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Anterior Sclerectomies in Uveal Effusion Syndrome - A Case Report

1Silva M., 1Schulze S., 2Hesse L.,
1Philipps-Universität Marburg, Medizinisches Zentrum für Augenheilkunde (Marburg)
2Augenklinik der SLK-Kliniken (Marburg)

Purpose: Uveal effusion defines a condition wherein fluid escapes from the choriocapillaris of the choroidea with a resulting thickening of the choroidea and non-rhegmatogenous retinal detachment. There are various conditions that may cause uveal effusion like inflammatory or vascular processes (e.g. arteriovenous fistula) or abnormally thickened sclera.
Methods: In february 2002 a 63year old female patient came to our clinic with photopsies at the right eye. Examination showed a bilateral amblyopia in high hyperopia (+16.75 dpt) determinating a VA of 0.3 resp. 0.1, a mikrophthalmus with an axial length of 15.72 resp. 15.84 mm as well as a bilateral serous retinal detachment (more extended in right eye). The B-scan showed a choroideal thickening of 2.7 mm, in the MRT was seen a scleral thickening as well. We carried out an anterior sclerectomy with scleral dissection continued to choroidea, producing 2 scleral bags in the infero-nasal and infero-temporal equatorial area.
Results: Right during surgery we saw an exudation in the sclerectomy area. At the first postoperative day a strong regression of the retinal detachment could be observed. We found the retina completely reattached in the last follow-up. There were no operative or postoperative complications. Visual acuity remained reduced due to amblyopia.
Conclusions: Anterior sclerectomies are useful in treatment of uveal effusion, if it's caused by abnormally thickened sclera as reported here. Pars plana vitrectomy should not be performed because it is no causal treatment of the underlying abnormity.