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Choroidal Detachment Workup

  • Author: Carlo E Traverso, MD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Sep 19, 2014
 

Imaging Studies

See the list below:

  • B-scan ultrasonography can aid in differentiating between serum and blood collected under or within the choroid (shown in the image below). B-scan ultrasonography is also helpful to delimit and stage the extent of the detachment when media are not clear.
    B-scan ultrasonography examination of choroidal deB-scan ultrasonography examination of choroidal detachment. Fluid appears to be serum on one side (upper) and blood on the other side (below). Retina-to-retina contact, or kissing choroidal detachment, is present.
 
 
Contributor Information and Disclosures
Author

Carlo E Traverso, MD Professor and Chairman, Clinica Oculistica of Department of Neurosciences, Ophthalmology, Maternal and Pediatrics and Genetics, University of Genova Medical School/IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Italy

Carlo E Traverso, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, European Glaucoma Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Richard W Allinson, MD Associate Professor, Department of Ophthalmology, Texas A&M University Health Science Center; Senior Staff Ophthalmologist, Scott and White Clinic

Richard W Allinson, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

References
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Serous choroidal detachment. Two lobes (ie, supertemporal, supranasal) of fluid accumulation are visible. The choroidal folds seen at the posterior pole are due to concomitant hypotony.
B-scan ultrasonography examination of choroidal detachment. Fluid appears to be serum on one side (upper) and blood on the other side (below). Retina-to-retina contact, or kissing choroidal detachment, is present.
Kissing choroidal detachment. When the lobes of the detachment are sufficiently large, retina-to-retina contact occurs. If this is extended centrally, the clinical picture is described as kissing choroidals. The extension of the lobes of detachment/edema is important for the decision-making process regarding the clinical management.
Postoperative suprachoroidal hemorrhage. In this buphthalmic aphakic eye, suprachoroidal hemorrhage resulted in vitreous hemorrhage, retinal detachment, and extrusion of retina and blood through the pupil into the anterior chamber.
Drainage of suprachoroidal space. After the posterior sclerostomies are performed, gentle infusion in the anterior chamber through a paracentesis tract helps the globe to maintain a tone while the fluid exit from the suprachoroidal space is facilitated.
Drainage of suprachoroidal space. The hemorrhagic fluid is darker than fresh blood. Mechanical gaping of the radial incisions facilitates the egress of fluid.
Drainage of suprachoroidal hemorrhage. At least two quadrants, guided by B-scan images. Careful sclerostomies are performed at 4-5 mm from the limbus. The anterior chamber (AC) should be frequently reformed or a low-pressure AC infusion line should be placed. Gentle pressure on the surrounding sclera will help drainage. Serum is yellow and clear, blood is very dark red. Do not grab or pull from inside the sclerostomies. The technique is the same for drainage of serous choroidal detachment.
 
 
 
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