What is the role of surgery in the treatment of exudative retinal detachment?

Updated: Jul 27, 2020
  • Author: Lihteh Wu, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Answer

The medical and surgical treatments of exudative retinal detachments have to be tailored to the underlying condition.

Conditions with vascular anomalies, such as Coats disease, should be treated with laser or cryotherapy to obliterate the vascular abnormalities. If an exudative retinal detachment is present, surgical techniques such as drainage with or without vitrectomy have been recommended. [13] A retrospective case review of 8 eyes in 8 children with total or subtotal retinal detachment due to Coats disease demonstrated that transscleral drainage of subretinal fluid accompanied by anti-VEGF injection and laser photocoagulation appears to be successful in halting progression of advanced Coats disease with exudative detachment and is less invasive than conventional management. [14]

In nanophthalmos where the sclera is abnormally thick, vortex vein decompression with scleral windows and suprachoroidal fluid drainage is indicated.

Congenital anomalies, such as optic pits or colobomas, may respond to vitrectomy and endolaser techniques.

Central serous chorioretinopathy may respond to mild laser treatment of the focal areas that leak on fluorescein angiogram. Photodynamic therapy and micropulse laser have been used in cases of central serous chorioretinopathy that involve the fovea. [15]


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