Choroidal detachment is a detachment of the choroid from the underlying sclera due to increased intraocular pressure (IOP), and occurs in some settings:
- transudative: trauma
- exudative: fluid accumulating in the suprachoroidal space secondary to many causes, most commonly inflammation (e.g. uveitis)
- haemorrhagic: trauma and surgery
Some of the more common causes of choroidal detachment are:
- spontaneous (Valsalva, etc.)
- medications for lowering IOP
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
- folded membranes with suprachoroidal space fluid (which is usually hyperdense on CT)
- the detachment is not limited anteriorly by the ora serrata (compared to retinal detachment that is limited)
- posteriorly the detachment diverges as it approaches the optic disc (compared to retinal detachment that converges to the disc) due to the insertion of neurovascular structures at the ciliary body
Treatment and prognosis
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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