[Reversal of optic disc cupping in juvenile glaucoma after filtering surgery]

To report and present imaging of a case of reversal of optic disc cupping following filtering surgery in juvenile glaucoma.

A 22-year-old woman visited our emergency department complaining of blurred vision in her right eye for two weeks associated with bilateral ocular pain. Her medical history included bilateral juvenile glaucoma treated since 2018, occurring in the context of a significant family history of glaucoma. On initial examination, intraocular pressure was 43mmHg in both eyes. Fundus examination showed bilateral optic disc cupping. Humphrey perimetry revealed advanced glaucomatous scotomas surrounding fixation. Filtering surgeries were performed: a deep non-perforating sclerectomy for the right eye followed by a trabeculectomy for the left. Transient hypotony retinopathy occurred in both eyes. Intraocular pressure reduction was followed by a reversal of the optic disc cupping. This morphologic recovery was not associated with improvement in other structural parameters such as retinal nerve fiber layer or ganglion cell complex thickness or perimetric functional indices.

This is a rare case of reversal of optic disc cupping in an adult. This case highlights the dynamic sclerolaminar movements involved in the pathogenesis of glaucoma and raises the question of the consequences of these kinetics.