Nanophthalmic uveal effusion syndrome after prophylactic laser treatment

Purpose. We report a case of nanophthalmic uveal effusion syndrome (NUES) w ith total exudative retinal detachment (RD) after prophylactic argon laser (AL) treatment. The RD subsided and eventually resolved with i.v. steroid t herapy. Methods. A 45-year-old woman was referred to us with NUES and total exudati ve RD after prophylactic AL treatment for retinoschisis performed elsewhere . The patient had been scheduled for surgical intervention and was given i. v. prednisolone. Results. Two days after starting i.v. prednisolone, the subretinal fluid pa rtially resolved. Intervention had therefore been postponed. After 15 days the RD almost disappeared and vision improved to 20/400. Ten days later the macula was flat and vision was 20/200. At the six-month follow-up visit vi sion was 20/40. Conclusions. To our knowledge this is the first report of NUES and total ex udative RD following AL treatment that resolved with i.v. steroid therapy a lone. Since the AL treatment clearly seemed to play a role in the pathogene sis of the NUES and associated RD we strongly advise careful assessment of the risk/benefit ratio of prophylactic laser treatment in nanophthalmic pat ients. Although sclerectomy and vortex vein decompression are well-establis hed techniques, we believe steroid therapy might be tried before proceeding to surgery.