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Bilateral Ocular Decompression Retinopathy after Ahmed Valve Implantation for Uveitic Glaucoma

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ABSTRACT

Case report: We report the case of a 29-year-old man who underwent Ahmed valve implantation in both eyes as treatment for uveitic glaucoma, subsequently presenting with bilateral ocular decompression retinopathy in the postoperative period.

Discussion: Ocular decompression retinopathy is a rare complication of filtering surgery in patients with glaucoma; however, the course is benign in most cases, with spontaneous resolution of bleedings and improvement of visual acuity.

No MeSH data available.


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Fluorescein angiography at the postoperative week revealing blockage hypofluorescence in the areas of intraretinal hemorrhages and disc hyperfluorescence but no delay in venous filling.
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Figure 2: Fluorescein angiography at the postoperative week revealing blockage hypofluorescence in the areas of intraretinal hemorrhages and disc hyperfluorescence but no delay in venous filling.

Mentions: In the following week, IOP was poorly controlled in spite of maximum medical treatment and IOP values remained consistently over 30 mm Hg. An Ahmed valve implantation was scheduled and performed sequentially in both eyes. On the first postoperative day, BCVA was 1.00 OD and 0.50 OS, and IOP was 0 and 3 mm Hg, respectively. Slit-lamp examination revealed a functional filtering bleb, a formed anterior chamber and a free tube opening. Pupillary response was somewhat delayed and a slight afferent pupillary defect was present. Fundus examination showed blurred, hyperemic optic disc with peripapillary hemorrhages and scattered white-centered retinal hemorrhages in the periphery and posterior pole in both eyes accompanied with macular folds in the OS (Fig 1). Early postoperative treatment with prednisolone acetate 1% q.i.d. and atropine 1% t.i.d. was initiated. At the postoperative week, a new fluorescein angiography revealed blockage hypofluorescence in the areas of intraretinal hemorrhages and disc hyperfluorescence but no delay in venous filling (Fig 2), leading to the diagnosis of decompression retinopathy in both eyes (OU) and hypotonic maculopathy of the OS. One week postoperatively, his IOP was 10 mm Hg in OU, BCVA was 0.70 OD and 0.40 OS, and the retinal hemorrhages began to resolve. One month after surgery, the retinal hemorrhages showed gradual reduction in size. (Fig 3). At the third month of follow-up, BCVA improved to 0.40 OD and 0.30 OS, and IOP was 16 mm Hg in OU. Fundal hemorrhages had faded and hypotonic maculopathy had resolved.


Bilateral Ocular Decompression Retinopathy after Ahmed Valve Implantation for Uveitic Glaucoma
Fluorescein angiography at the postoperative week revealing blockage hypofluorescence in the areas of intraretinal hemorrhages and disc hyperfluorescence but no delay in venous filling.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121563&req=5

Figure 2: Fluorescein angiography at the postoperative week revealing blockage hypofluorescence in the areas of intraretinal hemorrhages and disc hyperfluorescence but no delay in venous filling.
Mentions: In the following week, IOP was poorly controlled in spite of maximum medical treatment and IOP values remained consistently over 30 mm Hg. An Ahmed valve implantation was scheduled and performed sequentially in both eyes. On the first postoperative day, BCVA was 1.00 OD and 0.50 OS, and IOP was 0 and 3 mm Hg, respectively. Slit-lamp examination revealed a functional filtering bleb, a formed anterior chamber and a free tube opening. Pupillary response was somewhat delayed and a slight afferent pupillary defect was present. Fundus examination showed blurred, hyperemic optic disc with peripapillary hemorrhages and scattered white-centered retinal hemorrhages in the periphery and posterior pole in both eyes accompanied with macular folds in the OS (Fig 1). Early postoperative treatment with prednisolone acetate 1% q.i.d. and atropine 1% t.i.d. was initiated. At the postoperative week, a new fluorescein angiography revealed blockage hypofluorescence in the areas of intraretinal hemorrhages and disc hyperfluorescence but no delay in venous filling (Fig 2), leading to the diagnosis of decompression retinopathy in both eyes (OU) and hypotonic maculopathy of the OS. One week postoperatively, his IOP was 10 mm Hg in OU, BCVA was 0.70 OD and 0.40 OS, and the retinal hemorrhages began to resolve. One month after surgery, the retinal hemorrhages showed gradual reduction in size. (Fig 3). At the third month of follow-up, BCVA improved to 0.40 OD and 0.30 OS, and IOP was 16 mm Hg in OU. Fundal hemorrhages had faded and hypotonic maculopathy had resolved.

View Article: PubMed Central - PubMed

ABSTRACT

Case report: We report the case of a 29-year-old man who underwent Ahmed valve implantation in both eyes as treatment for uveitic glaucoma, subsequently presenting with bilateral ocular decompression retinopathy in the postoperative period.

Discussion: Ocular decompression retinopathy is a rare complication of filtering surgery in patients with glaucoma; however, the course is benign in most cases, with spontaneous resolution of bleedings and improvement of visual acuity.

No MeSH data available.


Related in: MedlinePlus