Acute uveal effusion during phacoemulsification with preoperative central serous chorioretinopathy: a case report

Abstract

BackgroundWe report a case of acute uveal effusion during phacoemulsification in an eye with preoperative chronic central serous chorioretinopathy (CSC).Case presentationA 55-year-old man with a history of chronic CSC for >18 months presented with bilateral opaque lenses. A preoperative ophthalmic examination showed suspected lenticonus and risky anatomical features, including a thick ciliary body, and anterior rotation of the ciliary process and iris root in both eyes. Optical coherence tomography (OCT) detected CSC in the left eye, but the results of fundus photography and B-scan ultrasonography were unremarkable. The anterior chamber flattened during phacoemulsification. Anterior vitrectomy was quickly performed for suspected infusion misdirection syndrome, and was followed by uneventful surgery. On postoperative day 1, fundus photography, type B ultrasound, and OCT revealed uveal exudation in the macula of the left eye. On postoperative day 50, the patient’s visual acuity recovered to 20/32, and fundus photography, ultrasonography, and OCT revealed complete resolution of the uveal effusion.ConclusionsThis case suggests an association between preoperative CSC and uveal effusion during surgery, because choroidal hyperperfusion and hyperpermeability were present in the patient’s CSC-affected eyes.

Ciliochoroidal Effusion in Central Serous Chorioretinopathy

“…All case reports have described atypical CSC cases, especially those with inferior bullous retinal detachment 23,24 or those acquiring CSC after intraocular surgery. 25 Ciliochoroidal effusion with CSC observed in the current study was more limited or milder than that in UES. However, CE was observed in 19.5% of CSC cases, whereas it was rarely observed in normal eyes.…”

Atypical Central Serous Chorioretinopathy With Choroidal Detachment: A Case Report

“…This accounts for the development of peripheral choroidal detachment with lobular appearance resulting from the collection of excess fluid in the suprachoroidal space. 4,9 Our case had an atypical presentation of CSCR with inferior exudative retinal detachment and peripheral choroidal detachment. With typical clinical features and angiographic features being characteristic of CSCR and in the absence of features suggestive of uveal effusion, the probable pathomechanism, in this case, could be a combination of that for CSCR and uveal effusion.…”

“…This accounts for the development of peripheral choroidal detachment with lobular appearance resulting from the collection of excess fluid in the suprachoroidal space. 4,9…”

Anterior Chamber Shallowing from the Early Stage of Surgery and Suprachoroidal Effusion during Clear Corneal Small-Incision Cataract Surgery: A Case Report

“…To date, the occurrence of acute SCE during clear cornea small-incision phacoemulsification and aspiration has rarely been observed. Recently, only one case of SCE identified during cataract surgery in the patient with central serous chorioretinopathy has been reported [ 3 ]. SCE is considered a precursor to choroidal and expulsive hemorrhage and is important because choroidal and expulsive hemorrhage can result in severe impairment of visual acuity [ 4 ].…”