Uveal effusion syndrome - Clinical features, surgical treatment, histologic examination of the sclera, and pathophysiology

Citation
M. Uyama et al., Uveal effusion syndrome - Clinical features, surgical treatment, histologic examination of the sclera, and pathophysiology, OPHTHALMOL, 107(3), 2000, pp. 441-449
Citations number
27
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Optalmology,"da verificare
Journal title
OPHTHALMOLOGY
ISSN journal
0161-6420 → ACNP
Volume
107
Issue
3
Year of publication
2000
Pages
441 - 449
Database
ISI
SICI code
0161-6420(200003)107:3<441:UES-CF>2.0.ZU;2-L
Abstract
Purpose: To clarify clinical features and pathophysiology and to evaluate s urgical outcome of subscleral sclerectomy for primary uveal effusion syndro me, Design. Prospective, consecutive noncomparative case series. Participants Nineteen eyes of 16 patients diagnosed with uveal effusion syn drome treated in our clinic between 1989 and 1998, Methods: Patients were examined by routine ophthalmologic examinations, flu orescein and indocyanine green angiography; measurement of the axial length of the eyeball; magnetic resonance imaging; and echography, Subscleral scl erectomy (sclerectomy under the scleral flap) was peformed at the equator o n all patients. Histologic examination of excised sclera was carried out on all samples. Patients were followed for outcome over time. Main Outcome Measures: Reattachment of the choroid and retina with resoluti on of the serous fluid. Results: Three subgroups were identified: In type 1 , nanophthalmic eye; the eyeball is small (average axial length 16 mm) and high hypermetropic (average +16 diopters); in type 2, the eyeball size is n ormal (average axial length 21 mm) with small refractive error; and in type 3, the eyeball size is normal. Histologically, types 1 and 2 demonstrated abnormal sclera with disorganization of collagen fiber bundles and deposits of proteoglycans in the matrix, whereas type 3 showed normal sclera. Subsc leral sclerectomy was effective for types 1 and 2, inducing postoperative r esolution of the subretinal fluid. However, type 3 eyes were not helped by this technique. Conclusions: Primary uveal effusion syndrome is caused by abnormalities of the sclera and increased resistance to transscleral fluid outflow as subscl eral sclerectomy is an effective treatment in types 1 and 2 only, correct p reoperative classification is essential for early surgical management. (C) 2000 by the American Academy of Ophthalmology.