Diep Martin Q, Madigan Michele C
School of Optometry and Vision Science, The University of New South Wales, Kensington, New South Wales, Australia.
Save Sight Institute, Discipline of Clinical Ophthalmology, The University of Sydney, Sydney, New South Wales, Australia.
Clin Exp Optom. 2019 Mar;102(2):116-125. doi: 10.1111/cxo.12807. Epub 2018 Jul 4.
Choroidal detachments occur when there is an accumulation of fluid or blood in the suprachoroidal space, a potential space situated between the choroid and the sclera. They are an uncommon ocular pathology. The most common cause of choroidal detachment is secondary to trabeculectomy; however, there are other causes such as trauma and inflammation. Clinically, choroidal detachments may vary in presentation from asymptomatic, to very poor vision, severe ocular pain, vomiting and nausea. Ocular findings associated with choroidal detachments include serous retinal detachment, secondary angle closure, and a very shallow anterior chamber. Optometrists, as primary eye care providers, need to be aware of the clinical signs and symptoms associated with choroidal detachments and ensure that appropriate and timely management, with a referral to an ophthalmologist, is instigated for optimal visual outcomes. In this review, the pathophysiology, detection, and associated risk factors for choroidal detachments are discussed, and evidence-based management recommendations in an optometric context are provided. The characteristics and management of uveal effusion syndrome are also reviewed, as this can cause idiopathic exudative choroidal detachments distinct from classical choroidal detachment.
脉络膜脱离是指脉络膜上腔（脉络膜与巩膜之间的潜在间隙）出现液体或血液积聚时发生的情况。它们是一种罕见的眼部病变。脉络膜脱离最常见的原因是小梁切除术后的继发情况；然而，还有其他原因，如外伤和炎症。临床上，脉络膜脱离的表现各不相同，从无症状到视力极差、严重眼痛、呕吐和恶心。与脉络膜脱离相关的眼部表现包括浆液性视网膜脱离、继发性房角关闭和前房极浅。作为主要的眼科护理人员，验光师需要了解与脉络膜脱离相关的临床体征和症状，并确保及时进行适当的处理，包括转诊给眼科医生，以实现最佳的视觉效果。在这篇综述中，讨论了脉络膜脱离的病理生理学、检测方法和相关危险因素，并提供了验光背景下基于证据的管理建议。还对葡萄膜渗漏综合征的特征和管理进行了综述，因为它可导致与经典脉络膜脱离不同的特发性渗出性脉络膜脱离。
