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Unilateral optic disc edema following trabeculectomy

A Kawasaki1, V Purvin

  • 1Midwest Eye Institute, Clarian Hospitals of Indiana, Indianapolis, USA.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|June 11, 1998
PubMed
Summary

Two cases of optic disc edema occurred after successful trabeculectomy surgery. This benign condition may result from altered pressure dynamics at the lamina cribrosa.

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Area of Science:

  • Ophthalmology
  • Neurosurgery

Background:

  • Trabeculectomy is a common surgical procedure to reduce intraocular pressure (IOP) in glaucoma patients.
  • Optic disc edema, swelling of the optic nerve head, can have various causes, including elevated intracranial pressure (ICP) or hypotony.

Observation:

  • Two patients developed optic disc edema 2-4 weeks post-trabeculectomy.
  • This edema was benign, with no associated visual acuity or visual field loss.
  • Neither patient had hypotony or pseudotumor cerebri; however, both exhibited high-normal intracranial pressure.

Findings:

  • The optic disc edema was not caused by typical hypotony or elevated intracranial pressure.
  • A decrease in IOP post-trabeculectomy may have shifted the ICP:IOP ratio.
  • This altered pressure ratio at the lamina cribrosa is hypothesized to be the cause of the optic disc edema.

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Implications:

  • This suggests a novel mechanism for optic disc edema following glaucoma surgery.
  • Clinicians should consider the ICP:IOP ratio in the differential diagnosis of optic disc edema post-trabeculectomy.
  • Further research is needed to confirm this pressure-related etiology.