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Decompression retinochoroidopathy: a unique presentation post-trabeculectomy.

Gaurav Mathur1, Narottama Sindhu2, Deependra Vikram Singh3

  • 1Eye Q Hospitals, 36 Vaishali, Pitampura, New Delhi, 110034, India. gaurav36vaishali@gmail.com.

International Ophthalmology
|March 12, 2018
PubMed
Summary
This summary is machine-generated.

Sudden lowering of intraocular pressure after glaucoma surgery can cause decompression retinopathy and choroidopathy, especially in older hypertensive women. This case highlights the risk of vision loss from hemodynamic changes in retinal vasculature.

Keywords:
Ocular decompression retinopathyTrabeculectomy

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Area of Science:

  • Ophthalmology
  • Retinal Vascular Diseases
  • Glaucoma Surgery

Background:

  • Decompression retinopathy is a rare complication following intraocular pressure reduction.
  • Primary open-angle glaucoma management often involves surgical interventions to lower intraocular pressure.
  • Hypertension is a significant comorbidity that can affect ocular vasculature.

Observation:

  • A 65-year-old hypertensive female with a history of primary open-angle glaucoma presented with vision loss in the right eye one week after trabeculectomy.
  • Postoperatively, the patient experienced a significant drop in intraocular pressure (IOP) in the right eye (6 mmHg on day 1), followed by an IOP spike (35 mmHg) due to a nonfunctional bleb.
  • Fundus examination revealed extensive intraretinal, subretinal, and preretinal hemorrhages in the right eye.

Findings:

  • The patient presented with vision impairment (6/36, N36 in the right eye) and significant intraocular hemorrhages.
  • Elevated intraocular pressure in the right eye (35 mmHg) was noted despite recent surgery aimed at lowering it.
  • The left eye showed signs of glaucomatous optic atrophy.

Implications:

  • This case underscores the potential for decompression retinopathy and choroidopathy following rapid intraocular pressure fluctuations after glaucoma surgery.
  • Older hypertensive patients may be more susceptible to hemodynamic changes in the retinal and choroidal vasculature.
  • Careful monitoring of intraocular pressure and prompt management of IOP spikes are crucial after glaucoma surgery to prevent vision-threatening complications.