Abstract
Purpose :
To evaluate the effect of scleral windows for uveal effusion syndrome on vortex vein anatomy imaged using ICG angiography.
Methods :
Retrospective, consecutive case series of patients who underwent scleral window surgery for the treatment of uveal effusion syndrome. Pre and post-surgery Indocyanine green angiography (ICG) images of vortex veins and macular vessels were collected. Vessel diameter was measured utilizing MicroDicom (version 2022.2 build 6006) using the distance feature under 200x magnification. A point of reference that is present in both pre and post-surgery images was recorded. Four vortex veins were labeled (A-D) at varying distances from the reference point in pre-surgery images and had their diameters measured. In post-surgical images the previously selected vortex veins at the same varying distances had their diameters measured again. The macular vessel was measured by selecting a point in the macula and then measuring the diameter in both pre and post-surgery images.
Results :
Two eyes from two patients had pre- and post-ICG angiography. The first patient is a 49 year-old female with prominent vortex veins present in the OD superotemporal and OD inferonasal quadrants. On average her vortex veins in the OD superotemporal quadrant decreased in diameter by 27.9%( Range:-48.1% - 9.6%) and the OD inferonasal quadrant decreased in diameter by 18.2%(Range: -45.4% – 0%). The average distance between the reference point and vortex vein was 1.5625mm (Range: 0.84mm-2.39mm) and 2.175mm (Range: 0.53mm-4.11mm) respectively. Her macular vessel decreased in diameter by 40.5%. The second patient was a 67 year-old male with vortex veins present in the OD inferonasal quadrant. On average his vortex veins decreased in diameter by 5.6%(Diameter change range: -16.1% - 7.1%) and his macular vessel decreased in diameter by 5.5%. The average distance between the reference point and vortex vein was 1.64mm (Range: 0.92mm-2.03mm).
Conclusions :
Scleral windows are an effective treatment for patients with uveal effusions, with various theorized mechanism of actions. One thought is that vortex vein decompression leads to a decreased hydrostatic pressure, allowing for resolution of uveal effusions. This unique series demonstrates that after scleral windows surgery, vortex vein decompression occurred as well as decompression of posterior, macular choroidal vessels.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.