Diagnostic Sonography • B-Scan Eye Pathology Atlas
Choroidal Detachment
A structured ocular ultrasound case collection covering the sonographic appearance of choroidal detachment, including smooth dome-shaped choroidal elevation, extent, mobility, configuration and differentiation from retinal detachment.
Choroidal Detachment — Sonographic Morphology Index
01
Peripheral / Localized Choroidal Detachment
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02
Bullous / Dome-Shaped Choroidal Detachment
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03
Serous Choroidal Detachment
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04
Hemorrhagic Choroidal Detachment
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05
Extensive / Circumferential Choroidal Detachment
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06
Choroidal Detachment with Ciliochoroidal Involvement
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07
Choroidal Detachment with Coexisting Retinal Detachment
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Chapter 01 • Case Study
Peripheral / Localized Choroidal Detachment
01 Clinical History
Patient referred for B-scan evaluation of a peripheral
choroidal elevation. Dynamic examination is performed to
characterize the contour, mobility, location and relationship
of the elevated choroid to the posterior wall and retina.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Location | Peripheral elevation of the choroidal layer along the ocular wall. |
| Configuration | Smooth, dome-shaped or convex elevation arising from the posterior wall. |
| Contour | Typically smooth and well-defined. |
| Mobility | Usually limited compared with a freely mobile retinal detachment membrane. |
| Retina | The retina should be separately evaluated for associated retinal detachment. |
04 Ultrasound Report
Localized smooth peripheral choroidal elevation is
demonstrated.
The elevated choroidal contour demonstrates limited
mobility on dynamic examination.
No definite freely mobile retinal detachment membrane is
identified on the examined views.
05 Impression
Sonographic Impression
Findings are compatible with localized choroidal
detachment.
06 Recommendation
Correlate with clinical examination and evaluate the
remaining retina systematically for an associated retinal
detachment or other vitreoretinal abnormality.
07 Learning Points
Identify the location and extent of the choroidal
elevation.
Recognize the smooth dome-shaped configuration.
Assess mobility dynamically.
Search for a separate retinal detachment membrane.
Chapter 02 • Case Study
Bullous / Dome-Shaped Choroidal Detachment
01 Clinical History
Patient with a prominent smooth peripheral ocular wall
elevation. B-scan is performed to assess the characteristic
dome-shaped configuration and to differentiate choroidal
elevation from retinal detachment.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Configuration | Prominent smooth convex or dome-shaped elevation of the choroid. |
| Contour | Smooth, broad-based and relatively regular. |
| Mobility | Limited mobility compared with a detached retina. |
| Location | Usually peripheral and may be visualized in multiple quadrants. |
| Differential | Retinal detachment and other posterior wall abnormalities should be excluded. |
04 Ultrasound Report
Prominent smooth dome-shaped choroidal elevation is
visualized.
The elevated choroidal contour demonstrates limited
mobility during dynamic examination.
No definite freely mobile retinal membrane is identified
on the examined views.
05 Impression
Sonographic Impression
Bullous / dome-shaped choroidal detachment.
06 Recommendation
Correlate with intraocular pressure, recent ocular surgery,
trauma and clinical findings where relevant. Carefully
evaluate for associated retinal detachment.
07 Learning Points
Recognize the smooth dome-shaped contour.
Assess the mobility of the elevated membrane.
Determine the number of involved quadrants.
Exclude a separate retinal detachment.
Chapter 03 • Case Study
Serous Choroidal Detachment
01 Clinical History
Patient referred for ocular ultrasound with suspected
choroidal fluid accumulation. B-scan is performed to
characterize the configuration and distribution of the
choroidal elevation.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Appearance | Smooth, curvilinear elevation of the choroid from the posterior ocular wall. |
| Configuration | Dome-shaped or lentiform configuration. |
| Internal echoes | The sonographic appearance depends on the nature and amount of fluid. |
| Mobility | Usually limited compared with a freely detached retina. |
| Distribution | May involve one or multiple peripheral quadrants. |
04 Ultrasound Report
Smooth curvilinear choroidal elevation is demonstrated.
The choroidal contour demonstrates limited mobility on
dynamic examination.
Findings are consistent with choroidal separation from
the underlying scleral surface.
05 Impression
Sonographic Impression
Sonographic features of serous choroidal detachment.
06 Recommendation
Correlate with clinical history and evaluate for possible
postoperative, inflammatory, traumatic or hypotony-related
causes as clinically appropriate.
07 Learning Points
Identify the choroidal-scleral separation.
Assess the shape and extent of the detachment.
Evaluate the remaining retina.
Correlate the ultrasound pattern with clinical history.
Chapter 04 • Case Study
Hemorrhagic Choroidal Detachment
01 Clinical History
Patient with suspected intraocular hemorrhagic complication.
B-scan is performed to assess choroidal elevation, internal
echoes, extent and associated retinal pathology.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Configuration | Smooth or lobulated choroidal elevation. |
| Internal echoes | Variable internal echoes may be present depending on the age and organization of hemorrhagic material. |
| Mobility | Usually limited compared with a mobile retinal detachment. |
| Extent | May be localized or extensive. |
| Associated pathology | Carefully assess for vitreous hemorrhage and retinal detachment. |
04 Ultrasound Report
Choroidal elevation is demonstrated with associated
internal echoes.
The elevated choroidal complex demonstrates limited
mobility.
The sonographic appearance raises the possibility of
hemorrhagic choroidal detachment.
05 Impression
Sonographic Impression
Choroidal detachment with internal echogenic material,
suspicious for hemorrhagic component.
06 Recommendation
Urgent ophthalmic correlation is recommended, particularly
when associated with recent surgery, trauma, severe pain or
visual deterioration.
07 Learning Points
Evaluate internal echogenicity carefully.
Assess the age and organization of hemorrhagic material
sonographically.
Distinguish the choroidal component from vitreous
hemorrhage.
Search systematically for retinal detachment.
Chapter 05 • Case Study
Extensive / Circumferential Choroidal Detachment
01 Clinical History
Patient with broad peripheral choroidal elevation and
limited fundus visualization. Multiplanar B-scan is
performed to determine the number of involved quadrants
and posterior extent.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Extent | Choroidal elevation involving multiple peripheral quadrants. |
| Configuration | Broad smooth convex elevations along the posterior ocular wall. |
| Distribution | May be bilateral, multifocal or circumferential within the affected eye. |
| Mobility | Generally limited mobility. |
| Retina | The posterior pole and optic disc region should be evaluated for associated retinal detachment. |
04 Ultrasound Report
Extensive smooth choroidal elevations are demonstrated
involving multiple peripheral quadrants.
The choroidal elevations demonstrate limited mobility.
The posterior pole is separately evaluated for associated
retinal detachment.
05 Impression
Sonographic Impression
Extensive / circumferential choroidal detachment.
06 Recommendation
Document the involved quadrants and correlate with the
clinical setting. Carefully assess the retina and optic
disc attachment.
07 Learning Points
Determine the complete circumferential extent.
Use multiple scan planes.
Assess the posterior pole independently.
Search for associated retinal detachment.
Chapter 06 • Case Study
Choroidal Detachment with Ciliochoroidal Involvement
01 Clinical History
Patient with anterior and peripheral choroidal elevation.
B-scan is performed to evaluate the extent of the
ciliochoroidal abnormality and its relationship to the
posterior segment.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Location | Anterior/peripheral choroidal elevation with extension toward the ciliary body region. |
| Configuration | Smooth convex elevation. |
| Extent | Define anterior and posterior limits using appropriate scanning planes. |
| Mobility | Limited mobility compared with retinal detachment. |
| Associated findings | Assess the vitreous, retina and posterior segment for associated pathology. |
04 Ultrasound Report
Peripheral choroidal elevation extends toward the
anterior segment/ciliary body region.
The elevated complex demonstrates limited mobility.
No definite separate freely mobile retinal detachment
membrane is identified on the examined views.
05 Impression
Sonographic Impression
Choroidal detachment with anterior/ciliochoroidal
involvement.
06 Recommendation
Correlate with clinical examination and surgical or
traumatic history where applicable. Further ophthalmic
assessment should determine the underlying cause.
07 Learning Points
Define the anterior extent of the abnormality.
Evaluate the ciliary body region when visualized.
Assess mobility dynamically.
Exclude posterior retinal pathology.
Chapter 07 • Case Study
Choroidal Detachment with Coexisting Retinal Detachment
01 Clinical History
Patient with suspected choroidal detachment and a separate
mobile retinal membrane on B-scan. Dynamic examination is
performed to characterize the choroidal and retinal
components independently.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Choroidal component | Smooth dome-shaped choroidal elevation with relatively limited mobility. |
| Retinal component | A separate retinal membrane demonstrates greater mobility during dynamic examination. |
| Relationship | The choroidal and retinal components should be traced separately through multiple scan planes. |
| Optic disc | Assess attachment of the retinal detachment to the optic disc when technically possible. |
| Extent | Document the involved quadrants and posterior extent of the retinal detachment. |
04 Ultrasound Report
Smooth choroidal elevations are demonstrated along the
posterior ocular wall.
A separate mobile retinal membrane is also identified on
dynamic examination.
The choroidal and retinal components demonstrate
different mobility characteristics.
The extent and posterior attachment of the retinal
component are documented.
05 Impression
Sonographic Impression
Choroidal detachment with coexisting retinal detachment.
06 Recommendation
Prompt ophthalmic assessment is recommended. Document the
extent of both choroidal and retinal detachment and correlate
with the clinical setting.
07 Learning Points
Identify the choroidal component separately.
Identify the separate mobile retinal detachment.
Use dynamic examination to distinguish the two
components.
Document retinal extent and optic-disc attachment.
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