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Optical coherence tomography imaging of chorioretinal folds associated with hypotony maculopathy following pars plana vitrectomy.

Williams BK, Chang JS, Flynn HW - Int Med Case Rep J (2015)

Bottom Line: Chorioretinal folds may occur as a consequence of hypotony and can be a cause of vision loss when associated with macular involvement.In this report, the spectral domain ocular coherence tomography imaging of three patients with chorioretinal folds before and after management are presented.The cases had unique presentations and each underwent different management approaches, but the results included improved visual acuities and lessened chorioretinal folds.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

ABSTRACT
Chorioretinal folds may occur as a consequence of hypotony and can be a cause of vision loss when associated with macular involvement. In this report, the spectral domain ocular coherence tomography imaging of three patients with chorioretinal folds before and after management are presented. The cases had unique presentations and each underwent different management approaches, but the results included improved visual acuities and lessened chorioretinal folds.

No MeSH data available.


Related in: MedlinePlus

The horizontal line scan from the SD-OCT of the left eye of the patient demonstrates subtle chorioretinal folds (A). The vertical line scan more clearly demonstrates the chorioretinal folds (B). On both the horizontal and vertical line scans taken after treatment, there is a resolution of the folds (C and D).Abbreviation: SD-OCT, spectral domain ocular coherence tomography.
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f3-imcrj-8-199: The horizontal line scan from the SD-OCT of the left eye of the patient demonstrates subtle chorioretinal folds (A). The vertical line scan more clearly demonstrates the chorioretinal folds (B). On both the horizontal and vertical line scans taken after treatment, there is a resolution of the folds (C and D).Abbreviation: SD-OCT, spectral domain ocular coherence tomography.

Mentions: An 86-year-old Caucasian man was referred for management of a dislocated IOL in the left eye 15 years after cataract surgery. The IOL was in the posterior pole on initial examination with a BCVA of 20/40 and an IOP of 11 mmHg. He underwent a 23-gauge PPV with lens removal and secondary sutured IOL placement. The eye was found to be hypotonous, with pressures not exceeding 4 mmHg, during the first postoperative month. The patient also had a hyphema and vitreous hemorrhage with vision fluctuating from 20/400 to hand motions. He was found to have chorioretinal folds by SD-OCT (Figure 3A) and received an intravitreal injection of triamcinolone acetonide 4 mg/0.1 mL with minimal improvement in IOP over the following 2 months. Contact B-scan ultrasonography demonstrated a cyclodialysis cleft possibly exacerbated by a subluxed IOL. He was treated conservatively with atropine 1% and prednisolone acetate 1% without improvement. He then underwent pupilloplasty and repositioning of the IOL and sequential rounds of diode laser to the cleft over the following 2 months with slow increase in pressure from approximately 1 mmHg to 10 mmHg. The maculopathy persisted for several months after the cleft closure with a near visual acuity of Jaeger 2. His pressure gradually decreased again, and he was treated with a 23-gauge PPV, membrane peeling, Healon injection, and cryotherapy to the cyclodialysis cleft to induce elevation in IOP. However, his IOP rose to 48 mmHg. A vitreous chamber tap was performed but rebound increases in IOP occurred, and the patient was taken back for a 23-gauge PPV and Healon removal 3 days after initial injection. Postoperatively, his IOP remained in the low-teens and vision stabilized. His chorioretinal folds by SD-OCT resolved (Figure 3B) over the ensuing 2 months, and 17 months after his most recent surgery, the BCVA had improved to 20/40 with a stable IOP ranging from 9 to 12 mmHg.


Optical coherence tomography imaging of chorioretinal folds associated with hypotony maculopathy following pars plana vitrectomy.

Williams BK, Chang JS, Flynn HW - Int Med Case Rep J (2015)

The horizontal line scan from the SD-OCT of the left eye of the patient demonstrates subtle chorioretinal folds (A). The vertical line scan more clearly demonstrates the chorioretinal folds (B). On both the horizontal and vertical line scans taken after treatment, there is a resolution of the folds (C and D).Abbreviation: SD-OCT, spectral domain ocular coherence tomography.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581779&req=5

f3-imcrj-8-199: The horizontal line scan from the SD-OCT of the left eye of the patient demonstrates subtle chorioretinal folds (A). The vertical line scan more clearly demonstrates the chorioretinal folds (B). On both the horizontal and vertical line scans taken after treatment, there is a resolution of the folds (C and D).Abbreviation: SD-OCT, spectral domain ocular coherence tomography.
Mentions: An 86-year-old Caucasian man was referred for management of a dislocated IOL in the left eye 15 years after cataract surgery. The IOL was in the posterior pole on initial examination with a BCVA of 20/40 and an IOP of 11 mmHg. He underwent a 23-gauge PPV with lens removal and secondary sutured IOL placement. The eye was found to be hypotonous, with pressures not exceeding 4 mmHg, during the first postoperative month. The patient also had a hyphema and vitreous hemorrhage with vision fluctuating from 20/400 to hand motions. He was found to have chorioretinal folds by SD-OCT (Figure 3A) and received an intravitreal injection of triamcinolone acetonide 4 mg/0.1 mL with minimal improvement in IOP over the following 2 months. Contact B-scan ultrasonography demonstrated a cyclodialysis cleft possibly exacerbated by a subluxed IOL. He was treated conservatively with atropine 1% and prednisolone acetate 1% without improvement. He then underwent pupilloplasty and repositioning of the IOL and sequential rounds of diode laser to the cleft over the following 2 months with slow increase in pressure from approximately 1 mmHg to 10 mmHg. The maculopathy persisted for several months after the cleft closure with a near visual acuity of Jaeger 2. His pressure gradually decreased again, and he was treated with a 23-gauge PPV, membrane peeling, Healon injection, and cryotherapy to the cyclodialysis cleft to induce elevation in IOP. However, his IOP rose to 48 mmHg. A vitreous chamber tap was performed but rebound increases in IOP occurred, and the patient was taken back for a 23-gauge PPV and Healon removal 3 days after initial injection. Postoperatively, his IOP remained in the low-teens and vision stabilized. His chorioretinal folds by SD-OCT resolved (Figure 3B) over the ensuing 2 months, and 17 months after his most recent surgery, the BCVA had improved to 20/40 with a stable IOP ranging from 9 to 12 mmHg.

Bottom Line: Chorioretinal folds may occur as a consequence of hypotony and can be a cause of vision loss when associated with macular involvement.In this report, the spectral domain ocular coherence tomography imaging of three patients with chorioretinal folds before and after management are presented.The cases had unique presentations and each underwent different management approaches, but the results included improved visual acuities and lessened chorioretinal folds.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

ABSTRACT
Chorioretinal folds may occur as a consequence of hypotony and can be a cause of vision loss when associated with macular involvement. In this report, the spectral domain ocular coherence tomography imaging of three patients with chorioretinal folds before and after management are presented. The cases had unique presentations and each underwent different management approaches, but the results included improved visual acuities and lessened chorioretinal folds.

No MeSH data available.


Related in: MedlinePlus