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)

References:

  1. Management of uveal effusion syndrome. Retina Today. 2018

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Location Birmingham Midlands Eye Centre 76 Dudley Road Birmingham B18 7QH UK Phone 0121 554 3801 Hours Mr Ch'ng | Vitreoretinal Clinic Sessions: Monday: 8.30am - 12.30pm Wednesday (alternate): 8.30am - 5.00pm Thursday: 8.30am - 12.30pm Friday: 8.30am - 12.30pm | Vitreoretinal Theatre Sessions: Wednesday (alternate): 8.30am - 5.00pm & Friday (emergency cases): 1.30pm - 5.00pm | Eye Casualty Session: Monday 1.00pm - 4.30pm |
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