A Case of Ciliochoroidal Detachment After Patterned Scanning Laser Photocoagulation With Short Exposure Time

PURPOSE: To report the case of a patient with ciliochoroidal detachment after brief exposure to patterned scanning laser photocoagulation. CASE SUMMARY: We examined a 62-year-old woman with early proliferative diabetic retinopathy and observed neovascularization and macular edema upon fundus examination. The patient underwent patterned scanning laser photocoagulation with an exposure time of 0.03 sec over the entire retina in a single pass. In vivo, the ciliary body and choroid were examined using ultrasound biomicroscopy (UBM), before, immediately after, 3 and 7 days after panretinal photocoagulation. Ciliochoroidal detachment was observed 3 days after panretinal photocoagulation and spontaneously disappeared by 7 days after photocoagulation. The change in IOP coincident with ciliochoroidal detachment were not significant. CONCLUSIONS: Ciliochoroidal detachment after panretinal photocoagulation may lead to complications such as angle-closure glaucoma. Patterned scanning laser photocoagulation with short exposure time should be practiced only with careful attention to the possible development of cilochoroidal detachment.

Study on imaging diagnosis of the ciliochoroidal detachment / 中华放射学杂志

Objective To investigate the characteristics of imaging appearances and diagnostic value of ciliochoroidal detachment.Methods Ultrasound,MRI and CT appearances of 19 cases of ciliochoroidal detachment were reviewed,which included 9 cases of serous ciliochoroidal detachment,7 cases of choroid hematoma,and 3 cases of ciliary body detachment.All cases were examined by both B ultrasound and MRI at the same time,11 of them were examined by CT.Results UItrasound showed membrane bulge of the eyeball wall with different extent in 9 cases of serous ciliochoroidal detachment.Its postzone connected the equator or close to optic disc and its prozone could not been detected by ultrasound.There was echofree fluid darkspace under detached membrane.MRI showed membrane detachment at both nasal side and temporal side of ocular annulation in 9 cases of ciliochoroidal detachment.The detached membrane was approximately symmetry,its anterior margin did not exceed ciliary body adhesion of ocular annnlation and its posterior margin stopped at posterior part of ocular annulafion.There was long T1 and long T2 signal under detached membrane.CT showed slight thickening of ocular annulafion and slightly increased density of eyeball in 5 cases of serous cilioehoroidal detachment.Ultrasound showed hemispheroid or curve bulge of eyeball wall,projected toward the vitreous cavity in 7 cases of choroid hematoma,and there was an amount of low echo light spot under the detached membrane.Both MRI (7 cases)and CT (5 cases) showed hemispheroid,fusfform or curve bulge on the nasal side,temporal side and posterior part of ocular annulation.They appeared as isodensity or slight high density on CT,iso- or high signal on T1 WI and T2WI.Stratification was seen on T2WI in I case of choroid hematoma.Ciliary body detachment could not been detected by either MBI (3 cases) or CT (1 case) except ultrasound.Conclusion Imaging examination may provide reliable diagnostic evidence for ciliochoroidal detachment.

Ultrasound Biomicroscopic Evaluation of Ciliary Body and Choroidal Detachment after Panretinal Photocoagulation

PURPOSE: To clarify the ciliary body and choroidal detachment after panretinal photocoagulation and to inspect complications by ciliary body and choroidal detachment after panretinal photocoagulation. METHODS: A dynamic, in vivo examination using ultrasound biomicroscope (UBM) was performed on 12 eyes of 11 patients before, immediately after, and 3 and 7 days after panretinal photocoagulation. IOP measurement was performed on each occasions, and the spot size, and spot number of laser applications of each patient was measured. RESULTS: Three days after photocoagulation, ciliochoroidal detachment was observed in 6 of the 12 eyes, but none was observed at 7 days. The retinal surface area that had been treated was associated with the development of detachment. No significant IOP change according to the ciliochoroidal detachment was present. CONCLUSIONS: Although ciliochoroidal detachment was asymptomatic and transient in this study, potential hazards such as angle closure glaucoma necessitate careful attention in the planning of panretinal photocoagulation. UBM is a useful tool for the evaluation of ciliochoroidal detachment after photocoagulation.

A Case of Bilateral Malignant Glaucoma with Ciliochoroidal Detachment

Malignant glaucoma is a disease process in which entire anterior chamber becomes uniformly shallow and elevates intraocular pressure. Classically, this has been described as limited to cases occurring following glaucoma surgery. Subsequently, association with trauma, inflammation, and the use of miotic agents, as well as spontaneous occurrence have also been noted. We have experienced one case of bilateral malignant glaucoma associated with ciliochoroidal detachment which was detected by ultrasoundbiomi-croscopy in a 55-year-old male. The episode followed the use of a strong miotic(pilocarpine hydrochloride 4%) and laser iridotomy for acute angle closure glaucoma. We report this case with review of available literature.

A Case of Post. Scleritis Associated with Ciliochoroidal Detachment and Ant. Uveitis in Background Diabetic Retinopathy Patient

Posterior scleritis is an uncommon disease. Its clinical manifestations may include pain. reduced visual acuity, cellular infiltration in the aqueous and vitreous humor, serous retinal detachment, chorioretinal lesions, and disc or macular edema. The diagnosis of posterior scleritis is often difficult due to its rarity and the diversity of symptoms. However, ultrasography and computed tomography are noninvasive methods for diagnosis of posterior scleritis. We treated posterior scleritis associated with ciliochoroidal detachment and anterior uveitis with sclerotomy, drainage of ciliochoroidal fluid in a background diabetic retinopathy patient.

Outflow of Aqueous Humor Following Cyclodialysis or Ciliochoroidal Detachment in Rabbit

Cyclodialysis and ciliochoroidal detachment was performed in one eye of three rabbits and in one eye of another three rabbits respectively. 0.1 ml of 10% sodium fluorescein was injected intracamerally after aspiration of aqueous humor and the eyeball was enucleated between 30 minutes and one hour after sodium fluorescein injection and prepared for fluorescence microscopy. Sodium fluorescein concentration in supraciliary space was much greater in group with cyclodialysis or ciliochoroidal detachment than in normal control group. These results suggest that in the eye with cyclodialysis, aqueous humor may gain access freely to supraciliary space through the cleft between anterior chamber and supraciliary space and then is removed rapidly and in the eye with ciliochoroidal detachment, aqueous humor may pass through uveoscleral outflow pathway.

Outflow of aqueous humor following cyclodialysis or ciliochoroidal detachment in rabbit

Cyclodialysis and ciliochoroidal detachment were performed in three eyes of three rabbits and in three eyes of another three rabbits, respectively. After aspiration of the aqueous humor, 0.1 ml of 10% sodium fluorescein was injected intracamerally, and the eyeball was enucleated between 30 minutes and one hour after injection and prepared for fluorescence microscopy. Sodium fluorescein concentrations in the supraciliary space were much greater in the group with cyclodialysis or ciliochoroidal detachment than in the normal control group. These results suggest that (1) in the eye with cyclodialysis, the aqueous humor may freely gain access to the supraciliary space through the cleft between the anterior chamber and the supraciliary space and then be removed rapidly and (2) in the eye with ciliochoroidal detachment, the aqueous humor may pass through the uveoscleral outflow pathway.