CHOROIDAL DETACHMENT - CLINICAL MANIFESTATION, THERAPY AND MECHANISM OF FORMATION

  • 1 January 1981
    • journal article
    • research article
    • Vol. 88 (11), 1107-1115
Abstract
From 103 patients 112 eyes were analyzed during a 9 1/2 yr period after surgical drainage of a choroidal (ciliochoroidal) detachment (CD). Choroidal detachment in 5 groups of postoperative patients was studied. CD after surgery for cataract, for cataract and glaucoma, and for glaucoma alone had different time courses, but in all of these, there were similar amounts of protein (67% of plasma protein concentration) in the suprachoroidal fluid (SCF). In marked contrast was a group of patients with intraoperative choroidal effusions and very little protein (18% of plasma concentration) in the SCF. Identified also was a chronic recurrent form of CD that usually persisted for < 3 mo. Distinct mechanisms (3) by which choroidal effusion is formed were recognized: 1 with evidence for the effusion occurring through an intact isoporous membrane (groups 1-3); a 2nd in which hemorrhagic SCF appeared acutely or subacutely (groups 1 and 2) through a disrupted isoporous membrane; and a 3rd form, an intraoperative choroidal effusion in patients with elevated episcleral venous pressure. Increased filtration rate of serum through an intact choriocapillary membrane caused molecular sieving of serum proteins. Inflammation, infection, cataract formation, and corneal edema were uncommonly encountered. Indications for surgery and recommended surgical technique are outlined in detail.

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