uveal effusion syndrome Dotaz Zobrazit nápovědu
PURPOSE: Purpose of this article is to present a case report of a patient with uveal effusion syndrome who underwent deep posterior sclerotomy. CASE REPORT: A 73-year-old patient with unilateral decrease in the best corrected visual acuity, ablation of choroid and secondary retinal detachment in the right eye was admitted to our clinic for examination in November 2017. At the first examination, the best corrected visual acuity in the right eye was 0.3, in the left eye 1.0. Intraocular pressure was 16 mmHg in the right eye and 21 mmHg in the left eye. After performing ultrasound biomicroscopy of the anterior segment (Accutome, Keeler, USA), ultrasound sonography of the affected eye (Accutome, Keeler, USA), magnetic resonance imaging, computed tomography, abdominal ultrasound and blood tests, we concluded the finding as uveal effusion syndrome. We initiated a conservative treatment consisting of oral administration of carbonic anhydrase inhibitor in combination with topical use of prostaglandin analogue. Despite conservative treatment the best corrected visual acuity of the affected eye decreased to 0.05 so we proceeded to a surgical procedure - deep posterior sclerotomy with perioperative scleral sampling for histological examination (detection of glycosaminoglycans in the sclera wall by Alcian blue staining), which was negative. This histological result ranks the patient as the third type of uveal effusion syndrome (ie, non-nanophthalmic with a normal sclera). After the operation both the ablation of choroid and retinal detachment reattached and the best corrected visual acuity in the right eye improved to 0.3. After the subsequent cataract surgery, the ablation of choroid and retinal detachment occurred again, this time with spontaneous recovery. Postoperatively, the best corrected visual acuity in the right eye was 0.5 and at the last check-up at our clinic 0.6. CONCLUSION: Deep posterior sclerotomy is a method of choice of surgical treatment for uveal effusion syndrome that does not respond to conservative therapy.
- Klíčová slova
- deep posterior sclerotomy, secondary retinal detachment, uvea, uveal effusion syndrome,
- MeSH
- exsudáty a transsudáty MeSH
- lidé MeSH
- nemoci choroidey * diagnóza terapie MeSH
- odchlípení sítnice * diagnóza chirurgie MeSH
- senioři MeSH
- skléra MeSH
- syndrom uveální efuze * MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The authors describe two cases of idiopathic uveal effusion syndrome, in one instance affecting consecutively both eyes, in the second patient the finding is unilateral so far. In the female patient with the bilateral finding reattachment of the retina and improvement of the visual acuity developed only after surgery (sclerotomy). The second patient, where the disease was detected only accidentally, is so far only under observation. The authors discuss the causes of this rare disease, the variability of clinical symptoms, diagnostic and therapeutic possibilities.
PURPOSE: To evaluate anatomical and functional results of perforating pars plana sclerotomy in 2 patients with the idiopathic uveal effusion syndrome (IUES). METHODS: In two patients with IUES the perforating pars plana sclerotomy was performed. During the surgery samples of the suprachoroidal fluid for biochemical analysis of protein fractions were taken. RESULTS: During the follow-up period (average 4 years) the retina and the choroid attached, and the central visual acuity (VA) improved as well in both patients. CONCLUSION: In IUES, the conservative treatment is not effective. Perforating pars plana sclerotomy is treatment of choice and it had positive anatomical and functional effect in both our patients with IUES.
- MeSH
- dospělí MeSH
- exsudáty a transsudáty MeSH
- lidé MeSH
- nemoci uvey chirurgie MeSH
- senioři MeSH
- sklerostomie * MeSH
- syndrom MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
The purpose of this article is to report the surgical treatment of two patients. After the filtering surgery a dehiscence of the conjunctiva emerged and was followed by an extreme hypotony of the eyeball and an extensive uveal effusion. The first patient, 82 years old lady, was treated with the diagnosis of chronic open angle glaucoma for 25 years. The right eye with an absolute glaucoma, the left eye had normal intraocular pressure (IOP) and was after a combined filtering surgical procedure with phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation in 1998. In autumn 2000, the patient suffered conjunctivitis, and the prominent filtering bleb was damaged due to frequent rubbing of the eye because of itching. Severe hypotony of the eyeball with secondary uveal effusion followed. Considering the age of the patient and the only functional eye, an extreme surgery was indicated: PC IOL explantation (removal), pars plana vitrectomy (ppV) with silicone oil implantation. After the surgery the eyeball was anatomically stabilized and the VA (visual acuity) improved from initial uncertain light perception to 0.08 (1/12 or 3/36) and certain light perception. The second patient, 35 years old man suffered in 1995 a serious penetrating injury with an intraocular foreign body of the right globe. During the following five years the patient underwent in altogether six intraocular surgeries due to posttraumatic cataract and rhegmatogenous and tractional detachment of the retina. In the year 2000, trabeculectomy due to secondary glaucoma was indicated and 8 months later, on patients demand an anterior chamber intraocular lens (AC IOL) was implanted. During the first week after the surgery severe hypotonia of the globe and secondary uveal effusion caused by conjunctival dehiscence in the upper nasal quadrant of the eyeball developed. Because of complicated ocular history of the patient who underwent on the whole eight eye surgeries a relative minimal procedure was indicated: AC IOL removal and insufflation of 1 ml of 100% hexafluorosulfide (SF6) expansive gas into the anterior chamber and vitreous cavity. The globe was stabilized and the VA (visual acuity) improved from initial uncertain light perception to 0.25 (6/24 or 20/80) with certain light perception.
- MeSH
- dospělí MeSH
- exsudáty a transsudáty MeSH
- filtrující operace škodlivé účinky MeSH
- lidé MeSH
- nemoci uvey etiologie chirurgie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- syndrom MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
