Retinal Detachment, Exudative Treatment & Management

  • Author: Lihteh Wu, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 23, 2010
 

Medical Care

The medical and surgical treatments of exudative retinal detachments have to be tailored to the underlying condition.

  • Inflammatory conditions, such as scleritis and Vogt-Koyanagi-Harada syndrome, should be treated with anti-inflammatory agents.[3]
  • Tumors need to be treated accordingly. External beam radiation therapy or brachytherapy with a plaque may be used for choroidal melanoma. Metastatic lesions respond to chemotherapy or localized radiation therapy. Choroidal hemangiomas may respond to laser photocoagulation or plaque brachytherapy. Retinoblastomas may be shrunk with chemotherapy and then treated locally with heat, laser, or cryotherapy.
  • Infectious etiologies may respond to antibiotics.
  • Reports exist of patients with exudative retinal detachments secondary to chronic renal failure that have spontaneous retinal reattachment following renal transplant or renal dialysis.[4]
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Surgical Care

The medical and surgical treatments of exudative retinal detachments have to be tailored to the underlying condition.

  • Conditions with vascular anomalies, such as Coats disease, should be treated with laser, cryotherapy, or even vitrectomy to obliterate the vascular abnormalities.
  • In nanophthalmos where the sclera is abnormally thick, vortex vein decompression with scleral windows and suprachoroidal fluid drainage is indicated.
  • Congenital anomalies, such as optic pits or colobomas, may respond to vitrectomy and endolaser techniques.
  • Central serous chorioretinopathy may respond to mild laser treatment of the focal areas that leak on fluorescein angiogram.
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Consultations

Consult a vitreoretinal specialist early in the disease process. If immunosuppressive therapy is being considered, consultation with an immunologist or rheumatologist is highly recommended.

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Contributor Information and Disclosures
Author

Lihteh Wu, MD  Consulting Surgeon, Department of Ophthalmology, Vitreo-Retinal Section, Instituto De Cirugia Ocular, Costa Rica

Lihteh Wu, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Pan-American Association of Ophthalmology, and Retina Society

Disclosure: Nothing to disclose.

Coauthor(s)

Teodoro Evans, MD  Retina Fellow, St Michael's Hospital, University of Toronto, Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

V Al Pakalnis, MD, PhD  Professor of Ophthalmology, University of South Carolina School of Medicine; Chief of Ophthalmology, Dorn Veterans Affairs Medical Center

V Al Pakalnis, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and South Carolina Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians & Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

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

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

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, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

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An 8-year-old boy with Coats disease. Notice the macular exudation.
An 8-year-old boy with Coats disease. Notice the peripheral vascular dilatations. This patient underwent cryotherapy months before, and the exudative retinal detachment has basically disappeared.
 
 
 
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