Partial thickness sclerectomy and intravitreal anti-VEGF therapy for intractable uveal effusion syndrome

Introduction: Nanophthalmos characterized by short axial length, high lens-to-eye ratio and thick sclera, is more prone to develop uveal effusion syndrome (UES). This rare entity can result in idiopathic exudative detachment of the choroid, ciliary body and retina. Abnormality in the scleral thickness with resultant obstruction of the vortex veins and reduced trans-scleral drainage of fluid is responsible for exudative retinal detachment (ERD). Methods: A retrospective study of UES in nanophthalmic patients treated with partial thickness sclerectomy in tertiary eye care centre from January 2015 to June 2019. Five eyes of five patients (four males and one female) with a diagnosis of nanophthalmos suffered from angle closure glaucoma associated with ERD. Raised intra-ocular pressure (IOP) not amenable to conservative medical management were subjected to surgery. Lamellar sclerectomy was performed in two or more quadrants without drainage which was judged on the basis of maximum amount of exudative fluid present in the subsequent quadrants. Results: The average age at surgery was 39.2 years and the mean follow-up duration was 9.2 months (6 to 18 months). Revision sclerectomy was required in 2/5 (60%) eyes. The serous fluid gradually resolved and retina remained reattached at the end of final follow up. The useful vision was preserved and IOP was normalized. Conclusion: Nanophthalmic UES remains a challenging clinical entity. Partial thickness sclerectomy may be an effective option in the treatment of nanophthalmic UES, not amenable to the conventional medical management in a low resource setup.

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long term follow up of cases of uveal effusion syndrome treated with partial thickness sclerectomies

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v35i4.915 ◽

2020 ◽

Vol 35 (4) ◽

Author(s):

Sidrah Riaz ◽

Muhammad Tariq Khan ◽

Khalid Mehmood

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Exudative Retinal Detachment ◽

Financial Interest ◽

Partial Thickness ◽

Uveal Effusion Syndrome ◽

Long Term Follow Up ◽

Uveal Effusion

LONG TERM FOLLOW UP OF CASES OF UVEAL EFFUSION SYNDROME TREATED WITH PARTIAL THICKNESS SCLERECTOMIESPurposeTo report our experience with partial thickness sclerectomy in patients diagnosed as idiopathic uveal effusion syndrome.Study Design: prospective quasi experimentalPlace and duration of study: multicentre study, duration of study is five yearsMaterial and methodsA prospective study conducted in multi centre hospitals including LRBT eye hospital, Medicare hospital and Myo hospital, Lahore, over the period of five years from January 2010 to august 2015.Total six eyes of four patients (two males and two females) with bilateral idiopathic uveal syndrome were included in study. The diagnosis was clinical confirmed on B scan ultrasonography which confirmed relatively short axial length, exudative retinal detachment and scleral thickening. ResultsAll six (6) patients showed improvement clinically in visual acuity and in fundoscopy in term of retinal reattachment on B scan after partial thickness sclerectomies. ConclusionPartial thickness sclerectomy is treatment of choice for patients of uveal effusion syndrome. It didn’t respond to medical treatment. Key wordsUveal effusion syndrome, quadrantic sclerectomy, exudative retinal detachment (RD), intraocular pressure (IOP), visual acuity (VA), light perception (PL). There is no financial interest of authors.

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