Indian Journal of Ophthalmology

PHOTO ESSAY
Year
: 2016  |  Volume : 64  |  Issue : 8  |  Page : 593--594

Diagnosis and a minimum effective management for nanophthalmic uveal effusion syndrome


Wei Jin1, Yaopeng Xu2, Wenjun Wang1, Anhuai Yang1,  
1 Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, P.R. China
2 Department of Urology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, Hubei, P.R. China

Correspondence Address:
Dr. Anhuai Yang
#238, Jiefang Road, Wuhan, Hubei
P.R. China




How to cite this article:
Jin W, Xu Y, Wang W, Yang A. Diagnosis and a minimum effective management for nanophthalmic uveal effusion syndrome.Indian J Ophthalmol 2016;64:593-594


How to cite this URL:
Jin W, Xu Y, Wang W, Yang A. Diagnosis and a minimum effective management for nanophthalmic uveal effusion syndrome. Indian J Ophthalmol [serial online] 2016 [cited 2020 Jan 20 ];64:593-594
Available from: http://www.ijo.in/text.asp?2016/64/8/593/191507


Full Text

A 38-year-old male presented with a 2-week history of sudden blurred vision (best-corrected visual acuity: 20/200) and pain in his right eye. Spectral domain optical coherence tomography (OCT) revealed focal thickening of the retinal pigment epithelium layer as leopard spots [Figure 1]a. Fundus examination demonstrated exudative retinal detachment and retinal vascular dilation [Figure 1]c whereas the contralateral eye remained unremarkable [Figure 1]b and d. B-scan ultrasonography showed a short axial length (17.3 mm). Fundus fluorescein angiography and indocyanine green angiography revealed leopard spots of granular hyperfluorescence in the posterior and inferior quadrants [Figure 1]e, which were increased with time and persisted until the late phase [Figure 1]f. On the basis of clinical findings, we diagnosed him and it revealed to be nanophthalmic uveal effusion syndrome (UES). [1] After 10 mg dexamethasone was applied intravenously, two-third thickness scleral flaps measuring 4 mm × 5 mm were performed at inferotemporal and inferonasal sites [Figure 2]a. Under them, the remaining sclerae were excised measuring 1 mm × 2 mm accordingly [Figure 2]b and c. Biopsy [Figure 2]d and pathologic evaluation revealed fibroblastic proliferation and hyaline degeneration of lamellar sclera [Figure 2]e and f. The effusion was not detected at least on 6-month follow-up [Figure 3], and the visual acuity was stabled at 20/100.{Figure 1}{Figure 2}{Figure 3}

 Discussion



UES is an extremely rare disease that trends to follow a relapsing-remitting course. Nanophthalmic eyes characteristically have a relatively normal corneal diameter but a shallow anterior chamber. [2] At the time of the surgery, we noted the insertions of the rectus muscles, and the equator was located unusually anteriorly. The sclera was abnormally rigid and unusually thick. When sclerectomy was performed and the choroid was exposed, abundant serous suprachoroidal fluid was spontaneously released. After the surgery, ciliochoroidal detachment resolved, and the retinal detachment gradually resolved within 1 month. OCT displayed that subretinal fluid under macula was absorbed completely. Other treatments with high-dose systemic steroids or prostaglandins analogs have been described with rare success. [3],[4] Thus, further studies are needed to explore the different causative mechanisms of UES, and to determine whether treatment can be tailored to a given patient.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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