Suprachoroidal Proliferative Membrane in Uveal Effusion Syndrome with Nanophthalmos: Incidental Finding During Sclerectomy.

Purpose: To report the identification and histopathological analysis of a suprachoroidal proliferative membrane in a patient with uveal effusion syndrome (UES) and nanophthalmos, highlighting its potential role in the pathophysiology of the condition.

Methods: A comprehensive ophthalmological examination, including fundus examination IOL-Master biometry, and B-scan ultrasound, was performed on a 52-year-old female patient presenting with blurred vision. Sclerectomy was conducted, during which a white strand-like substance was extracted from the suprachoroidal space. Histopathological and immunohistochemical analyses were carried out to characterize the substance.

Results: The patient presented with hand motion visual acuity in the right eye and a best-corrected visual acuity of 0.4 in the left eye. Fundus examination revealed a spherical bulge of the retina in the right eye, and IOL-Master confirmed nanophthalmos with axial lengths of 18.2 mm (right) and 18.5 mm (left). B-scan ultrasound showed a retinal and choroidal detachment in the right eye. During sclerectomy, a 3 cm white strand-like substance was extracted from the suprachoroidal space of the right eye. Histopathological analysis identified it as a collagen-rich proliferative membrane, with immunohistochemical staining showing strong positivity for collagen type I and moderate positivity for CD68. Post-surgery, with topical corticosteroids, the uveal effusion resolved, the retina flattened, and visual acuity improved to 0.02 in the right eye.

Conclusion: The discovery of a suprachoroidal proliferative membrane rich in fibroblasts and macrophages in a patient with UES and nanophthalmos suggests an inflammatory component in the pathophysiology of nanophthalmic UES, providing new insights into its mechanism and potential therapeutic targets.