Choroidal detachment
Updates to Article Attributes
Choroidal detachment is a detachment of the choroid from the underlying sclera due to increased intraocular pressure (IOP), and occurs in a number of settings:
- transudative: trauma
- exudative: fluid accumulating in the suprachoroidal space secondary to many causes, most commonly inflammation.
- haemorrhagic: trauma, surgery
Pathology
Aetiology
Some of the more common causes of choroidal detachment are:
- trauma
- surgery
- spontaneous (valsalva etc)
- medications for lowering IOP
- hypertension
Radiographic features
Imaging is usually not required unless a specific underlying cause, such as a metastasis is considered.
Ultrasound
A high frequency, small foot print probe, performed though the closed eyelid provides good detail:
- typically appears on ultrasound as a detachment sparing the optic disk
CT/MRI
- folded membranes with suprachoroidal space fluid (which is usually hyperdense on CT)
- the detachment is limited anteriorly by the ora serrata (compared to retinal detachment which is not limited)
- posteriorly the detachment diverges as it approaches the optic disc (compared to retinal detachment which converges to the disc)
Differential diagnosis
- retinal detachment
- choroidal melanoma
- glaucoma
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 damaged the cornea and cuase cataracts.
-<li>choroidal melanoma</li>- +<li><a title="Choroidal melanoma" href="/articles/primary-uveal-malignant-melanoma">choroidal melanoma</a></li>
References changed:
- 1. Lebedis CA, Sakai O. Nontraumatic orbital conditions: diagnosis with CT and MR imaging in the emergent setting. Radiographics. 2008;28 (6): 1741-53. <a href="http://radiographics.rsna.org/content/28/6/1741.full">Radiographics (full text)</a> - <a href="http://dx.doi.org/10.1148/rg.286085515">doi:10.1148/rg.286085515</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/18936033">Pubmed citation</a><span class="ref_v3"></span>
- 2. Aironi VD, Gandage SG. Pictorial essay: B-scan ultrasonography in ocular abnormalities. Indian J Radiol Imaging. 2009;19 (2): 109-15. <a href="http://dx.doi.org/10.4103/0971-3026.50827">doi:10.4103/0971-3026.50827</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765186">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/19881064">Pubmed citation</a><span class="auto"></span>
- 3. Dutton JJ. Radiology of the Orbit and Visual Pathways: Expert Consult. Saunders. ISBN:1437711510. <a href="http://books.google.com/books?vid=ISBN1437711510">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1437711510">Find it at Amazon</a><span class="auto"></span>
- 1. http://emedicine.medscape.com/article/1190349-overview
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