Uveal Effusion Syndrome (UES)

Definition = Idiopathic cause of choroidal detachment that may be a/w nanophthalmos and increased scleral thickness (eg. hypermetropia).

Epidemiology – middle aged males, 65% bilateral.

Pathophysiology (theories) – hydrostatic or inflammatory

REMEMBER – this is a diagnosis of EXCLUSION!

Differential diagnosis:

1. Scleritis

2. Posterior uveitis

3. Hypotony after glaucoma surgery

4. Intraocular lymphoma

5. Choroidal neoplasia

6. Postoperative infallmation

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Clinical features:

1. Gradual superior visual field loss

2. Blurred vision or metamorphopsia

3. Exudative RD

4. Leopard spots

5. Relapsed and remitting

6. ONH oedema – sometimes

7. CSR with multiple RPE detachments

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Diagnostic tools:

1. B-scan USS – choroid/sclera is thickened. Rule out RD.

2. FAF – leopard spots.

3. Enhanced depth OCT – increased choroidal thickness.

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Management:

1. Oral, periocular or topical steroids – UES with normal axial length & normal scleral thickness – 95% resolution but 5% need scleral window Sx (see reference below for Sx steps)