Peripheral Choroidal Detachment Research Articles

A case report: co-occurrence of probable Vogt-Koyanagi-Harada disease and diabetic retinopathy

BackgroundBilateral retinal detachment and choroidal detachment in a patient are rare occurrences. The presence of bilateral diabetic retinopathy (DR) in such a case is even rarer and complicates the condition.Case presentationIn this study, we document a case of unconventional VKH. Manifestations in this patient included intense peripheral retinal detachment and choroidal detachment, along with vitreous opacities akin to cotton wool spots, concurrent with DR. The diagnosis was considered as probable VKH with DR. Treatment according to VKH protocols, including high-dose corticosteroids, yielded positive results.ConclusionsVKH can co-occurrence with DR. VKH manifestations vary, and early, aggressive, and long-term treatment is essential. The complexity of treatment increases with concurrent DR, necessitating the use of immunosuppressants.

Central Serous Chorioretinopathy mimicking Idiopathic Uveal Effusion Syndrome.

To describe central serous chorioretinopathy (CSCR) cases presenting as uveal effusion syndrome, providing new insights into "pachychoroid spectrum" diseases. Clinical charts, color fundus photographs, fluorescein angiography, indocyanine green angiography, optical coherence tomography, ultrasound imaging, cerebral magnetic resonance imaging and biometry of four eyes of three patients were assessed. A literature review was conducted. The three patients had peripheral choroidal detachment and inferior bullous retinal detachment associated with CSCR features detected using multimodal imaging, including fluorescein and indocyanine green angiography. The choroid was thick in the three patients, and uveal effusion occurred after steroid treatment in all cases. Subretinal fluid drainage and deep sclerectomy with flaps of 4x4 mm in both inferior quadrants were performed in 3 eyes of 2 patients with good outcomes. One patient was treated with photodynamic therapy. All three patients developed a typical leopard-spot pigmentary pattern in the fundus. A severe presentation of highly exudative CSCR may occur in rare cases with a peripheral choroidal detachment mimicking uveal effusion syndrome. These severe cases highlighted the role of choroidal thickening and hyperpermeability, choroidal vein dilation and possible scleral thickening in both entities.

Clinical presentation and treatment outcomes of an algorithmic approach to uveal effusion syndrome.

To describe the clinical features and treatment outcomes in spontaneous uveal effusion syndrome (UES). A 10-year retrospective chart review of UES patients from a tertiary eye center was carried out. Optical coherence tomography (OCT), fundus fluorescein angiography, and ultrasound biomicroscopy (UBM) scans were performed. UES was managed based on presenting best-corrected visual acuity (BCVA), symptoms, and fundus findings. Patients with secondary causes of uveal effusion were excluded. Twenty-five eyes of 16 patients were included. Of the 16 patients, 14 (88%) were male and 9 (56%) had bilateral disease. Fifteen of 25 affected eyes had nanophthalmos (axial length (AL) <20.5 mm) and 6 had hyperopia with AL >20.5 mm. The presenting mean distance BCVA was 0.74 ± 0.64 logMAR (mean Snellen: 20/100). Eleven eyes had exudative retinal detachment, and 4 also had exudative choroidal detachment (CD). Choroidal thickness (CT) was increased in 11 eyes on B-scan ultrasonography, and the mean CT was 1.74 ± 0.38 mm. Sub-retinal fluid (SRF) and retinal folds were the most common OCT findings. UBM findings included shallow angles, peripheral CD, and supra-ciliary effusion. A combination of local and systemic corticosteroids was used to successfully treat 12 eyes, 6 needed surgery, and 7 were observed. Partial sclerectomy with anterior chamber maintainer-assisted SRF drainage was the favored surgery. The median period of follow-up was 6.5 months (0.1-76 months), and the mean distance BCVA at the last follow-up was 0.58 ± 0.42 logMAR (mean Snellen: 20/80). UES can be suitably managed both medically and surgically based on clinical presentation.

Bilateral Pachychoroid disease with type 3 Uveal effusion syndrome in one eye and central serous Chorioretinopathy in contralateral eye: a case report

BackgroundWe report a case of bilateral pachychoroid disease with type 3 uveal effusion syndrome (UES) in one eye and central serous chorioretinopathy (CSC) in the contralateral eye.Case presentationA 65-year-old man presented to our department because of decreased vision. Visual acuity was 16/20 in the right eye and 2/20 in the left eye, with normal axial lengths. The left eye was diagnosed with CSC and underwent photocoagulation 8 years ago. The right eye showed inferior non-rhegmatogenous retinal detachment and peripheral choroidal detachment. Macular optical coherence tomography showed submacular fluid in the right eye, pachychoroid in both eyes, and choroidal thickness of 565 μm in the right and 545 μm in the left eye. In both eyes, fluorescence angiography showed window defects and mild fluorescence leakage, and indocyanine green angiography showed dilated choroidal vessels, mild choroidal hyperpermeability, and mild dye leakage. The left eye was diagnosed with chronic CSC. Initially, chronic CSC was also suspected in the right eye. However, photodynamic therapy failed, with worsened retinal detachment and visual acuity. Pachychoroid in the peripheral fundus (choroidal thickness 820 μm) was observed only in the right eye. Based on these findings, UES was diagnosed in the right eye. Sclerectomies were performed. The absence of scleral thickening and glycosaminoglycan deposition led to a final diagnosis of type 3 UES. The procedure was not effective, due to connective tissue regeneration at the sclerectomy sites. In the revision surgery, mitomycin-C was used with sclerectomies. One month after surgery, retinal and choroidal detachment disappeared, visual acuity recovered to 8/20, pachychoroid in the macula and peripheral fundus decreased, and choroidal thickness decreased to 352 μm in the macula and 554 μm in inferior peripheral fundus.ConclusionsPachychoroid in the posterior pole was the common finding in type 3 UES and CSC, although extensive pachychoroid in the peripheral fundus may have caused retinal and choroidal detachment in the eye with type 3 UES. Full-thickness sclerectomies with mitomycin-C improved pachychoroid in the peripheral fundus and resolved retinal and choroidal detachment, clearly indicating that the sclera was the main cause of type 3 UES.

Retinal Pigment Epithelium Tear after Glaucoma Surgery

Retinal pigment tear (RPE) is a very rare complication of glaucoma filtering surgeries. The right eye of a 65-year-old woman underwent an Ex-Press shunt implantation to treat uncontrolled primary open-angle glaucoma. On day 3, the intraocular pressure (IOP) was 5 mmHg with an over-filtering bleb. Wide-field fundus color and autofluorescence images showed peripheral choroidal detachment, RPE detachment (arrow), RPE tear, and macula-off exudative retinal detachment (Fig A-B). Additional sutures were placed on the scleral flap to achieve an increase in IOP.

Hypotony maculopathy and photoreceptor folds with disruptions after vitrectomy for epiretinal membrane removal: two case reports

BackgroundHypotony maculopathy has been classically reported as a complication of glaucoma surgery or ocular trauma. There have been only a few reports of hypotony maculopathy following pars plana vitrectomy (PPV). Here, we report two cases of hypotony maculopathy occurring after PPV for epiretinal membrane (ERM) removal and characteristic photoreceptor folds observed on optical coherence tomography (OCT).Case presentationA 53-year-old Korean woman (case 1) underwent phacoemulsification and posterior chamber lens implantation combined with 25-gauge PPV for ERM removal in the right eye. On the following day, she had severe ocular hypotony, with an intraocular pressure (IOP) that was unmeasurable using a pneumatic tonometer. Despite normalization of IOP, macular retinal and photoreceptor folds with photoreceptor disruptions developed, and Henle’s fiber layer hyperreflectivity was identified. Thereafter, retinal and photoreceptor folds gradually disappeared but photoreceptor disruption and Henle’s fiber layer hyperreflectivity did not improve until 1 year postoperatively, with persistent central visual field distortion and visual acuity worse than that at the preoperative state. A 20-year-old Korean man (case 2) underwent an additional 25-gauge PPV for ERM removal in the left eye. Examination on the following day showed ocular hypotony and retinal folds with peripheral choroidal detachment. Although IOP was normalized, further OCT revealed photoreceptor folds and photoreceptor disruptions. Since then, the photoreceptor folds resolved; however, the photoreceptor disruption remained in the macula at the 1-year follow up, with persistent distorted vision and visual acuity worse than that at the preoperative state.ConclusionsEarly hypotony after vitrectomy for ERM could result in maculopathy leading to irreversible visual decline and metamorphopsia. Photoreceptor folds on OCT are characteristic features and the predominant mechanism of central visual loss in cases of hypotony maculopathy.

Two Cases of Extremely High-IL-6 Pan-uveitis with Subretinal Exudation and Cell Migration

ABSTRACT Purpose To describe two cases of extremely high-IL-6 pan-uveitis with subretinal exudation and cell migration. Methods Pre-operative and postoperative images and IL-6 values in vitreous samples of two pan-uveitis cases were analyzed. Results Case 1 was a 76-year-old man with blurry vision in his right eye. Fundus examination and optical coherence tomography showed vitreous opacification with vitreous cells and the presence of a white-yellowish retinal exudate with peripheral choroidal detachment all around. The IL-6 value was 16,600 pg/ml. Case 2 was a 63-year-old man with blurry vision in his right eye. On fundus examination, there was severe vitreous opacification in his right eye. The IL-6 value was 26,600 pg/ml. Importantly, there was good responsiveness to steroids and the TNF inhibitor. Conclusion Unclassified intraocular inflammation might include a new category of disease with unilateral pan-uveitis with good response to steroid therapy and extremely high vitreous IL-6 values.

Clinical features of uveal effusion syndrome and the efficacy of sclerectomy in the treatment of uveal effusion syndrome

Objective To observe the clinical features of uveal effusion syndrome (UES) and the efficacy of sclerectomy in the treatment of UES. Methods A retrospective case series. Twenty patients (36 eyes) of UES with sclerectomy were enrolled in this study from June 2012 to December 2016 in Beijing Tongren Hospital. Among them, there were 12 males (22 eyes) and 8 females (14 eyes), with an average age of 37.8 years. All patients suffered from bilateral diseases, including 4 patients in single eye group and 16 patients in double eye group. Visual acuity, intraocular pressure, indirect ophthalmoscope, UBM, FFA combined with ICGA, A/B ultrasonography, axial length (AL) and scleral thickness were measured. All patients underwent lamellar sclerectomy, and those with exudative retinal detachment underwent four quadrant lamellar sclerectomy, followed by four quadrant full-thickness sclerectomy with the size of 1 mm × 2 mm in the center of the scleral bed. The follow-up time after operation was more than 6 months. Visual acuity, intraocular pressure and fundus examination were performed 1, 3 and 6 months after operation with the same equipment and methods before operation. Results There was no obvious inflammation in the anterior chamber of all eyes, and intraocular pressure was 24-28 mmHg (1 mmHg = 0.133 kPa) in 4 eyes (11.1%). Axial length of 8 eyes (22.2%) were 16-18 mm (true microphthalmia). 12 eyes (33.3%) had scleral thickness>1.0-1.8 mm. Visual acuity ranged from hand movement to 0.05 in 20 eyes, 0.1 to 0.3 in 10 eyes and>0.3 in 6 eyes. Fundus examination showed peripheral choroidal and ciliary detachment; UBM examination showed annular peripheral ciliary and choroidal detachment. 32 eyes (88.9%) were complicated with exudative retinal detachment. FFA examination showed that 14 eyes (38.9%) had leopard spot changes. Compared with preoperative vision, the visual acuity improved in 28 eyes (77.8%) and remained unchanged in 8 eyes (22.2%) after surgery. Thirty-two eyes with different degrees of retinal detachment were found before surgery. After surgery, ciliary body detachment, choroidal detachment and retinal detachment were restored. Six eyes (16.7%) recurred and underwent sclerectomy again. Conclusions The mild symptoms and recurrent attack are the characteristics of UES. Sclerectomy is an effective method to treat UES. Key words: Uveal diseases/diagnosis; Uveal diseases/therapy; Sclerectomy

Ultrasonographic differentiation of the peripheral choroidal detachment from the circumferential scleral buckle

A 40-year-old male patient presented with a history of surgery in the left eye for retinal detachment 1 year ago. His history of medical and surgical interventions was incomplete as...

Intravitreal Dexamethasone Implant in a Case of Recurrent Posterior Scleritis

We report a patient with posterior scleritis who developed a recurrence on systemic immunosuppressive therapy that improved dramatically following an intravitreal dexamethasone implant. A 47-year-old male presented with sudden painless vision decline in the left eye of 3-day duration; corrected visual acuity was 20/200. The anterior chamber depth was shallow, and an exudative retinal detachment with peripheral shallow choroidal detachment was seen. B-scan ultrasonography confirmed findings typical for posterior scleritis. A short course of tapering oral steroids and chronic methotrexate treatment were initiated with resolution of the visual decrease and the ocular abnormalities. Despite the maintenance methotrexate, he returned with a complaint of new visual decline in the left eye. His best-corrected visual acuity was 20/30, and peripheral shallow exudative retinal with choroidal detachment was again noted. Oral steroids were returned to his regimen. His exudative retinal detachment continued to worsen, so pulse intravenous methylprednisolone therapy was started, resulting in minimal improvement. Furthermore, his immunosuppressives had to be modified due to systemic complications. Consequently, an intravitreal dexamethasone implant was injected into the left eye with subsequent improvement in his vision and resolution of his exudative retinal detachment.

Changes in retinochoroidal thickness after vitrectomy for proliferative diabetic retinopathy.

To evaluate the changes in the peripheral retinochoroidal thickness after pars plana vitrectomy (PPV) with scatter photocoagulation for proliferative diabetic retinopathy (PDR). Small gauge PPV was performed on 22 eyes with PDR with scatter photocoagulation, and on 32 eyes with an epiretinal membrane (ERM) without photocoagulation as control. The peripheral retinochoroidal thickness was measured at 5 mm from the limbus in the four quadrants using anterior segment optical coherence tomography preoperatively, and 3 days and 1 and 2 weeks after the surgery. In eyes with a peripheral choroidal detachment, the retinochoroidal thickness and the height of choroidal detachment were measured separately. The total peripheral thickness was defined as the sum of retinochoroidal thickness and the height of choroidal detachment. A significant larger number of eyes developed a choroidal detachment in the PDR group than in the ERM group 3 days after surgery (P < 0.001). The total peripheral choroidal thickness 3 days after surgery was significantly thicker than that before surgery in the PDR group (P = 0.009). The increase in the total peripheral thickness in the PDR group was significantly greater than that in the ERM group at 3 days after surgery (P = 0.007). The number of photocoagulation burns was significantly and positively correlated with the total peripheral thickness (r = 0.57, P = 0.006). We conclude that the transient thickening of the total peripheral thickness in early postoperative stage for PDR was due to the intraoperative scatter photocoagulation.

English

Topiramate is an oral sulfamate medication used primarily for seizure treatment and has also demonstrated efficacy in the treatment of bipolar disorders and migraine. The mechanism of causation of angle closure and acute myopia is not clearly understood and several theories have been proposed of which the uveal effusion theory is widely accepted. We report a case of topiramate induced acute myopia with bilateral acute angle closure. With the increase in the frequency of prescribing topiramate for migraine prophylaxis it is important that the prescribing physicians should be aware of these complications. It is also important to educate the patients regarding the possible symptoms so that they can report at the earliest. INTRODUCTION: Several drugs are known to cause angle closure and induce acute myopic shift in refraction. The mechanism of causation is not clearly understood and several theories have been proposed. Topiramate is a new antiepileptic drug which is used in several medical conditions like migraine, epilepsy, de addiction. We report a case of topiramate induced acute myopia, with acute angle closure which was wrongly diagnosed. A 39 year old male presented with history of sudden onset headache with nausea and vomiting of 2 days duration. He was using spectacles of -1.00DS/-1DC x 90° in the right eye and1.25DS/-1.00DC x 90° in the left eye of for the past 20years. He was a known alcoholic was under the care of psychiatrist and had undergone de addiction 10 years ago. 10 days ago he had a relapse and presented with disulphiram like reaction after a binge of alcohol. He was admitted and then was discharged on tab topiramate 25mgfor 3 days followed by 50 mg for 10 days. 5 days after initiating treatment he presented with sudden onset headache with nausea and vomiting. On examination he was restless but oriented, his vitals were stable. He was clinically diagnosed to have a cerebro vascular accident and was admitted in the intensive care unit. A whole battery of investigations was ordered including CT brain which was all normal. Finally the ophthalmologist was called in owing to bilateral congestion and chemosis in the eyes (Fig-1). On examination he had 45degrees of exotropia, his visual acuity in both the eyes was 2/200 improving with pinhole to 20/20, near vision N6. Refraction was -8.00 DS/ 2.75DC x90°in the right eye and 8.00DS/-2.00DC x90° in the left eye. AC was shallow (Fig-2) and pupils were 4mm sluggishly reacting to light. IOP measured by applanation was 40 and 42 mmHg in the right and left eye respectively. Gonioscopy showed 360 degrees oppositional angle closure in both eyes (Fig-3). Examination of fundus showed the presence of fine retinal striae radiating from the fovea and no peripheral choroidal detachment. A diagnosis of topiramate induced acute bilateral angle closure with bilateral acute myopia was made and the drug was discontinued immediately in consultation with the psychiatrist. When reviewed 24 hours after the discontinuation of medication, his BCVA was 20/60 with previous acceptance. AC was still shallow and IOP measured by applanation was 37 mm of Hg in DOI: 10.14260/jemds/2014/3978

Tolerance of porcine eyes to epiretinal prostheses implantation

was achieved during the follow-up (p < 0.05). Informations regarding VA, IOP, anterior chamber reaction and vitreous haze are summarized in Table 2. No case required conversion to 20-gauge instrumentation nor suture placement. Three patients who were left with fluid in the vitreous cavity developed hypotony in the first postoperative day, one of them with peripheral choroidal detachment; all cases had spontaneous resolution during the first postoperative month. One patient had a relapse of the toxoplasmic retinochoroiditis 2 months after surgery and was successfully treated with trimethoprim ⁄ sulfamethoxazole associated with prednisone, regaining the VA of the last visit before the recurrence. Six of seven phakic eyes developed cataract during the followup and underwent uneventful phacoemulsification. Bosch-Driessen et al. reported retinochoroiditis reactivation in 36% of the patients within 4 months of cataract surgery, a higher rate than the one found in our series. However, antiparasitic prophylactic treatment should be considered for individuals with history of frequent and severe recurrences and those at great risk of vision loss (Bosch-Driessen et al. 2002). In patients with residual vitreous opacities because of OT, 25-gauge PPV showed to be a feasible technique, with low postoperative inflammatory response and relapse rate, promoting vitreous clearance and VA improvement in all studied patients without any major complication.

PRIMARY 23-GAUGE TRANSCONJUNCTIVAL SUTURELESS VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT

To describe the results of primary 23-gauge transconjunctival sutureless vitrectomy for rhegmatogenous retinal detachment (RRD). In a prospective case series, 24 eyes of 24 consecutive patients with RRD underwent primary 23-gauge transconjunctival pars plana vitrectomy with intraocular gas tamponade. Postoperative follow-up ranged from 6 months to 16 months. Fifteen eyes (62.5%) had multiple breaks. Seven eyes (29.2%) had inferior breaks. Other complications included giant tear in one eye, peripheral choroidal detachment in one eye, and concomitant macular holes in two eyes. The primary anatomical success rate was 91.7%. The mean postoperative visual acuity at postoperative month 3 improved from 20/41 to 20/25 (P = 0.111) and from 20/735 to 20/56 (P < 0.0001) in macula-on and macula-off cases, respectively. One patient (4.2%) had hypotony on postoperative day 1. No patients developed choroidal detachments. No sutures were used in any of the sclerotomy sites. Of the patients, 87.5% reported no or mild foreign body sensation, whereas 79.1% reported no or mild pain on the first postoperative day. Twenty-three-gauge transconjunctival sutureless vitrectomy appears to be a feasible option in treating RRD in selected cases, with the potential benefit of reducing postoperative ocular irritation.

Simultaneous Bilateral Retinal Detachment following Coronary Artery Bypass Graft: Case Report

To present an unusual case of simultaneous bilateral retinal detachment (RD) following a coronary artery bypass graft in a patient with acute myocardial infarction (AMI). A 78-year-old man was first seen for bilateral sudden visual loss after surgical treatment of AMI. The patient underwent ultrasound biomicroscopy (UBM) and ocular B-scan echographic examination. The ocular assessment showed a bilateral seclusion of the pupil with bombe of the iris, an anterior chamber without cells or flare, and hypotonia. The evaluation of the visual acuity revealed no light perception in the right eye (RE) and uncertain light perception in the left eye (LE). The UBM analysis of the anterior segment confirmed the presence of bilateral pupillary block due to the seclusion of the pupil and a peripheral serous choroidal detachment involving the RE. The echographic B-scan analysis of the posterior segment showed a bilateral closed funnel-shaped RD and confirmed the presence of the peripheral flat serous choroidal detachment in RE. The cause for simultaneous bilateral RD remained unclear. It may have been a consequence of a persistent choroidal detachment with multiple swelling and 'kissing' of retinal surface. The increased venous pressure caused by congestive heart failure due to AMI could have caused a bilateral uveal effusion. Alternatively, the absence of retinal tears, the presence of a closed funnel-shaped morphology, and seclusion of the pupils allowed us to suspect an exudative pathogenetic mechanism due to a previous unrecognized ocular inflammatory state.

Laser Surgery of the Posterior Segment

Part 1 Principles: principles of photocoagulation. Part 2 Photocoagualation of the posterior segment: diabetic retinopathy diabetic macular edema retinal vein occlusion peripheral retinal neovascularizations choroidal neovascularizations idiopathic central serous chorioretinopathy fundus vascular anomalies nonvascular intraocular tumours retinal breaks and detachment miscellaneous disorders. Part 3 Complications: complications of photocoagulation.

Annular Peripheral Choroidal Detachment Simulating Aqueous Misdirection after Glaucoma Surgery

The purpose of the study was to define a newly recognized complication after glaucoma surgery and to recommend a therapeutic regimen. Eighteen patients diagnosed initially as having aqueous misdirection after glaucoma surgery, but who subsequently were found by ultrasonography to have an annular peripheral choroidal detachment that resulted in secondary angle closure glaucoma, were studied. Ten of these patients were treated with topical cycloplegics and corticosteroids, and 8 were treated with drainage of suprachoroidal fluid. Outcomes of these two treatment methods were compared. Annular peripheral choroidal detachment reliably was diagnosed with ultrasonography. Of the variables studied, time elapsed before resolution of the annular peripheral choroidal detachment was noted to be statistically significant (P < 0.00005). Immediate resolution followed drainage of suprachoroidal fluid, whereas a mean of 19.6 days was required for resolution after medical therapy. Annular peripheral choroidal detachment should be considered in the differential diagnosis of a flat or shallow anterior chamber with normal or high intraocular pressure after glaucoma surgery. The diagnosis of annular peripheral choroidal detachment can be confirmed most reliably by ultrasonography. Medical therapy is as effective as is surgery, although a significantly longer time to resolution is required.

Hypertensive choroidopathy: A case report

The authors report a case of exudative retinal detachment of the posterior pole and peripheral choroidal detachment in a patient with renovascular accelerated hypertension. The peculiar clinical situation of this patient was comparable with experimental models of hypertension recently reported in the literature. Both the retinal and the choroidal detachment regressed after blood pressure stabilization with systemic antihypertensive therapy, supporting a choroidal pathogenesis for the chorioretinal lesions.

Uveal effusion as a sign of myxoedema.

The only frequent extraocular abnormalities they found, in spite of fairly intense medical investigation, were raised cerebrospinal fluid protein without pleocytosis and some patients with rheumatic disorder. They reported seventeen cases, including one female. They drew attention to several previous papers reporting cases similar to their own. Stallard (I954) described six cases of a peculiar type of retinal detachment, which is likely to involve the choroid also, which is annular, peripheral, and so dark in colour that it is sometimes misdiagnosed as ring sarcoma of the choroid. His cases were all males between the ages of 30 and 6o and three of the six had bilateral disease. All had dark colouring of the hair and skin. No associated systemic or local disorder waspresent. Lewallen (1957) reported the case of I03-year-old Negro with chemosis, exophthalmos, and unilateral retinal detachment without breaks. The fellow eye became similarly affected but both returned to normal in 4 months without treatment. Graham (I958) reported case in which 37-year-old woman presented complete retinal detachment, ocular hypotony, shallow anterior chamber, and posterior synechiae. Enucleation was carried out for suspected melanoma and ocular examination showed total retinal detachment, choroidal detachment reaching the scleral spur, moderate uveal congestion, and markedly thickened sclera. A retinal tear was said to be present on one occasion but subsequently could never be found. In discussing this case, Davenport (I 958) described female whose enucleated eye showed clhoroido-retinal detachment, congested uvea, and thick sclera, while the other eye displayed low grade uveitis with annular choroidal detachment. Ridley (1958) also mentioned uniocular patient with low-grade uveitis, hypotension, and anterior choroido-retinal detachment without visible retinal breaks. Rosen and Lyne (i 968) reported two cases of uveal effusion: one was localized choroidal detachment secondary to scleritis in patient with rheumatoid arthritis; the other developed unilateral peripheral annular choroidal detachment with no retinal detachment. Thus neither fits the specific description given by Schepens and Brockhurst. Reports of bilateral low-grade uveitis associated with retinal detachment have appeared in the literature (Duke-Elder, I966), but in the condition described by Schepens and