Full-thickness Sclerotomy for Uveal Effusion Syndrome
A 77-year-old man presented to the emergency room with a ten-day history of a shadow that affected the upper part of the vision in his left eye. He had no relevant ocular history, but had undergone cataract surgery in both eyes four years prior to presentation. BCVA without any refractive error was 1.0 and 0.4 logMAR in the right and left eyes, respectively. Fundus examination revealed marked shifting of the subretinal fluid underneath the retinal detachment of the left eye. On OCT examination, the retinal findings looked like an atypical central serous chorioretinopathy (). For further workup, ultrasonography, FAG, and ICGA were performed. The axial length was 21.74 mm in the right eye and 21.56 mm in the left eye, which was not compatible with nanophthalmos. There were no definite leaking points on ICG, but leopard-spot patterns were noted on FAG. On the basis of these findings, we diagnosed him with UES. Despite treatment with steroids (50 mg oral prednisolone per day), the retinal findings and vision did not improve. Drainage sclerotomy was conducted in the inferotemporal and inferonasal quadrants. External subretinal fluid drainage was also performed. Ten days later, only a small amount of subretinal fluid was noted on fundus examination. His visual acuity improved to 0.6 logMAR three months after surgery, and no subretinal fluid was noted on OCT (). His visual acuity improved to 0.9 logMAR, and the retina was stable at the last visit seven months postoperatively.