A patient was referred to the ocular oncology service for evaluation of a suspicious choroidal mass and serous retinal detachment in the right eye. The Snellen visual acuity was 20/80 and intraocular pressures were normal in both eyes. Examination and imaging of the right eye revealed a thickened choroid, serous retinal detachment and cystoid macular edema. The left eye examination was unremarkable. A basic uveitis work-up was negative. The patient received a sub-tenon’s Kenalog injection followed by intravitreal Triesence, which led to improvement of the serous detachment and decreased choroidal thickness. However, after undergoing cataract extraction in that eye, there was a recurrence of the serous detachment and cystoid macular edema, this time with a poor response to intravitreal Triesence. Subsequently, the patient was sent for systemic imaging and underwent fine needle aspiration biopsy of the choroid in order to rule out uveal lymphoma. The biopsy was negative for lymphoma, and the systemic imaging was negative. Therefore, surgical treatment for uveal effusion syndrome with partial thickness scleral windows in all four quadrants was performed. This case presentation will discuss some of the examination and imaging features that distinguish uveal lymphoma from uveal effusion syndrome. It will also highlight the surgical technique utilized for the management of this patient as well as the pathology of the scleral specimens and the final outcome of the patient.
Presentation Date: 04/08/2021
Issue Date: 04/23/2021
- Faculty Discussant: J. William Harbour, MD
Continuing Medical Education (CME)