Grand Rounds
A hyperopic patient developed blurry vision in the right eye associated with flashes and floaters. He was seen by a retina specialist who diagnosed the patient for unilateral serous retinal and choroidal detachments. The patient was given high doses of oral prednisone for a suspected inflammatory process, but the treatment was held due to ineffectiveness. Focal laser to a pinpoint area of leakage superior to the disc in the right eye was administered. The patient came to Bascom Palmer Eye Institute for another opinion. No retinal tears were identified. A second round of high doses of oral prednisone with a slower taper failed to treat the condition. Observation for nearly three months off corticosteroids led to worsening fluid accumulation. The axial length was approximately 22 mm bilaterally. Multimodal imaging led to a suspected diagnosis of uveal effusion syndrome. Partial thickness scleral windows were performed in all four quadrants and the sclera was noted to be thickened. Histology showed accumulation of mucopolysaccharides and disorganization of the scleral fibers, which was consistent with a diagnosis of Type 2 uveal effusion syndrome. There was marked improvement in the subretinal fluid and choroidal detachments at 2 months follow up postoperatively.
Presentation Date: 04/21/2022
Issue Date: 05/06/2022
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