This 49YOM underwent trabeculectomy surgery elsewhere 6 weeks earlier.
Peripheral choroidal detachments are noted on Optos imaging. Fluorescein angiography shows significant peripheral ischemia.
Recent panretinal photocoagulation was started due to proliferative diabetic retinopathy (neovascularization not visualized due to the choroidals).
Learning Points:
Choroidal detachment is relatively common after glaucoma surgery. Two mechanisms are believed to be at play: hypotony allows fluid to accumulate in the suprachoroidal space, and inflammation increases the choroidal permeability. The detached ciliary body may also produce less aqueous humor, thus creating a self-perpetuating cycle.
Often, observation is sufficient, but topical steroids and cycloplegics can help promote resolution.
