The Experts below are selected from a list of 342 Experts worldwide ranked by ideXlab platform
Tsunehiko Ikeda - One of the best experts on this subject based on the ideXlab platform.
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type iii Uveal Effusion Syndrome suspected to be related to pachychoroid spectrum disease a case report
Medicine, 2020Co-Authors: Yuya Terubayashi, Seita Morishita, Ryohsuke Kohmoto, Masashi Mimura, Masanori Fukumoto, Takaki Sato, Takatoshi Kobayashi, Teruyo Kida, Tsunehiko IkedaAbstract:Introduction We report a case of type III Uveal Effusion Syndrome (UES) suspected to be related to pachychoroid spectrum disease. Patient concerns A 42-year-old man became aware of visual field constriction and deterioration of visual acuity in his right eye. Diagnosis Upon examination, a bullous non-rhegmatogenous retinal detachment was observed in the inferior 2 quadrants of the right eye fundus, and the subretinal fluid moved with postural changes. The axial length in that eye was 22.36 mm, thus indicating no nanophthalmia. Preoperative indocyanine green angiography revealed dilated choroidal vessels in the posterior pole of the right eye and mild leakage in the late phase. Optical coherence tomography examination revealed choroidal thickening in both eyes. Interventions For treatment, we first performed sclerotomy, and the intraoperative findings showed no thickening of the sclera. Following surgery, reattachment of the retina was not achieved. Outcomes Thus, we next performed vitrectomy, which led to successful reattachment of the retina. Lessons In this case, we theorize that pachychoroid spectrum disease might have been involved in the pathogenesis of type III UES.
Robert E Maclaren - One of the best experts on this subject based on the ideXlab platform.
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scleral punch method with topical mitomycin c for safe revision of failed deep sclerectomy in nanophthalmic Uveal Effusion Syndrome
Graefes Archive for Clinical and Experimental Ophthalmology, 2009Co-Authors: Nelson A Sabrosa, Henry B Smith, Robert E MaclarenAbstract:To describe a novel surgical technique for revision of deep sclerectomy surgery in nanophthalmic Uveal Effusion Syndrome. A 46-year-old woman with recessively inherited nanophthalmos and chronic Uveal Effusions underwent a revision of previous failed deep sclerectomy surgery. In the presence of scar tissue, revision of sclerectomies was greatly facilitated by the use of a Kelly scleral punch (Katena Products, Inc., Denville, NJ, USA). To inhibit further scarring, mitomycin-C (MMC) was applied topically in each quadrant posterior to the equator. The scleral punch allowed outward scleral dissection from the suprachoroidal space, and brisk enlargement of sclerectomies in all quadrants without perforation of choroidal tissue. Post-operative conjunctival wound healing appeared unimpeded by the posteriorly placed MMC sponges. Near-total resolution of the Effusions had occurred by 3 months. The scleral punch provides a safe and effective method for constructing and revising full-thickness sclerectomies in the nanophthalmic eye, minimizing the risk of choroidal trauma. The use of topical MMC may reduce the risk of late failure of trans-scleral outflow due to fibrosis.
Timothy L Jackson - One of the best experts on this subject based on the ideXlab platform.
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a prospective population based surveillance bosu study of Uveal Effusion Syndrome in the uk
European Journal of Ophthalmology, 2021Co-Authors: Barny Foot, Rohit Sharma, Timothy L JacksonAbstract:Purpose:To determine the incidence and demographic profile of Uveal Effusion Syndrome (UES), and to describe the visual and anatomic outcome following deep sclerectomy or vortex vein decompression....
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transscleral albumin diffusion and suprachoroidal albumin concentration in Uveal Effusion Syndrome
Retina-the Journal of Retinal and Vitreous Diseases, 2012Co-Authors: Timothy L Jackson, A A Hussain, J R Salisbury, Roy Sherwood, Paul Sullivan, John C MarshallAbstract:PURPOSE: To test the hypothesis that Uveal Effusion Syndrome is caused by reduced transscleral albumin permeability. METHODS: Surgical scleral specimens were obtained from a 55-year-old patient with nanophthalmic Uveal Effusion Syndrome. Specimens were clamped in a modified Ussing chamber, and the rate of transscleral diffusion of fluorescein isothiocyanate-albumin was measured over 12 hours, using a spectrophotometer and predetermined standard curves. The diffusion coefficient was determined at 20°C, and then adjusted to body temperature using Einstein's equation. Results in 3 scleral samples were compared with 10 age-matched controls. Albumin and total protein concentration were measured in choroidal fluid and serum. RESULTS: Histologic staining with Alcian blue showed interfibrillary acid mucin deposits. Transmission electron microscopy showed deposits measuring 1 μm to 10 μm and collections of expanded, degenerate collagen fibrils. The mean (±SD) albumin diffusion coefficient was 12% of that in controls (1.22 ± 0.67(-8) × 10 vs. 10.3 ± 7.0 × 10(-8) cm2/second) and below the lower 95% confidence limit of the control group. The diffusion coefficient was calculated to increase 53% to 1.87 ± 1.03 × 10(-8) cm2/second at 37°C. Choroidal albumin concentration was much higher than physiologic levels, measuring 200 g/L (total protein 321 g/L), 5 times the serum albumin concentration of 42 g/L (total protein 70 g/L). CONCLUSION: Nanophthalmic Uveal Effusion Syndrome can be associated with reduced scleral permeability to albumin, and a very high concentration of retained suprachoroidal albumin. This will lead to an osmotic gradient that retains fluid and may partly explain the pathogenesis of Uveal Effusion Syndrome in some patients.
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Uveal Effusion Syndrome
Survey of Ophthalmology, 2010Co-Authors: Timothy L Jackson, Mohammed Elagouz, Dinu StanescusegallAbstract:The terms Uveal Effusion, choroidal Effusion, ciliochoroidal Effusion, ciliochoroidal detachment, and choroidal detachment have been used interchangeably in the literature. These labels all describe an abnormal collection of fluid that expands the suprachoroidal space, producing internal elevation of the choroidal. There are various inflammatory and hydrostatic conditions that can cause Uveal Effusion, but in some cases no obvious cause exists. In this setting, patients are thought to have a distinct, primary abnormality of the choroid or sclera, called Uveal Effusion Syndrome (UES). UES may be idiopathic, or associated with hypermetropia, and should be considered a diagnosis of exclusion. Histological studies show amorphous glycosaminoglycan-like material filling the interfibrillary spaces of excised scleral tissue, with disruption of collagen fibers. In some patients there may be reduced macromolecular diffusion that interferes with the normal transscleral egress of albumin out of the eye, perhaps causing choroidal fluid retention due to altered osmotic forces. An alternative, and perhaps complementary hypothesis, is that swollen sclera compresses the transscleral vessels with resulting fluid retention. Patients with UES are most typically middle-aged men who have a relapsing remitting clinical course. There is often co-existing, shifting subretinal fluid that may involve the macula. Chronic disease may lead to secondary retinal pigment epithelial (leopard spot) changes and permanently reduced visual acuity. Treatment with systemic steroids does not appear to be effective. Surgical decompression of the vortex veins as they pass through the sclera has been described, but the most common treatment is full-thickness sclerectomies to provide an exit for choroidal fluid. The largest case series suggests that this produces an anatomic improvement in approximately 83% of treated eyes after a single procedure and in about 96% after one or two procedures. Final visual acuity improves by two or more lines in 56% of the eyes, is stable in 35%, and worsens in 9%. Although extremely rare, UES is a serious condition that is difficult to treat and can lead to severe and permanent visual loss in both eyes.
Cintia Storti - One of the best experts on this subject based on the ideXlab platform.
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choroidal metastasis simulating Uveal Effusion Syndrome case report
Arquivos Brasileiros De Oftalmologia, 2008Co-Authors: Carlos Eduardo Cury, Alexandre Cury, Rubens Camargo Siqueira, Cintia StortiAbstract:We report a case of choroidal metastasis simulating Uveal Effusion Syndrome. This patient with Uveal metastasis from lung carcinoma presented with decreased vision in the left eye. Fundoscopic examination revealed pigmentary clumping, multiple choroidal nodules and serous retinal detachment. Fluorescein angioraphy revealed a leopard spots pattern similar to Uveal Effusion Syndrome. Ultrasound revealed the presence of choroidal nodules with moderate internal reflectivity, choroidal thickening and serous retinal detachment. Optical coherence tomography showed retinal pigment epithelium tear and hyper-reflective nodules within the choroid and areas of serous retinal detachment. Image investigation demonstrated the presence of a solitary pulmonary nodule at the left apical lung. Choroidal metastasis can lead to a scenario that simulates Uveal Effusion Syndrome. This possibility must be considered when having an atypical Uveal Effusion symptomatoloy and a systemic screening for systemic cancer should be performed.
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Metástase de coróide simulando síndrome de efusão Uveal: relato de caso Choroidal metastasis simulating Uveal Effusion Syndrome: case report
Conselho Brasileiro de Oftalmologia, 2008Co-Authors: Carlos Eduardo Cury Júnior, Rubens Camargo Siqueira, Alexandre Cury Júnior, Cintia StortiAbstract:Descrição de um caso de efusão Uveal secundária a metástase de coróide e revisão dos principais diagnósticos diferenciais. Uma paciente com baixa da acuidade visual, no olho esquerdo, apresentou nódulos ao nível da coróide, dispersão pigmentar retiniana e descolamento seroso da retina. O exame angiofluoresceinográfico demonstrou padrão "leopard spots", semelhante ao encontrado nos casos de efusão Uveal. A ecografia ocular demonstrou a presença do descolamento seroso da retina, presença de espessamento e nódulos na coróide e a tomografia de coerência óptica evidenciou ruptura do epitélio pigmentado da retina, presença de nodulações coroidianas hiperrefletivas e áreas de descolamento de retina seroso. Após ser submetido a exames diagnósticos de imagem, constatou-se a presença de nódulo único no ápice pulmonar esquerdo. As metástases de coróide podem levar a um quadro similar à síndrome de efusão Uveal. Esta possibilidade deve sempre ser pensada diante de um quadro de efusão Uveal atípica e avaliação sistêmica para pesquisa de carcinoma deverá ser solicitada.We report a case of choroidal metastasis simulating Uveal Effusion Syndrome. This patient with Uveal metastasis from lung carcinoma presented with decreased vision in the left eye. Fundoscopic examination revealed pigmentary clumping, multiple choroidal nodules and serous retinal detachment. Fluorescein angioraphy revealed a leopard spots pattern similar to Uveal Effusion Syndrome. Ultrasound revealed the presence of choroidal nodules with moderate internal reflectivity, choroidal thickening and serous retinal detachment. Optical coherence tomography showed retinal pigment epithelium tear and hyper-reflective nodules within the choroid and areas of serous retinal detachment. Image investigation demonstrated the presence of a solitary pulmonary nodule at the left apical lung. Choroidal metastasis can lead to a scenario that simulates Uveal Effusion Syndrome. This possibility must be considered when having an atypical Uveal Effusion symptomatoloy and a systemic screening for systemic cancer should be performed
Yuya Terubayashi - One of the best experts on this subject based on the ideXlab platform.
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type iii Uveal Effusion Syndrome suspected to be related to pachychoroid spectrum disease a case report
Medicine, 2020Co-Authors: Yuya Terubayashi, Seita Morishita, Ryohsuke Kohmoto, Masashi Mimura, Masanori Fukumoto, Takaki Sato, Takatoshi Kobayashi, Teruyo Kida, Tsunehiko IkedaAbstract:Introduction We report a case of type III Uveal Effusion Syndrome (UES) suspected to be related to pachychoroid spectrum disease. Patient concerns A 42-year-old man became aware of visual field constriction and deterioration of visual acuity in his right eye. Diagnosis Upon examination, a bullous non-rhegmatogenous retinal detachment was observed in the inferior 2 quadrants of the right eye fundus, and the subretinal fluid moved with postural changes. The axial length in that eye was 22.36 mm, thus indicating no nanophthalmia. Preoperative indocyanine green angiography revealed dilated choroidal vessels in the posterior pole of the right eye and mild leakage in the late phase. Optical coherence tomography examination revealed choroidal thickening in both eyes. Interventions For treatment, we first performed sclerotomy, and the intraoperative findings showed no thickening of the sclera. Following surgery, reattachment of the retina was not achieved. Outcomes Thus, we next performed vitrectomy, which led to successful reattachment of the retina. Lessons In this case, we theorize that pachychoroid spectrum disease might have been involved in the pathogenesis of type III UES.
