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Sturge-Weber syndrome is complicated by glaucoma in 30% of patients; of these, 60% develop glaucoma in infancy and 40%, in childhood. Medical treatment often fails to adequately control IOP in these patients, and surgical intervention is frequently necessary. Filtration surgery may be complicated by expulsive choroidal hemorrhage and massive choroidal effusion, more often in patients with Sturge-Weber syndrome compared with other patients presenting with glaucoma, particularly in eyes with choroidal hemangioma, because the rapid decrease in IOP during surgery may induce the transudation of fluid from a fragile vessel in the choroidal hemangioma, leading to the development of choroidal effusion. When the risk of drainage surgery is considered too high, diode laser cyclophotocoagulation may, in theory, be a safer treatment to lower the IOP. Our case illustrates that significant but transient choroidal effusions can still occur after diode laser procedure.
Dr. F. Quagliano, Maggiore Hospital, Bologna, Italy. francescaquagliano@libero.it