This 68YO male patient presented with peripheral choroidal detachments following placement of a Baerveldt shunt 1 week earlier. Vision was counting fingers, and pressure was 1 mmHg. All wounds were secure, and the anterior chamber was formed.
Learning Points:
Choroidal detachment is relatively common immediately following glaucoma surgery. Two mechanisms are believed to be at play:
1) hypotony allows fluid to accumulate in the suprachoroidal space, and 2) inflammation increases the choroidal permeability. The detached ciliary body may also produce less aqueous, thus creating a self-perpetuating cycle.
Often, observation is sufficient, but topical steroids and cycloplegics can be helpful in promoting resolution. We are following this patient closely and expect the choroidals to resolve as postoperative pressure increases.
