Choroidal detachment

Choroidal detachment is a detachment of the choroid from the underlying sclera due to the accumulation of fluid in the suprachoroidal space generally due to increased intraocular pressure (IOP), as observed in some settings:

  • choroidal effusion
    • transudative: trauma
    • exudative: fluid accumulating in the suprachoroidal space secondary to many causes, most commonly inflammation (e.g. uveitis)
  • choroidal haemorrhage: trauma and surgery

Please note that this article will prefer the term choroidal detachment regardless its fluid content, with choroidal effusion and choroidal haemorrhage used as its subtypes. 

Depending or not on the rupture of small choroidal vessels, the content within the detachment may be haemorrhagic or effusion. Some of the more common causes of choroidal detachment are:

Imaging is usually not required unless a specific underlying cause, such as a metastasis is considered. 

A high frequency, small footprint probe, performed through the closed eyelid provides excellent detail:

  • typically appears on ultrasound as a detachment sparing the optic disk
  • the detachment is not limited anteriorly by the ora serrata (compared to the retinal detachment that is limited)
  • posteriorly the detachment diverges as it approaches the optic disc (compared to the retinal detachment that converges to the disc) due to the insertion of neurovascular structures at the ciliary body
  • choroidal effusions appear on CT as hypodense linear fluid collections elevating a thick hyperdense choroid. On MRI, they usually will exhibit low T1 and high T2 signal
  • choroidal haemorrhage classically appears as a hyperdense lentiform lesion on CT and, on MRI, will show haemoglobin products throughout the sequences, typically with a high T1 signal

In non-traumatic cases, the cause is treated and IOP is reduced with appropriate medication. Trauma cases may be treated with surgery, like non-traumatic cases persisting for a week or more, where the fluid may be drain and a tamponade method performed.

Un- or under-treated choroidal detachment can damage the cornea and cause cataracts.

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Article information

rID: 41964
Synonyms or Alternate Spellings:
  • Choroid detachment
  • Choroid detachments
  • Choroidal detachments
  • Detachment of the choroid
  • Choroidal effusion
  • Choroidal haemorrhage

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Cases and figures

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    Figure 1: the eye
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    Figure 2: retinal vs. choroidal detachments
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    Case 1: traumatic choroidal haemorrhage
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    Case 2: retinal and choroidal detachments
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    Case 3: choroidal effusion
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    Case 4: traumatic choroidal haemorrhage
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    Case 5
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