Clinical features of uveal effusion syndrome and the efficacy of sclerectomy in the treatment of uveal effusion syndrome_Chinese Journal of Ocular Fundus Diseases

Authors：

Qi Yuanyuan ,  Wang Hong , Cao Xusheng , Zhao Meng , Mo Bin , Shen Lin

Beijing Ophthalmology & Visual Science Key Laboratory, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;

Corresponding author：

Wang Hong, Email: wanghongyk@sina.com

Keywords：

Uveal diseases/diagnosis; Uveal diseases/therapy; Sclerectomy

DOI：

10.3760/cma.j.issn.1005-1015.2019.04.012

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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.

Citation： Qi Yuanyuan, Wang Hong, Cao Xusheng, Zhao Meng, Mo Bin, Shen Lin. Clinical features of uveal effusion syndrome and the efficacy of sclerectomy in the treatment of uveal effusion syndrome. Chinese Journal of Ocular Fundus Diseases, 2019, 35(4): 374-378. doi: 10.3760/cma.j.issn.1005-1015.2019.04.012 Copy

1.	张风.葡萄膜渗漏综合征[M]//魏文斌, 陈积中.眼底病鉴别诊断学.北京: 人民卫生出版社, 2012: 443-446.Zhang F. Uveal effusion syndrome[M]//Wei WB, Chen JZ. Differential diagnosis of fundus disease.Beijing: People's Medical Publishing House, 2012: 443-446.
2.	彭晓燕, 孟淑敏, 王光璐, 等. 葡萄膜渗漏综合征的诊断与治疗探讨[J]. 眼科研究, 2005, 23(3): 327-330. DOI: 10.3760/cma.j.issn.2095-0160.2005.03.032.Peng XY, Meng SM, Wang GL, et al. Diagnosis and treatment of uveal effusion syndrome[J]. Chin Ophthal Res, 2005, 23(3): 327-330. DOI: 10.3760/cma.j.issn.2095-0160.2005.03.032.
3.	Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and treatment[J]. 3rd ed. St Louis: Mosby, 1987:166-170.
4.	翁乃清, 胡信芳, 孙宪丽, 等. 特发性葡萄膜渗漏综合征的临床和病理研究[J]. 中华眼科杂志, 1995, 31(6): 403-406.Weng NQ, Hu XF, Sun XL, et al. Clinical feature and pathological study of Idiopathic uveal effusion syndrome[J]. Chin J Ophthalmol, 1995, 31(6): 403-406.
5.	Jackson TL, Hussain A, Hodgetts A, et al. Human scleral hydraulic conductivity: age-related changes, topographical variation, and potential scleral outflow facility[J]. Invest Ophthalmol Vis Sci, 2006, 47(11): 4942-4946. DOI: 10.1167/iovs.06-0362.
6.	Kong M, Kim JH, Kim SJ, et al. Full-thickness sclerotomy for uveal effusion syndrome[J]. Korean J Ophthalmol, 2013, 27(4): 294-298. DOI: 10.3341/kjo.2013.27.4.294.
7.	吴婵, 董方田, 陈有信, 等. 葡萄膜渗漏综合征的临床特征和治疗效果[J]. 中华实验眼科杂志, 2012, 30(9): 811-814. DOI: 10.3760/cma.j.issn.2095-0160.2012.09.011.Wu C, Dong FT, Chen YX, et al. Clinical feature and management of uveal effusion syndrome[J]. Chin J Exp Ophthalmol, 2012, 30(9): 811-814. DOI: 10.3760/cma.j.issn.2095-0160.2012.09.011.
8.	Bausili MM, Raja H, Kotowski J, et al. Use of fiberoptic-guided CO2 laser in the treatment of uveal effusion[J]. Retin Cases Brief Rep, 2017, 11(3): 191-194. DOI: 10.1097/ICB.0000000000000357.
9.	Yepez JB, Arevalo JF. Ex-PRESS shunt for choroidal fluid drainage in uveal effusion syndrome type 2: a potentially novel technique[J]. JAMA Ophthalmol, 2015, 133(4): 470-471. DOI: 10.1001/jamaophthalmol.2014.5913.
10.	孙声桃, 郭希让, 鲍玉洲, 等. 视网膜脱离状态下色素上皮细胞的凋亡变异[J]. 眼科研究, 2001, 19(5): 416-418. DOI: 10.3760/cma.j.issn.2095-0160.2001.05.009.Sun ST, Gu XR, Bao YZ, et al. The apoptosis of the retinal pigment epithelial cells after retinal detachment[J]. Chin Ophthal Res, 2001, 19(5): 416-418. DOI: 10.3760/cma.j.issn.2095-0160.2001.05.009.
11.	Liew SC, McCluskey PJ, Parker G, et al. Bilateral uveal effusion associated with scleral thickening due to amyloidosis[J]. Arch Ophthalmol, 2000, 118(9): 1293-1295. DOI: 10.1001/archopht.118.9.1293.
12.	Sabrosa NA, Smith HB, MacLaren RE. Scleral punch method with topical mitomycin C for safe revision of failed deep sclerectomy in nanophthalmic uveal effusion syndrome[J]. Graefe’s Arch Clin Exp Ophthalmol, 2009, 247(7): 999-1001. DOI: 10.1007/s00417-008-1020-3.
13.	Ozgonul C, Dedania VS, Cohen SR, et al. Scleral surgery for uveal effusion[J]. Retina, 2017, 37(10): 1977-1983. DOI: 10.1097/IAE.0000000000001521.
14.	黎铧, 李娟娟, 王萍, 等. 脉络膜渗漏综合征多种眼底影像特征对比观察[J]. 中华眼底病杂志, 2016, 32(6): 639-641. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.018.Li H, Li JJ, Wang P, et al. Comparative observation of various image features of uveal effusion syndrome[J]. Chin J Ocul Fundus Dis, 2016, 32(6): 639-641. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.018.

1. 张风.葡萄膜渗漏综合征[M]//魏文斌, 陈积中.眼底病鉴别诊断学.北京: 人民卫生出版社, 2012: 443-446.Zhang F. Uveal effusion syndrome[M]//Wei WB, Chen JZ. Differential diagnosis of fundus disease.Beijing: People's Medical Publishing House, 2012: 443-446.
2. 彭晓燕, 孟淑敏, 王光璐, 等. 葡萄膜渗漏综合征的诊断与治疗探讨[J]. 眼科研究, 2005, 23(3): 327-330. DOI: 10.3760/cma.j.issn.2095-0160.2005.03.032.Peng XY, Meng SM, Wang GL, et al. Diagnosis and treatment of uveal effusion syndrome[J]. Chin Ophthal Res, 2005, 23(3): 327-330. DOI: 10.3760/cma.j.issn.2095-0160.2005.03.032.
3. Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and treatment[J]. 3rd ed. St Louis: Mosby, 1987:166-170.
4. 翁乃清, 胡信芳, 孙宪丽, 等. 特发性葡萄膜渗漏综合征的临床和病理研究[J]. 中华眼科杂志, 1995, 31(6): 403-406.Weng NQ, Hu XF, Sun XL, et al. Clinical feature and pathological study of Idiopathic uveal effusion syndrome[J]. Chin J Ophthalmol, 1995, 31(6): 403-406.
5. Jackson TL, Hussain A, Hodgetts A, et al. Human scleral hydraulic conductivity: age-related changes, topographical variation, and potential scleral outflow facility[J]. Invest Ophthalmol Vis Sci, 2006, 47(11): 4942-4946. DOI: 10.1167/iovs.06-0362.
6. Kong M, Kim JH, Kim SJ, et al. Full-thickness sclerotomy for uveal effusion syndrome[J]. Korean J Ophthalmol, 2013, 27(4): 294-298. DOI: 10.3341/kjo.2013.27.4.294.
7. 吴婵, 董方田, 陈有信, 等. 葡萄膜渗漏综合征的临床特征和治疗效果[J]. 中华实验眼科杂志, 2012, 30(9): 811-814. DOI: 10.3760/cma.j.issn.2095-0160.2012.09.011.Wu C, Dong FT, Chen YX, et al. Clinical feature and management of uveal effusion syndrome[J]. Chin J Exp Ophthalmol, 2012, 30(9): 811-814. DOI: 10.3760/cma.j.issn.2095-0160.2012.09.011.
8. Bausili MM, Raja H, Kotowski J, et al. Use of fiberoptic-guided CO2 laser in the treatment of uveal effusion[J]. Retin Cases Brief Rep, 2017, 11(3): 191-194. DOI: 10.1097/ICB.0000000000000357.
9. Yepez JB, Arevalo JF. Ex-PRESS shunt for choroidal fluid drainage in uveal effusion syndrome type 2: a potentially novel technique[J]. JAMA Ophthalmol, 2015, 133(4): 470-471. DOI: 10.1001/jamaophthalmol.2014.5913.
10. 孙声桃, 郭希让, 鲍玉洲, 等. 视网膜脱离状态下色素上皮细胞的凋亡变异[J]. 眼科研究, 2001, 19(5): 416-418. DOI: 10.3760/cma.j.issn.2095-0160.2001.05.009.Sun ST, Gu XR, Bao YZ, et al. The apoptosis of the retinal pigment epithelial cells after retinal detachment[J]. Chin Ophthal Res, 2001, 19(5): 416-418. DOI: 10.3760/cma.j.issn.2095-0160.2001.05.009.
11. Liew SC, McCluskey PJ, Parker G, et al. Bilateral uveal effusion associated with scleral thickening due to amyloidosis[J]. Arch Ophthalmol, 2000, 118(9): 1293-1295. DOI: 10.1001/archopht.118.9.1293.
12. Sabrosa NA, Smith HB, MacLaren RE. Scleral punch method with topical mitomycin C for safe revision of failed deep sclerectomy in nanophthalmic uveal effusion syndrome[J]. Graefe’s Arch Clin Exp Ophthalmol, 2009, 247(7): 999-1001. DOI: 10.1007/s00417-008-1020-3.
13. Ozgonul C, Dedania VS, Cohen SR, et al. Scleral surgery for uveal effusion[J]. Retina, 2017, 37(10): 1977-1983. DOI: 10.1097/IAE.0000000000001521.
14. 黎铧, 李娟娟, 王萍, 等. 脉络膜渗漏综合征多种眼底影像特征对比观察[J]. 中华眼底病杂志, 2016, 32(6): 639-641. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.018.Li H, Li JJ, Wang P, et al. Comparative observation of various image features of uveal effusion syndrome[J]. Chin J Ocul Fundus Dis, 2016, 32(6): 639-641. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.018.

Chinese Journal of Ocular Fundus Diseases

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

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