Choroidal Detachment in a Patient on a CPAP Therapy

The aim of the study is to present a rare case of choroidal detachment in a patient on continuous positive airway pressure (CPAP) therapy.

A 76-year-old man on CPAP therapy due to obstructive sleep apnea presented to the ocular oncology clinic with a suspicion of an intraocular tumor. He complained of tunnel vision in red, floaters and flashes in the visual field, and irritation of the left eye since 13 weeks.

On initial assessment, the best corrected visual acuity (BCVA) of the left eye was 1.0, and the intraocular pressure (IOP) was 21 mmHg. The examination revealed dilated, tortuous episcleral vessels and a massive choroidal effusion. The patient was diagnosed with choroidal detachment and was treated with topical dexamethasone 0.1% and cyclopentolate. On a follow-up visit 3 weeks later, the BCVA got worse to hand movements and IOP increased to 27 mmHg. The patient received a combination of dorzolamide and timolol in addition to the aforementioned treatment. Over the following 16 weeks, a gradual resolution of the choroidal detachment was documented.

The CPAP treatment is a possible, though unproven, contributor to the choroidal detachment. The patient improved during corticosteroid, cycloplegic, and IOP-lowering treatment.