Kissing choroidal sign: A case report

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Choroidal detachment (CD) is a rare but vision-threatening complication following glaucoma surgery.
• Inflammation and prolonged ocular hypotony are key factors promoting fluid accumulation between the choroid and sclera.
• Risk factors include trauma, advanced age, anticoagulants, hypertension, atherosclerosis, and diabetes.

Observation:

• Ultrasound reveals CD as two convexly protruding layers into the vitreous, anteriorly to the ciliary bodies, without optic disc extension (kissing choroidal sign).
• Retinal detachments present a distinct 'V' shape due to retinal fixation at the optic nerve head.
• Hemorrhagic CD management focuses on reducing intraocular pressure.

Findings:

• Point-of-care ultrasound effectively differentiates choroidal from retinal detachments.
• Treatment for the presented case included atropine and prednisolone drops, with discontinuation of glaucoma medications in the affected eye.
• Serous CDs are typically benign, but persistent effusions or hemorrhagic CDs carry significant morbidity and a worse prognosis.

Implications:

• Point-of-care ultrasound enables rapid diagnosis and appropriate management of choroidal detachments in emergency settings.
• Timely differentiation between CD and retinal detachment is crucial for preventing vision loss.
• Understanding risk factors and ultrasound characteristics aids in managing this rare surgical complication.