Choroidal effusions are an accumulation of fluid in the suprachoroidal space, between the choroid and sclera. They differ from retinal detachments in their clinical presentation and radiologic appearance.

• Choroidal effusions can be associated with:

• • Ocular hypotony
  • Neoplasm
  • Inflammatory choroidal disorders
  • Carotid cavernous fistulas

• Once choroidal effusions are detected, causes can be narrowed down by careful evaluation of the CT scans.

• • Ocular hypotony is the determined cause when there is visualization of a small globe with a characteristic umbrella sign or scleral infolding.
  • Tumors can be identified by a focal mass.
  • Inflammatory processes are associated with fat stranding.
  • Enlarged superior ophthalmic veins and enlarged cavernous sinuses are associated with carotid cavernous fistulas.

The imaging findings are

• On cross-sectional images, choroidal detachments appear as semilunar elevations with the anterior margins at the ciliary bodies and the posterior extensions at the entry points of the vortex veins or posterior ciliary arteries.
• Retinal detachments appear as V-shaped elevations with the apex at the optic nerve, because the retina is a neural structure continuous with the optic nerve.

Patient #1: CT images demonstrate a left choroidal effusion