affected patients exhibited more than four risk factors of expulsive hemorrhage. The probability of more than four risk factors being involved in any cataract operation was approximately 0.33% (0.17 approximately 0.67%; 95% confidence interval). The incidence of expulsive hemorrhage at our hospital was approximately 0.2%, which is similar to the probability rate. Thus, we concluded that the development of expulsive hemorrhage was proved to be related to an accumulation of the risk factors for expulsive hemorrhage.

Aged↗