choroidal detachment

Introduction

separation of the choroid from the sclera

Etiology

• surgery (most common)
• trauma
• panretinal photocoagulation
• corneal ulcers
• globe hypotony (serous)
• ocular inflammation (serous)

Pathology

• serous:
  • transudative fluid accumulation in the potential suprachoroidal space
• hemorrhagic:
  • hemorrhage in the suprachoroidal space or within the choroid caused by the rupture of choroidal vessels
• separation of the choroid from the sclera

Clinical manifestations

• spontaneous (serous)
  • generally painless
  • variable visual impairment
• post surgical (hemorrhagic):
  • sudden excruciating throbbing pain
  • immediate loss of vision

Diagnostic procedures

• B-scan ultrasonography
• tonometry for intraocular pressure

Complications

• retinal detachment
• maculopathy
• globe phthisis
• visual impairment (40%)

Differential diagnosis

• acute angle-closure glaucoma
• ocular melanoma
• pupillary block
• retinal detachment

Management

• topical corticosteroids
• cycloplegics
• mydriatics
• oral steroids may be indicated for ocular inflammation
• lower intraocular pressure if elevated
  • acetazolamide (carbonic anhydrase inhibitor)
  • timolol
  • mannitol
  • parasympathomimetics are contraindicated
    • pilocarpine contraindicated

More general terms

• choroid disease

Additional terms

• choroid