Four quadrant sclerotomies for uveal effusion syndrome

Wang, B Z; Clark, Ben; McKelvie, Penny; Matthews, Bryan J.; Buttery, Robert; Chandra, Aman

doi:10.1038/eye.2014.291

Cited by 8 publications

(9 citation statements)

References 2 publications

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“…Following partial scleral resection all 6 eyes showed improvement in visual acuity. It was comparable with other studies done at other centers in London, USA and Bangladesh 19,20,21 .…”

Section: Discussionsupporting

confidence: 91%

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

Riaz¹,

Khan²,

Mehmood³

2020

pak J Ophthalmol

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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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“…Following partial scleral resection all 6 eyes showed improvement in visual acuity. It was comparable with other studies done at other centers in London, USA and Bangladesh 19,20,21 .…”

Section: Discussionsupporting

confidence: 91%

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

Riaz¹,

Khan²,

Mehmood³

2020

pak J Ophthalmol

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“…The management of UES typically has involved surgical sclerectomies (scleral window surgery), using partial or full-thickness scleral resection to allow for transscleral drainage of suprachoroidal and supraciliary fluid. [ 10 11 12 13 14 15 16 17 18 19 ] Based on published data, systemic or local corticosteroids are not often employed for the management. In one comprehensive review, the authors wrote that “treatment with systemic steroids does not appear to be effective” and “the most common treatment is full-thickness sclerotomies to provide an exit for choroidal fluid”.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the literature, therapy for UES generally involves surgical creation of scleral windows to decompress suprachoroidal fluid, and more recently, implantation of Express Valve. [ 3 4 10 11 12 13 14 15 16 17 18 19 20 ] There is very little information on the role of systemic or periocular corticosteroids (PCS) for UES and PubMed search for keywords “uvea,” “choroid,” “effusion,” and “steroid” yielded one case series in the English literature. [ 21 ] A major survey on UES indicated that “treatment with systemic steroids does not appear to be effective.”[ 4 ] The mechanism of corticosteroids for UES is unclear, but some speculate that there could be generalized reduction in inflammatory factors or control of transudation and edema by membrane stabilization.…”

mentioning

confidence: 99%

Uveal effusion syndrome in 104 eyes: Response to corticosteroids – The 2017 Axel C. Hansen lecture

Shields

Roelofs

Nicola

et al. 2017

Indian J Ophthalmol

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Purpose:The purpose of the study was to investigate the corticosteroids for uveal effusion syndrome (UES).Methods:Retrospective series of 104 eyes with UES treated with oral corticosteroids (OCS), periocular corticosteroids (PCS), topical corticosteroids (TCS), or observation (OBS). Main outcome measure was UES resolution.Results:Of 104 eyes, treatment included OCS (n = 27), PCS (n = 12), TCS (n = 11), and OBS (n = 54). A comparison of the four groups (OCS vs. PCS vs. TCS vs. OBS) revealed differences in those managed with OCS versus OBS as younger (66 vs. 72 years, P = 0.049), PCS versus OBS as male (100% vs. 54%, P = 0.002), PCS versus OBS with decreased visual acuity (VA)/visual field (91% vs. 51%, P = 0.018), and OBS versus OCS as asymptomatic (28% vs. 0%, P = 0.001). Of the 59 with follow-up information, management included OCS (n = 21), PCS (n = 12), TCS (n = 6), and OBS (n = 20). There were differences in initial VA <20/400 in PCS versus OBS (42% vs. 5%, P = 0.018), effusion thickness in TCS versus OCS (7 vs. 3 mm, P = 0.004), and serous retinal detachment in PCS versus OBS (100% vs. 30%, P < 0.001) and PCS versus OCS (100% vs. 57%, P = 0.012). Regarding outcomes, VA showed less worsening in OCS versus OBS (0% vs. 30%, P = 0.008) and OCS versus PCS (0% vs. 33%, P = 0.012). There was no difference in rate of effusion resolution or effusion recurrence. Overall, using combination of corticosteroid therapies, effusion resolution was achieved in 56/59 (95%) cases and the need for surgical management with scleral windows was necessary in only 3/59 (5%) cases. Complications included cataract (n = 9) and no instance of steroid-induced glaucoma.Conclusion:Management of UES is complex and depends on disease severity. Using various corticosteroid delivery routes, UES control was achieved in 95%, and scleral window surgery was required in only 5%. A trial of corticosteroids can benefit patients with UES.

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“…The resistance of the transscleral sclera to protein movement decreases after sclerectomy, although this may be affected by the amount of sclera excised and postoperative fibrous scarring [ 63 ]. A prospective study showed that partial quadrant PTS (90% of the scleral thickness) in nanophthalmic eyes with UES had a significant effect [ 64 ], and PTS produced better results in the four quadrants [ 65 ]. The authors of the study considered that the PTS performed in the four quadrants could reduce the overall resistance to subchoroidal fluid outflow, thereby promoting the outflow of fluids in the suprachoroidal and subretinal spaces [ 64 , 65 ].…”

Section: Treatments For Uveal Effusion Syndrome In Nanophthalmic Ementioning

confidence: 99%

“…A prospective study showed that partial quadrant PTS (90% of the scleral thickness) in nanophthalmic eyes with UES had a significant effect [ 64 ], and PTS produced better results in the four quadrants [ 65 ]. The authors of the study considered that the PTS performed in the four quadrants could reduce the overall resistance to subchoroidal fluid outflow, thereby promoting the outflow of fluids in the suprachoroidal and subretinal spaces [ 64 , 65 ]. However, due to the large area of sclera removed, current technology may cause dilation of the sclera [ 64 ].…”

Section: Treatments For Uveal Effusion Syndrome In Nanophthalmic Ementioning

confidence: 99%

The Pathogenesis and Treatment of Complications in Nanophthalmos

Yang

Jin

et al. 2020

Journal of Ophthalmology

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Microphthalmos is a type of developmental disorder ophthalmopathy, which can occur isolated or combined with other ocular malformations and can occur secondary to a systemic syndrome. Nanophthalmos is one of the clinical phenotypes of microphthalmos. Due to the special and complex structure of nanophthalmic eyes, the disorder is often associated with many complications, including high hyperopia, angle-closure glaucoma, and uveal effusion syndrome. The management of these complications is challenging, and conventional therapeutic methods are often ineffective in treating them. The purpose of this paper was to review the concept of nanophthalmos and present the latest progress in the study of the pathogenesis and treatment of its complications. As it is considerably challenging for ophthalmologists to prevent or treat these nanophthalmos complications, timely diagnosis and a suitable clinical treatment plan are vital to ensure that nanophthalmos patients are treated and managed effectively.

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Four quadrant sclerotomies for uveal effusion syndrome

Cited by 8 publications

References 2 publications

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

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

Uveal effusion syndrome in 104 eyes: Response to corticosteroids – The 2017 Axel C. Hansen lecture

The Pathogenesis and Treatment of Complications in Nanophthalmos

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