Choroidal Detachment
Section outline
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A patient with a complex ophthalmic history including pseudophakic bullous keratopathy, pseudoexfoliation glaucoma post glaucoma drainage devices, prior pars plana vitrectomy with membrane peel and intraocular lens fixation, epiretinal membrane, and cystoid macular edema presented for urgent evaluation of an elevation noted on B-scan one week after DMEK with tube trimming in the left eye. The patient reported new-onset floaters but no subjective decrease in vision. Visual acuity was 20/400 and intraocular pressure was 5 mmHg. Significant corneal edema limited posterior segment visualization. B-scan demonstrated a localized temporal elevation initially interpreted as a possible retinal detachment with a possible retinal tear, associated vitreous hemorrhage, and an attached macula. Optical coherence tomography demonstrated choroidal folds with an attached macula. Given concern for a retinal detachment, surgical repair was initially considered. Over the following days awaiting corneal edema to subside, visual acuity and intraocular pressure improved, while B-scan findings remained stable and OCT continued to demonstrate choroidal folds. Approximately 10 days later, repeat B-scan demonstrated near-complete resolution of the previously noted elevation and significant improvement in the temporal subretinal/choroidal fluid, with no retinal tears or holes identified. In the setting of postoperative hypotony following tube trimming, the findings were ultimately determined to represent a resolving choroidal effusion rather than a retinal detachment. The patient was observed without surgical intervention, with continued close monitoring and improvement in intraocular pressure and choroidal fluid.
Presentation Date: 09/10/2026
Issue Date: 09/11/2026
