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!
- Posterior uveitis
- Hypotony after glaucoma surgery
- Intraocular lymphoma
- Choroidal neoplasia
- Postoperative infallmation
- Gradual superior visual field loss
- Blurred vision or metamorphopsia
- Exudative RD
- Leopard spots
- Relapsed and remitting
- ONH oedema – sometimes
- CSR with multiple RPE detachments
- B-scan USS – choroid/sclera is thickened. Rule out RD.
- FAF – leopard spots.
- Enhanced depth OCT – increased choroidal thickness.
- 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)