Exudative retinal detachment in nanophthalmos

Abstract

ABSTRACT.Purpose: To report the treatment of exudative retinal detachment in a patient with nanophthalmos. Methods: A 46-year-old man with bilateral nanophthalmos suffered from acute angle-closure glaucoma in his left eye. The first day after a peripheral iridectomy an exudative retinal detachment was obseved. Two months later a partial thickness sclerectomy with a central sclerostomy, covered by a thin film of absorbable gelatine, was performed in each quadrant of the left eye. Results: The retinal detachment gradually resolved and after eight months the retina was completely reattached. Vision, which had been limited to hand movements, improved to 6/18 with correction. Conclusion: Scleral resections are effective in the treatment of nanophthalmic retinal detachment. The use of absorbable gelatine film to cover the sclerectomized area may prevent regeneration of scleral tissue and recurrence of the exudative retinal detachment.

Uveal effusion and ultrasonic imaging: a clinical series

“…The most unambiguous cases in our series were those involving small eyes, and those where there was a presumed hydrostatic effect via the vorticose vein drainage system, as in the case outlined by Krohn & Seland (1998). Scleral resection (Brockhurst 1980) eventually also proved helpful for the two patients in our series who had undergone similar surgery (cases 7 and 8).…”

Uveal effusion and ultrasonic imaging: a clinical series

“…The most unambiguous cases in our series were those involving small eyes, and those where there was a presumed hydrostatic effect via the vorticose vein drainage system, as in the case outlined by Krohn & Seland (1998). Scleral resection (Brockhurst 1980) eventually also proved helpful for the two patients in our series who had undergone similar surgery (cases 7 and 8).…”

Unusual rapid resolution of postsclerectomy exudative retinal detachment with topical NSAIDs therapy in a case of nanophthalmos

“…The present report describes ERD, which is a complication frequently observed in patients with nanophthalmos; ERD is thought to result from an abnormality in the sclera that impedes transscleral intraocular fluid outflow and compresses the vortex vein, thereby causing fluid accumulation in the choroid and leading to ciliochoroidal detachment. 5 Previous studies 4 have suggested that in patients who exhibit nanophthalmos with ERD, inelastic scleral fibers might replace normal elastic fibers; however, the fundamental mechanism underlying ERD in patients with nanophthalmos remains unclear and warrants further research.…”

“…13 As a result of disturbance of the normal movement of fluid from the subretinal space to the suprachoroidal space via the vortex veins, as well as disruption of the mechanism by which the retinal pigment epithelium pumps water but excludes colloids, the subretinal fluid becomes enriched in protein. 13 Recurrence of ERD after scleral resection has been reported, and histological examination showed that both scleral and fibrous scar tissues obtained from previous sclerectomy sites were able to regenerate; 5 in this situation, a second surgery is indicated. Although several studies 1,3,9 have demonstrated that certain gene mutations can cause nanophthalmos, no gene mutation was identified in our patient.…”

Scleral resection in chronic central serous chorioretinopathy complicated by exudative retinal detachment

“…The most important differentials in our case included chronic CSCR [1] and serous RD secondary to nanophthalmos [18]. Considering the clinical picture, fluorescein angiography and OCT findings, our primary diagnosis was chronic CSCR.…”

Uveal effusion and ultrasonic imaging: a clinical series

“…The most unambiguous cases in our series were those involving small eyes, and those where there was a presumed hydrostatic effect via the vorticose vein drainage system, as in the case outlined by Krohn & Seland (1998). Scleral resection (Brockhurst 1980) eventually also proved helpful for the two patients in our series who had undergone similar surgery (cases 7 and 8).…”

Unusual rapid resolution of postsclerectomy exudative retinal detachment with topical NSAIDs therapy in a case of nanophthalmos

“…The present report describes ERD, which is a complication frequently observed in patients with nanophthalmos; ERD is thought to result from an abnormality in the sclera that impedes transscleral intraocular fluid outflow and compresses the vortex vein, thereby causing fluid accumulation in the choroid and leading to ciliochoroidal detachment. 5 Previous studies 4 have suggested that in patients who exhibit nanophthalmos with ERD, inelastic scleral fibers might replace normal elastic fibers; however, the fundamental mechanism underlying ERD in patients with nanophthalmos remains unclear and warrants further research.…”

“…13 As a result of disturbance of the normal movement of fluid from the subretinal space to the suprachoroidal space via the vortex veins, as well as disruption of the mechanism by which the retinal pigment epithelium pumps water but excludes colloids, the subretinal fluid becomes enriched in protein. 13 Recurrence of ERD after scleral resection has been reported, and histological examination showed that both scleral and fibrous scar tissues obtained from previous sclerectomy sites were able to regenerate; 5 in this situation, a second surgery is indicated. Although several studies 1,3,9 have demonstrated that certain gene mutations can cause nanophthalmos, no gene mutation was identified in our patient.…”

Scleral resection in chronic central serous chorioretinopathy complicated by exudative retinal detachment

“…The most important differentials in our case included chronic CSCR [1] and serous RD secondary to nanophthalmos [18]. Considering the clinical picture, fluorescein angiography and OCT findings, our primary diagnosis was chronic CSCR.…”

Uveal effusion and ultrasonic imaging: a clinical series

“…The most unambiguous cases in our series were those involving small eyes, and those where there was a presumed hydrostatic effect via the vorticose vein drainage system, as in the case outlined by Krohn & Seland (1998). Scleral resection (Brockhurst 1980) eventually also proved helpful for the two patients in our series who had undergone similar surgery (cases 7 and 8).…”

Unusual rapid resolution of postsclerectomy exudative retinal detachment with topical NSAIDs therapy in a case of nanophthalmos

“…The present report describes ERD, which is a complication frequently observed in patients with nanophthalmos; ERD is thought to result from an abnormality in the sclera that impedes transscleral intraocular fluid outflow and compresses the vortex vein, thereby causing fluid accumulation in the choroid and leading to ciliochoroidal detachment. 5 Previous studies 4 have suggested that in patients who exhibit nanophthalmos with ERD, inelastic scleral fibers might replace normal elastic fibers; however, the fundamental mechanism underlying ERD in patients with nanophthalmos remains unclear and warrants further research.…”

“…13 As a result of disturbance of the normal movement of fluid from the subretinal space to the suprachoroidal space via the vortex veins, as well as disruption of the mechanism by which the retinal pigment epithelium pumps water but excludes colloids, the subretinal fluid becomes enriched in protein. 13 Recurrence of ERD after scleral resection has been reported, and histological examination showed that both scleral and fibrous scar tissues obtained from previous sclerectomy sites were able to regenerate; 5 in this situation, a second surgery is indicated. Although several studies 1,3,9 have demonstrated that certain gene mutations can cause nanophthalmos, no gene mutation was identified in our patient.…”

Scleral resection in chronic central serous chorioretinopathy complicated by exudative retinal detachment

“…The most important differentials in our case included chronic CSCR [1] and serous RD secondary to nanophthalmos [18]. Considering the clinical picture, fluorescein angiography and OCT findings, our primary diagnosis was chronic CSCR.…”