Table of Contents
What are Choroidals?
The choroid (pronounced “CORE-oyd”) is a spongy layer of blood vessels that lines the back wall of the eye between the retina and the sclera (or the white part of the eye). It plays an important role in delivering oxygen and nutrients to the outer half of the retina.
How do you distinguish between choroidal detachment and retinal detachment?
Retinal detachments are mobile and highly reflective. Choroidal detachments are domed shaped and are serous or hemorrhagic and often extend anteriorly toward the ciliary body, versus retinal detachments that are usually demarcated most anteriorly at the ora serrata.
What is choroidal effusion?
Choroidal effusion—an abnormal accumulation of fluid in the suprachoroidal space—is a common complication of glaucoma surgery. However, this may arise from other intraocular surgeries and a number of conditions, including inflammatory and infectious diseases, trauma, neoplasms, drug reactions, and venous congestion.
Why do Choroidals form and how do you treat them?
Choroidals form when serum or blood accumulates in the suprachoroidal space between the choroid and sclera. Clinically, they may be either serous or hemorrhagic, depending on the characteristics of the fluid contained between the tissue planes.
How do you drain Choroidals?
The classic and commonly performed drainage procedure1,2 involves conjunctival peritomy followed by a 3-mm radial incision in the sclera, about 3 to 4 mm posterior to the limbus. During the surgery the eye is kept pressurized by a recurrent injections of Balanced Salt Solution (BSS), or the use of a maintainer.
What is hemorrhagic choroidal detachment?
Hemorrhagic choroidal detachment is a hemorrhage in the suprachoroidal space or within the choroid caused by the rupture of choroidal vessels. This can occur spontaneously (rare), secondary to ocular trauma, secondary to eye surgery, or during the post-operative period.
How can you tell the difference between RD and PVD?
Ultrasonographic features of Retinal detachment versus posterior vitreous detachment
| Retinal detachment (RD) | Posterior vitreous detachment (PVD) | |
|---|---|---|
| Doppler | Vascular | Usually avascular. The fibrovascular proliferations with attached vitreous membranes may have active vascularity. |
What causes choroidal hemorrhage?
The primary cause of choroidal effusion and hemorrhage is low IOP, although inflammation can sometimes play a role. Other risk factors include anticoagulation, aphakia, high myopia, prior ocular surgery, hypotony, straining, hypertension, and heart and respiratory disease.
How do you drain a Suprachoroidal hemorrhage?
Consider inserting a cyclodialysis spatula into the suprachoroidal space to keep the cut-down open for egress of the hemorrhage and to clear clots that obstruct flow. Focal pressure applied to the anterior lip of the wound and/or ocular massage can help maximize drainage.
What happens if the choroid is damaged?
Degeneration of the blood vessels of the choroid is followed by damage to the retina, which usually leads to loss of peripheral vision that can progress to eventual blindness. Central vision is usually preserved until late in life.
When do you drain kiss Choroidals?
The choroidals show heterogeneous, high internal reflectivity (light areas), indicating the presence of blood. The appositional (kissing) choroidals required surgical drainage after about 10 days to allow time for liquefaction/lysis of the blood clot.
What is Jelly in eye called?
The vitreous is the gel-like fluid that fills your eye. It’s full of tiny fibers that attach to your retina (the light-sensitive layer of tissue at the back of the eye). As you get older, the fibers of your vitreous pull away from the retina.
How do you give a Suprachoroidal injection?
Suprachoroidal injection (4mg/0.1ml) of triamcinolone acetonide will be done using a custom-made 30-31 gauge needle with a sleeve to prevent further penetration of the needle into the vitreous cavity. Injection will be done at approximately 4 mm from the limbus.