Choroid Plexus (CP) plays an integral part in producing cerebrospinal fluid and brain nutrition. A variety of imaging modalities exist for diagnosing choroidopathy and developing its treatment protocol.

This condition causes fluid to build up beneath the retina, the back part of the eye which transmits sight signals to the brain. This build-up of fluid may be triggered by cardiovascular, inflammatory or cancerous conditions.

Symptoms

Flocculation occurs when fluid leaks from choroid blood vessels beneath the retina and causes blurry vision with central dark areas (scotoma) in one or both eyes, often more common among men between their mid-30s to 50s. While usually harmless over time (usually within 6 months or treated using laser treatment or photodynamic therapy), it can signal more serious eye conditions like central serous chorioretinopathy that usually affect both eyes simultaneously.

Diabetes, high blood pressure, chronic obstructive pulmonary disease (COPD), rheumatoid arthritis, systemic lupus erythematosus (SLE), inflammatory myopathies, systemic sclerosis and vasculitis can be the causes. Additionally, eye conditions like glaucoma, cataracts and macular degeneration may contribute to macular degeneration; infection or certain medications like corticosteroids, cyclosporine anticoagulants or Sulfa drugs could all have an influence.

Symptoms may include a dark area in the center of your field of vision, blurry images, difficulty with straight lines and moving objects, loss of color perception and distortion of faces, along with various other possible manifestations depending on their cause. Other possible manifestations may also exist depending on what’s causing this condition:

Headaches, neck stiffness, fever and tinnitus can be symptoms of Uveitis. There are four clinical phases: prodromal phase, acute uveitic stage, convalescent stage and chronic recurrent phase. Uveitic conditions tend to run in families and men are more prone than women.

Some factors increase your risk for choroidopathy, such as having family members with it or health conditions like high blood pressure, heart disease, kidney diseases and diabetes. Signs and symptoms of a choroidopathy include dry mouth, fatigue, weight loss and unusual white deposits in skin, nails or hair – and it may alter mood changes such as depression or bipolar disorder – so if these occur consult your physician as soon as possible to have further checks performed and possibly change dosage or prescribe additional medicine if needed.

Diagnosis

Central serous choroidopathy symptoms consist of fluid build-up beneath the retina, the back part of your inner eye responsible for transmitting sight information to your brain. This leakage originates in blood vessel layers under your retina known as the choroid; stress seems to play a part. Most people recover without treatment within one to two months while some may require laser or photodynamic therapy therapy in order to stop further leakage and improve vision.

Central Serous Chorioretinopathy differs from most posterior uveitic entities in that it does not typically present with choroidal neovascularization (CNV). Diagnosis is made by dilation of both eyes, an eye exam and possibly optical coherence tomography angiography which measures blood flow through both retina and choroid vessels to detect early leakage or neovascularization.

CSC can be easily diagnosed using an ophthalmoscopic examination and identified by white-to-yellow lesions found on both choroid and pigment epithelium that resemble buckshot from being shot from a gun; hence its name: birdshot retinochoroidopathy.

These lesions often feature clear areas of subretinal fluid. A severe lesion may result in serous retinal detachment; as lesions heal they often transform into atrophic scars with no fluorescein staining; typically located over large areas of retina such as macula; but may appear anywhere on retinal tissue. A variety of conditions can simulate these symptoms including multiple evanescent white dot syndrome, Vogt-Koyanagi-Harada disease, chronic iridocyclitis syndrome ocular histoplasmosis syndrome ocular histoplasmosis syndrome sympathetic ophthalmia.

Punctate inner choroidopathy (PIC) is an uncommon, idiopathic inflammatory condition affecting the choroid and outer retina, most often found among myopic women. Diagnosing PIC may be difficult due to symptoms that resemble other posterior uveitis entities – making diagnosis even harder – such as choroidal neovascularization, idiopathic central serous chorioretinopathy or multifocal serpiginous choroiditis. For accurate identification it requires thorough clinical examination combined with multimodal imaging technology for accurate diagnosis. Multimodal imaging plays an integral part in accurate diagnosis and accurate diagnosis.

Treatment

Choroidal effusion is an unfortunate side effect of glaucoma surgery or medications. This fluid leaks from blood vessel layer under retina that transmits sight information to brain – the choroid. Although its exact cause remains unknown, possible factors include eye pressure, systemic conditions or drugs, as well as decreased choroid blood flow due to decreased oxygen delivery from retina. There are various treatments available to reduce frequency of choroidal effusions including medications, surgical drainage and ligation of drainage device tubes – while understanding risk factors can help mitigate or avoid future incidents of this serious condition altogether.

Patient with classic Choroidal Neovascular Membranes (CNVs) from punctate inner choroidopathy received intravitreal bevacizumab therapy and experienced significant visual improvement after treatment.

Progressive subretinal fibrosis and uveitis syndrome is an unusual disorder characterized by white, fibrous lesions that form rings-like clusters around the macula and choroidal space. Most patients remain asymptomatic with no evidence of systemic illness. PSUF shares many characteristics with antiphospholipid antibody syndrome (APS), including deep venous thrombosis, pulmonary emboli, recurrent miscarriage in the second and third trimesters of pregnancy, recurrent miscarriage of newborns during their third trimester, thrombocytopenia, etc. However, many individuals diagnosed with PSUF don’t meet American College of Rheumatology criteria for SLE. Therefore, it is vitally important to differentiate this entity from SLE and other forms of autoimmune retinopathy such as inflammatory pigment epithelial detachment using optical coherence tomography (OCT) or fluorescein angiography – tools which may assist with this task.

Prevention

Early treatment of choroidal leakage and hyperpermeability may prevent permanent visual loss for those suffering from idiopathic central serous choroidopathy, with laser photocoagulation showing rapid absorption and visual recovery from fluid leaks in this group. Thalidomide has also been used as a prophylactic agent against punctate inner choroidopathy which puts them at high risk of choroidal neovascular membrane formation; however, according to one case report of someone starting on this medication who then experienced new membrane formation suggests its limited efficacy.