Treatment of serous chorodial detachment with intravitreal air injection

ABSTRACT

Duke Elder described three types of choroidal detachments [1] Annular, [2] Lobular and [3] Flat. Annular type of choroidal detachment usually involves the ciliary body and peripheral part of the choroid. In the lobular type, there is massive choroidal detachment. Usually there are 2 or 4 lobules in 4 quadrants of the eyeball. Sometimes, they are so big that they touch one another in the middle of the vitreous cavity. Prolonged approximation of these lobules produces strong adhesion between the above-lying retinal layers. The Lobular type of choroidal detachment usually involves ora serrata as well as posterior part of the choroid. The flat type has small areas of choroidal detachments and may be found anywhere. The anterior limit of the choroidal detachment is marked by scleral spur anteriorly, while the posterior limit is the edge of the optic disc. There is a negative pressure in suprachoroidal space about2 mm Hg less than IOP. This negative pressure as well as loose attachment of the ciliary body and choroid to the sclera are responsible for attracting fluid and loose attachment allows easy separation and accumulation of the fluid in the suprachoroidal space