Idiopathic chorioretinal effusion: An analysis of extracellular fluids

A case of nonrhegmatogenous retinal detachment with choroidal detachment was seen 3 weeks after onset and was evaluated clinically with emphasis on the fluid contents from one eye. The right eye showed slight subretinal fluid and minimal RPE pigmentary mottling. The left eye was severely involved with a near flat anterior chamber, a 360 degrees peripheral serous retinal detachment with shifting fluid and 360 degrees choroidal separations. Fluorescein showed mottled retinal pigment epithelium changes in each eye. Cell free samples of the subretinal fluid were high in protein (16.5 gm/100 ml) with a near absence of the alpha-2 fraction. Epichoroidal fluid from the choroidal detachments exhibited a protein content and makeup similar to that of normal plasma. The concentration of protein in the cerebrospinal fluid was elevated (0.096 gm/100 ml) without evidence of inflammatory changes. Ultrastructural examinations of sclera revealed a normal structure. There was no indication of the cause of the elevated protein content of the subretinal and spinal fluids. Following subretinal and epichoroidal fluid evacuation, the patient was treated with systemic steroids. The retinal and choroidal separations subsided slowly over several months, leaving multiple retinal pigment epithelial pigmentary clumps with drusen-like centers. A more appropriate name for this entity is idiopathic chorioretinal effusion.