In some cases, a ‘kissing’ or appositional choroidal detachment extends from the optic nerve to the retro‐lenticular space, pushing the lens‐iris diaphragm anteriorly and causing a secondary angle closure attack. 1. Grant, Gerard A. Lutty, in Retina (Fifth Edition), 2013.
If bupropion use were causative in this case, the absence of other similar reports may reflect underreporting; alternatively, this patient may harbor a rare, private polymorphism that causes bupropion or one of its metabolites to become a particularly potent choroidal vasodilator.Arias HR, Santamaría A, Ali SF. If it is a moderate wound leak, but the anterior chamber is still formed and of adequate depth, a bandage contact lens can be applied to promote re‐epithelialisation and prevent lid interaction with the cornea.Patients who experience pain from a haemorrhagic detachment may initially benefit from topical cycloplegia and analgesia; however, aspirin and non‐steroidal anti‐inflammatory medication should be avoided to prevent the risk of increased bleeding.To reduce the risk of developing a post‐operative suprachoroidal haemorrhage, patients should be informed to avoid straining, excessive exercise, heavy lifting or Valsalva‐type manoeuvres until the serous detachment resolves, as these activities may increase episcleral venous pressure, causing an increased pressure gradient out of the capillaries into the suprachoroidal space.The management approach for uveal effusion syndrome involves surgical intervention with sclerotomy. By continuing to use our site, or clicking "Continue," you are agreeing to our 2020 American Medical Association. Sulfa drugs have been reported to cause transient myopia, uveal effusion, ciliary body edema, and anterior rotation of the lens-iris diaphragm . Certain scleral characteristics that may influence protein and fluid egress from the eye include scleral thickness, scleral composition, and the number of scleral emissary channels. Craig JE, Ong TJ, Louis DL, Wells JM.
Reitsamer HA, Zawinka C, Branka M. Dopaminergic vasodilation in the choroidal circulation by d1/d5 receptor activation.
Optometrists play a pivotal role, especially if access to an ophthalmologist is limited, as for example in rural or remote communities; commencing immediate treatment under the guidance of an ophthalmologist improves possible likelihood of visual recovery.Most post‐operative serous choroidal detachments are localised and have no effect on visual acuity.
95, 99 In one study, the number or caliber of vortex veins was decreased in 68% of uveal effusion syndrome cases during surgery. Haemorrhagic choroidal detachments occur when there is abnormal blood accumulation in the suprachoroidal space secondary to rupture of a ciliary blood vessel.
investigated 420 consecutive Japanese patients who underwent trabeculectomy and topical mitomycin C, and found that increased age, and reduced pre‐operative and post‐operative intraocular pressures increased the risk of choroidal detachments.Particular types of filters or shunt implants can further increase this risk, with Ahmed valves having a 15 per cent post‐operative choroidal detachment rate, compared to 10 per cent with Baerveldt valves.A large retrospective study of 17,843 trabeculectomies and 9,597 tube shunt surgeries found the incidence of haemorrhagic choroidal detachments to be 0.6–1.4 per cent after trabeculectomy, and 1.2–2.7 per cent after tube shunt surgery.Individuals with nanophthalmos and high hypermetropia also have an increased risk of developing choroidal detachment following cataract surgery, as well as secondary retinal detachment, and malignant glaucoma.Another study in 2004 on 12 nanophthalmic eyes reported complications in four, with those eyes developing phthisis, broken intraocular lens haptics, severe iritis, choroidal haemorrhage and glaucoma progression.Due to the increased fragility of the choroidal vasculature, people with increased age, arterial hypertension, tachycardia, atherosclerosis and diabetes are also reported to be at higher risk of choroidal detachments.There have also been case reports of choroidal detachments occurring after the use of certain medications (Table Suprachoroidal haemorrhages have also been observed secondary to age‐related macular degeneration and polypoidal choroidal vasculopathy, and patients usually report pain on presentation.Trauma has also been documented to cause choroidal detachments, although most reports available to date are retrospective studies.
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