INSIGHT OPHTHALMOLOGY RETINA NOTE

Exudative Retinal Detachment

Causes, Diagnosis and Management

Understand why subretinal fluid accumulates, recognise the important clinical clues and identify the disease that requires treatment.

Related Foundation Notes

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What Is Exudative Retinal Detachment?

An exudative retinal detachment occurs when subretinal fluid accumulates and separates the neurosensory retina from the retinal pigment epithelium. 1

There is no primary causative full-thickness retinal break, and vitreoretinal traction is not the primary force producing the detachment.

What is present? Fluid within the potential space between the neurosensory retina and the RPE.
What is absent? A primary retinal break through which liquefied vitreous enters the subretinal space.
What must be identified? The ocular or systemic disease producing the fluid.

The diagnosis is only complete when the underlying cause of the subretinal fluid has been identified.

Exudative vs Serous Terminology

The terms exudative retinal detachment and serous retinal detachment are commonly used for the same broad process: accumulation of subretinal fluid without a primary causative retinal break. 1

Exudative retinal detachment Usually refers to a clinically evident retinal detachment caused by leakage, inflammation, choroidal circulatory disturbance, impaired RPE function or a combination of these.
Serous retinal detachment Often used synonymously with exudative retinal detachment. It may also describe a smaller, localised elevation of the neurosensory retina seen on OCT. 2
Clinical usage

Interpret the term in context. It may describe either an extensive clinical retinal detachment or a localised pocket of subretinal fluid on imaging.

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How Is Subretinal Fluid Normally Cleared?

The neurosensory retina normally remains closely apposed to the RPE because several mechanisms act together to keep the subretinal space relatively free of fluid. 3–5

Active RPE transport The RPE actively transports ions and water from the subretinal space toward the choroid.
Hydrostatic gradients Pressure differences across the retina and RPE favour movement of fluid away from the subretinal space.
Oncotic gradients The relatively high oncotic pressure of the choroidal circulation assists outward fluid movement.
Outer blood–retinal barrier RPE tight junctions restrict uncontrolled movement of fluid and proteins from the choroid into the subretinal space.
Retinal apposition Weak adhesive and interfacial forces help maintain contact between the neurosensory retina and the RPE.
Important

Normal retinal apposition does not depend on an “RPE pump” alone. It reflects the combined effect of RPE transport, pressure gradients, barrier integrity and interfacial forces.

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How Does Exudative Retinal Detachment Develop?

Exudative retinal detachment develops when fluid entry into the subretinal space exceeds the ability of the retina and RPE to clear it 1, 3–5 .

Underlying disease

Inflammatory, vascular, hypertensive, neoplastic or choroidal disorder

Fluid imbalance

Increased fluid entry, reduced clearance or both

Subretinal accumulation

Fluid collects between the neurosensory retina and RPE

Retinal or choroidal leakage Increased vascular permeability allows fluid and proteins to enter the subretinal space.
Inflammation Breakdown of vascular and RPE barriers promotes leakage and may impair normal fluid transport.
Hydrostatic disturbance Severe hypertension or altered choroidal circulation changes the pressure gradients controlling fluid movement.
Choroidal congestion or effusion Expansion or impaired drainage of the choroid may disturb the RPE–choroidal interface and promote subretinal fluid.
Impaired RPE barrier or transport Dysfunction of the outer blood–retinal barrier or RPE fluid transport reduces clearance from the subretinal space.
Combined mechanisms Many diseases produce detachment through more than one pathway at the same time.
Clinical principle

Exudative retinal detachment is not a single disease. It is the anatomical result of an underlying disorder that has disturbed subretinal-fluid balance.

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Causes of Exudative Retinal Detachment

Exudative retinal detachment is a manifestation of an underlying ocular or systemic disorder. A practical differential can be organised by the main disease process involved. 1

Cause group Important examples Useful diagnostic direction
Non-infectious inflammatory or choroidal disease Vogt–Koyanagi–Harada disease, posterior scleritis and selected non-infectious posterior uveitides or choroiditides. 6, 7 Look for ocular inflammation, choroidal thickening, disc oedema, pain, choroidal folds or neurological and auditory symptoms.
Infectious posterior uveitis or choroiditis Selected infectious posterior uveitides and choroiditides, guided by the ocular phenotype, exposure history and systemic context. 1 Consider infection particularly in immunosuppression, relevant exposure, systemic infection or atypical inflammatory disease.
Hypertensive or choroidal-ischaemic disease Severe or malignant hypertension, preeclampsia and eclampsia. 8 Acute bilateral serous detachment may accompany hypertensive choroidopathy and can indicate a systemic or obstetric emergency.
Choroidal congestion or effusion Uveal effusion syndrome, nanophthalmos, hypotony and postoperative or medication-related ciliochoroidal effusion. 9, 22 Look for a short axial length, marked hyperopia, shallow anterior chamber, low intraocular pressure or choroidal detachment.
Retinal vascular leakage Coats disease, retinal capillary haemangioblastoma and vasoproliferative retinal tumour. 10 Look for telangiectatic or aneurysmal retinal vessels, extensive lipid exudation and focal vascular lesions.
Choroidal tumours Choroidal melanoma, choroidal metastasis and circumscribed or diffuse choroidal haemangioma. 11, 12, 19 Suspect an underlying mass when the detachment is focal, persistent, asymmetric or associated with an elevated choroidal lesion.
Developmental or mixed retinal disease Familial exudative vitreoretinopathy and other developmental retinal vascular disorders. 1 The anatomy may be mixed, with exudation accompanied by traction, fibrosis or peripheral avascular retina.
Other selected choroidal or RPE disorders Rare bullous presentations of central serous chorioretinopathy. 13 Multimodal imaging is usually required because the appearance may mimic another form of extensive retinal detachment.
Practical approach

Do not attempt to memorise the differential as one long list. First decide whether the dominant clue is inflammation, systemic vascular disease, choroidal congestion, retinal vascular leakage or an intraocular mass.

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Important Diagnostic Red Flags

Some presentations require urgent ocular, systemic or multidisciplinary assessment. Recognising urgency is more important here than naming every possible differential diagnosis.

Severe hypertension with acute visual symptoms
Assess immediately for hypertensive emergency and end-organ injury. Bilateral serous detachment may reflect hypertensive choroidopathy. 8
Pregnancy or postpartum state with hypertension and visual disturbance
Arrange urgent obstetric and systemic evaluation. Consider preeclampsia, eclampsia or HELLP syndrome. 8
Child with unilateral leukocoria, strabismus or extensive retinal detachment
Exclude retinoblastoma before assuming Coats disease. Avoid invasive intervention until an intraocular malignancy has been appropriately assessed. 10
Elevated choroidal lesion or unexplained focal detachment
Consider an intraocular tumour and arrange specialist assessment. A choroidal metastasis may occasionally be the first manifestation of systemic malignancy. 11, 19
Painful eye with disc oedema, choroidal folds or unexplained serous detachment
Consider posterior scleritis and investigate promptly. Delayed recognition may prolong inflammation and threaten vision. 7, 15
Incomplete peripheral examination or uncertain detachment mechanism
Do not label the detachment as purely exudative yet. A small or obscured retinal break must be reconsidered. 17
Urgent principle

The retinal detachment may be the presenting sign of a systemic emergency, intraocular malignancy or sight-threatening inflammatory disease. Escalate according to the underlying clinical risk—not only the amount of subretinal fluid.

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Clinical Appearance

Exudative retinal detachment often has a smooth, elevated appearance, but its morphology varies with the volume, location and cause of the subretinal fluid. 1

Clinical feature Typical appearance
Retinal surface The detached retina is often smooth, without the corrugations commonly associated with a mobile rhegmatogenous detachment.
Contour The elevation may be convex, dome-shaped or markedly bullous, depending on the amount and distribution of subretinal fluid.
Distribution Fluid may be localised, multifocal, inferiorly dependent or extensive. Multiple pockets may occur in inflammatory choroidal disease.
Mobility The fluid may redistribute with posture, although the degree of movement varies and may be absent.
Associated findings Look for inflammation, disc oedema, choroidal folds, retinal telangiectasia, lipid exudation, choroidal detachment or an underlying mass.
Retinal break No causative full-thickness retinal break is identified in a pure exudative detachment. The adequacy of the peripheral retinal examination must still be documented.
Clinical sign

Shifting subretinal fluid

Shifting fluid describes redistribution of subretinal fluid after a change in posture.

  • It may support an exudative mechanism when present.
  • It may be absent when the fluid is shallow, loculated, chronic or restricted by the underlying disease.
  • It is not diagnostic by itself and may occasionally occur in rhegmatogenous retinal detachment. 16
Clinical principle

Retinal morphology can suggest an exudative mechanism, but the diagnosis requires integration of the peripheral retinal examination, associated ocular signs and cause-directed imaging.

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The Occult Retinal-Break Problem

Failure to identify a retinal break does not automatically establish an exudative mechanism. A small or poorly visualised break may be missed, particularly when the peripheral examination is incomplete. 17

Small or anterior break A tiny tear, atrophic hole or very anterior break may be difficult to identify without careful peripheral examination and scleral indentation.
Obscured peripheral retina Cataract, vitreous haemorrhage, corneal opacity, small pupil or markedly bullous elevation may prevent complete visualisation.
Break hidden by anatomy A break may lie beneath a retinal fold, within lattice degeneration, close to the ora serrata or in an area that is difficult to examine.
Incomplete initial examination The diagnosis may remain uncertain when the retina has not been examined through 360 degrees or when indentation was not possible.
Do Not Confuse

Shifting subretinal fluid does not exclude a rhegmatogenous retinal detachment. It may occasionally occur when a retinal break is present. 16

Practical action

When the mechanism remains uncertain

  • Repeat the dilated peripheral retinal examination with scleral indentation where appropriate.
  • Re-examine after media clarity improves or after the configuration of the detachment changes.
  • Use B-scan ultrasonography when the fundus cannot be visualised, while recognising that ultrasonography cannot reliably exclude every small retinal break.
  • Seek vitreoretinal review before committing the patient to a purely exudative diagnosis when significant doubt remains.
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Clinical Assessment

Each question in the history should help narrow the disease responsible for the subretinal fluid. These clues guide the differential but do not establish the diagnosis alone.

History: what does each question suggest?

History question or clue Diagnostic direction
Was the onset acute, subacute or chronic?
  • Acute bilateral: consider VKH, severe hypertension, preeclampsia or another systemic inflammatory or choroidal process.
  • Subacute unilateral: consider posterior scleritis, particularly when pain, choroidal folds or disc oedema are present.
  • Chronic or recurrent: consider persistent inflammatory or choroidal disease, uveal effusion, a retinal vascular lesion or an underlying tumour. 6, 8, 9, 15
Is the detachment unilateral or bilateral?
  • Unilateral: consider posterior scleritis, Coats disease, a focal retinal vascular lesion, choroidal tumour or localised uveal effusion.
  • Bilateral: consider VKH, severe hypertension, preeclampsia or another systemic inflammatory or choroidal disorder. 6, 8, 10, 15
Is there ocular pain, tenderness or redness?
  • Painful or tender eye: consider posterior scleritis.
  • Absence of pain does not exclude posterior scleritis. 7, 14, 15
Are headache, meningismus, tinnitus or hearing disturbance present?
  • Neurological or auditory symptoms with bilateral serous detachments: consider Vogt–Koyanagi–Harada disease. 6
Is the patient severely hypertensive?
  • Severe hypertension with bilateral serous detachment: consider hypertensive choroidopathy.
  • Assess urgently for systemic end-organ injury.
  • This may represent a medical emergency. 8
Is the patient pregnant or postpartum?
  • Hypertension with acute visual symptoms: consider preeclampsia, eclampsia or HELLP syndrome.
  • Arrange urgent obstetric and systemic assessment. 8
Is there a history of malignancy, weight loss or systemic cancer symptoms?
  • Known malignancy: consider choroidal metastasis.
  • No previously diagnosed malignancy: ocular metastasis may occasionally be the presenting manifestation.
  • Look for an elevated choroidal lesion or an unexplained focal detachment. 11, 19
Is there marked hyperopia or a known small eye?
  • Marked hyperopia or short axial length: consider nanophthalmos-associated uveal effusion.
  • Look for shallow anterior chambers and choroidal detachment. 9, 22
Has there been recent ocular surgery or hypotony?
  • Recent surgery with low intraocular pressure: consider postoperative choroidal or ciliochoroidal effusion.
  • Assess for wound leak, hypotony and choroidal detachment. 1, 9
Has a relevant medication recently been started?
  • Acute bilateral refractive change or angle shallowing: consider medication-associated ciliochoroidal effusion.
  • Review recently introduced medication and assess the anterior chamber and choroid. 1
Are there infectious exposures, systemic infection or immunosuppression?
  • Relevant exposure or systemic infection: consider infectious posterior uveitis or choroiditis.
  • Investigations should be guided by the ocular phenotype and systemic context. 1
Is the patient a child with unilateral leukocoria, strabismus or extensive ERD?
  • Telangiectasia and lipid exudation: Coats disease may be considered.
  • Leukocoria or a suspected intraocular mass: retinoblastoma must be excluded first. 10
Examination checklist

Examination: what should be documented?

Detachment anatomy Laterality, extent, height, macular involvement, contour, mobility and the presence or absence of demonstrable shifting fluid.
Peripheral retina Whether the peripheral retina has been adequately examined and whether a causative retinal break has been confidently excluded.
Inflammatory and choroidal clues Anterior-chamber or vitreous inflammation, disc oedema, choroidal folds and choroidal detachment.
Vascular or mass lesion Retinal telangiectasia, aneurysmal vessels, lipid exudation and any visible or suspected choroidal mass.
Clinical principle

The purpose of assessment is not merely to confirm subretinal fluid. It is to identify the ocular or systemic process generating that fluid.

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Imaging According to the Clinical Question

Choose imaging to answer a specific diagnostic question. No single scan confirms every cause of exudative retinal detachment, so findings must be interpreted alongside the history and examination. 1

Clinical question Useful imaging What does it assess?
Is subretinal fluid present, and is the fovea involved? Macular OCT Confirms and maps subretinal fluid, foveal involvement, intraretinal fluid, retinal folds and associated RPE changes.
Is diffuse or focal choroidal disease suspected? Enhanced-depth OCT or swept-source OCT Assesses choroidal thickness, folds and focal elevation in inflammatory choroidal disease, VKH and selected pachychoroid-spectrum presentations. 6, 13
Is posterior scleritis suspected? B-scan ultrasonography Looks for posterior coat thickening, choroidal thickening and fluid in Tenon’s space. A T-sign supports the diagnosis, but its absence does not exclude posterior scleritis. 7, 18
Is there active retinal, disc or choroidal leakage? Fundus fluorescein angiography Identifies retinal vascular leakage, telangiectasia, disc leakage, focal leakage points and characteristic inflammatory leakage patterns. 6, 10
Is the primary abnormality within the choroidal circulation? Indocyanine green angiography Assesses choroidal vascular abnormalities, inflammatory hypofluorescent lesions, delayed perfusion and selected tumour-related vascular patterns. 6, 12
Is a choroidal mass suspected? B-scan and A-scan ultrasonography, OCT and tumour-directed multimodal imaging Defines lesion size, contour, internal reflectivity and associated subretinal fluid, helping differentiate melanoma, metastasis and choroidal haemangioma. 11, 12, 19
Is the fundus obscured or the peripheral retina inadequately visible? B-scan ultrasonography with repeat peripheral examination when possible Confirms retinal detachment behind opaque media and detects vitreous haemorrhage, posterior vitreous abnormalities or a mass. It cannot reliably exclude every small retinal break. 17
Is peripheral retinal vascular disease suspected? Widefield photography and widefield angiography Documents peripheral telangiectasia, non-perfusion, abnormal vessels, lipid exudation and areas requiring targeted treatment. 10
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Management Principle

Management begins by identifying and treating the disease producing the subretinal fluid. 1

Identify the cause

Determine whether the dominant process is inflammatory, hypertensive, vascular, neoplastic, effusive, infectious or mixed.

Recognise urgency

Severe hypertension, preeclampsia, serious ocular inflammation and suspected intraocular malignancy may require urgent systemic or multidisciplinary management.

Begin cause-directed treatment

Target the inflammation, vascular leakage, choroidal congestion, infection or causative lesion responsible for the detachment.

Monitor the response

Follow visual function, foveal involvement, OCT subretinal fluid, the extent of detachment and activity of the underlying disease.

Important

A pure exudative retinal detachment does not routinely require retinal-break repair. Laser to an absent break, cryotherapy, scleral buckling or vitrectomy should not replace treatment of the disease generating the fluid.

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Treatment According to the Cause

Treatment varies according to the disease producing the detachment. The table summarises the main treatment direction for each major cause.

Underlying cause Cause-directed treatment
Vogt–Koyanagi–Harada disease Promptly control inflammation with systemic corticosteroid therapy. Early steroid-sparing immunomodulatory treatment may be considered according to disease severity and specialist assessment. 6, 20
Posterior scleritis Treat the scleral inflammation with systemic anti-inflammatory therapy. Corticosteroids or additional immunomodulatory treatment may be required in severe, recurrent or refractory disease. 7, 21
Infectious posterior uveitis or choroiditis Use organism-directed antimicrobial treatment guided by the ocular phenotype, systemic context and relevant investigations. Do not use immunosuppression alone while an infectious cause remains clinically plausible.
Severe hypertension, preeclampsia or eclampsia Arrange urgent control of the systemic hypertensive or obstetric disorder with the appropriate medical team. The retinal fluid commonly improves as the systemic condition is stabilised. 8
Uveal effusion syndrome or nanophthalmos Management depends on the underlying anatomy. Selected persistent cases may require scleral decompression or sclerectomy-based surgery. 9, 22
Hypotony or postoperative ciliochoroidal effusion Correct the cause of hypotony, such as a wound leak, excessive filtration, inflammation or another postoperative complication.
Medication-associated ciliochoroidal effusion Stop the suspected causative medication when clinically appropriate and treat any associated inflammation, angle shallowing or pressure disturbance.
Coats disease Ablate abnormal retinal vessels with laser photocoagulation or cryotherapy. Anti-VEGF therapy may be used selectively as an adjunct. Advanced bullous detachment may require subretinal-fluid drainage to permit effective ablation of the abnormal vessels. 10, 23, 24
Retinal capillary haemangioblastoma or vasoproliferative tumour Treat the vascular lesion using an appropriate ablative or tumour-directed technique, selected according to its size, location and associated exudation.
Choroidal melanoma, metastasis or haemangioma Arrange ocular-oncology-directed treatment. Management depends on tumour type and may include radiotherapy, systemic oncological treatment, photodynamic therapy or another lesion-specific intervention. Systemic investigation is particularly important when choroidal metastasis is suspected. 11, 12, 19
Bullous central serous chorioretinopathy Confirm the diagnosis with multimodal imaging and follow a CSCR-specific management strategy. 13
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When Is Drainage or Retinal Surgery Considered?

Drainage or vitreoretinal surgery is not routine treatment for a pure exudative retinal detachment. It is considered only when altering the retinal anatomy serves a defined therapeutic purpose.

Core principle

Drainage may flatten the retina, but lasting resolution still depends on control of the disease producing the subretinal fluid.

When may intervention be useful?

To enable treatment of the causative lesion A markedly bullous retina may prevent effective laser or cryotherapy. Drainage may be used to flatten the retina sufficiently to treat abnormal vessels, particularly in advanced Coats disease. 23, 24
Persistent sight-threatening detachment Intervention may be considered when substantial subretinal fluid persists despite appropriate cause-directed treatment and continues to threaten the posterior pole or ocular integrity. 25
Complex vitreoretinal anatomy Vitrectomy may be required when exudative detachment is accompanied by significant vitreoretinal fibrosis, traction or a mixed rhegmatogenous component.
Selected effusive or tumour-associated cases Persistent uveal-effusion detachments may require scleral decompression with or without subretinal-fluid drainage. Selected tumour-associated detachments persisting after tumour treatment may require specialist vitreoretinal intervention. 22, 26

External and internal drainage

Principle External drainage Internal drainage
Route Subretinal fluid is drained through a controlled transscleral approach. Subretinal fluid is drained from inside the eye during pars plana vitrectomy.
Retinal opening A retinal drainage retinotomy is generally not required. In a pure exudative detachment, a planned drainage retinotomy is usually required to access the subretinal space.
Best suited to Markedly bullous detachments in which flattening the retina will permit treatment of the underlying lesion. Persistent or complex detachments in which vitrectomy is also needed to manage traction, fibrosis or associated retinal pathology.
Selected settings Advanced Coats disease and selected uveal-effusion cases. 22, 23, 24 Complex Coats disease, persistent ERD with vitreoretinal fibrosis, mixed detachment and selected tumour-associated ERD. 24, 25, 26
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Prognosis

Prognosis depends on the underlying disease, the duration and extent of subretinal fluid, macular involvement and the response to cause-directed treatment. 1

Cause and treatment response Inflammatory, hypertensive, medication-related and postoperative detachments may improve substantially when the causative process is treated promptly. Persistent vascular, neoplastic or structural disease may require prolonged treatment and surveillance.
Duration and macular involvement Prognosis is generally better when the fovea remains attached or when foveal detachment is brief. Longstanding subretinal fluid may produce irreversible photoreceptor and RPE damage.
Associated retinal damage Extensive lipid exudation, outer-retinal disruption, fibrosis, macular ischaemia and chronic inflammatory damage may limit vision even after the retina becomes anatomically flat.
Anatomical complexity Cases requiring drainage or vitreoretinal surgery are usually more complex. Surgery may improve retinal anatomy, but the final visual result still depends on the underlying disease and pre-existing macular damage. 25
Counselling point

Anatomical resolution does not guarantee complete visual recovery. Counsel separately about control of the underlying disease, retinal flattening and the realistic potential for visual improvement.

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Take-Home Framework

A practical approach to suspected exudative retinal detachment can be reduced to five questions.

Is this true subretinal fluid?

Confirm separation of the neurosensory retina from the RPE and distinguish it from intraretinal fluid, retinoschisis or choroidal elevation.

Has a retinal break been adequately excluded?

Shifting fluid supports an exudative mechanism but is not diagnostic. Re-examine the peripheral retina when the morphology is atypical, the view is incomplete or doubt remains. 16, 17

What disease is generating the fluid?

Use laterality, pain, inflammation, blood pressure, pregnancy, vascular abnormalities, ocular size, systemic disease and cause-directed imaging to identify the underlying process.

Does the patient need disease-directed treatment alone or a procedure?

Treat the causative inflammatory, vascular, hypertensive, infectious, effusive or neoplastic disorder. Reserve drainage or retinal surgery for a clearly defined anatomical or therapeutic purpose. 1

What should the patient expect?

Counsel separately about control of the underlying disease, anatomical retinal flattening and the realistic potential for visual recovery.

Final clinical message

Exudative retinal detachment is an anatomical consequence of another ocular or systemic disease. The central task is to identify and treat that disease without overlooking an occult retinal break.

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Related Videos

Continue with these Insight Ophthalmology lectures for the underlying retinal-detachment framework and relevant ultrasonography principles.

Retinal Detachment: Types, Risk Factors, Pathophysiology, Symptoms and Signs Review the foundational clinical approach to retinal detachment before comparing exudative and rhegmatogenous presentations. B-Scan Ultrasonography Basics Learn the basic scan orientation and interpretation needed when media opacity, posterior scleritis or an intraocular mass is suspected.
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References

Key reviews, diagnostic studies and treatment literature used for this companion note.

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  8. Lee CS, Choi EY, Lee M, Kim H, Chung H. Serous retinal detachment in preeclampsia and malignant hypertension. Eye. 2019;33:1707–1714. doi:10.1038/s41433-019-0461-8
  9. Elagouz M, Stanescu-Segall D, Jackson TL. Uveal effusion syndrome. Surv Ophthalmol. 2010;55:134–145. doi:10.1016/j.survophthal.2009.05.003
  10. Mahesh M, et al. International consensus on the diagnosis, classification and management of Coats disease. Am J Ophthalmol. 2026;282:162–186. doi:10.1016/j.ajo.2025.10.014
  11. Kivelä T, Eskelin S, Mäkitie T, Summanen P. Exudative retinal detachment associated with uveal melanoma. Invest Ophthalmol Vis Sci. 2001;42:2085–2093. PubMed:11481276
  12. Lupidi M, et al. Choroidal haemangioma: diagnosis and management. Graefes Arch Clin Exp Ophthalmol. 2024;262:1093–1110. doi:10.1007/s00417-023-06179-x
  13. Balaratnasingam C, Freund KB, Tan AM, et al. Bullous variant of central serous chorioretinopathy. Ophthalmology. 2016;123:1541–1552. doi:10.1016/j.ophtha.2016.03.017
  14. Calthorpe CM, Watson PG, McCartney ACE. Posterior scleritis: a clinical and histological survey. Eye. 1988;2:267–277. doi:10.1038/eye.1988.52
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  16. Kirkby GR, Chignell AH. Shifting subretinal fluid in rhegmatogenous retinal detachment. Br J Ophthalmol. 1985;69:654–655. doi:10.1136/bjo.69.9.654
  17. Gupta D, Ching J, Tornambe PE. Clinically undetected retinal breaks causing retinal detachment. Surv Ophthalmol. 2018;63:579–588. doi:10.1016/j.survophthal.2017.08.002
  18. Maleki A, et al. B-scan ultrasonography findings in posterior scleritis. J Curr Ophthalmol. 2022;34:93–99. doi:10.4103/joco.joco_267_21
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  22. Braga de Sousa L, Barbosa-Breda J. Sclerectomy-based procedures for nanophthalmos and uveal effusion syndrome. Graefes Arch Clin Exp Ophthalmol. 2025;263:2709–2722. doi:10.1007/s00417-025-06908-4
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