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

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

Diagnostic tools:

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

  2. FAF – leopard spots.

  3. Enhanced depth OCT – increased choroidal thickness.

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)

 
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