Hypertonie oculaire aiguë tardive compliquant une rétinopathie de la prématurité

Abstract

We report the case of an acute rise in intraocular pressure occurring decades after the treatment for prematurity (ROP). A 54-year-old preterm woman presented an acute rise in intraocular pressure in her right amblyopic eye. Prominent dilatation of iridal vessels was noted. Fundus was not visible at that time because of corneal edema. Ocular echography was normal. The fellow eye showed temporal attraction of temporal vessels suggestive of retinopathy of prematurity at the cicatricial stage. Neovascular glaucoma was postulated and pressure control was obtained after cyclodestruction and transscleral cryoapplication. After resolution of corneal edema, fundus examination revealed extensive peripheral retinal photocoagulation scars. Iridocorneal angle presented extensive iridocorneal synechias without true new vessels. Visual acuity remained limited to hand motion. Prominent iris dilatation seen in some preterm patients can mimic rubeosis, and, in the present case, mislead to a diagnosis of neovascular glaucoma. Diagnosis can be difficult if the patient is not specifically asked for a history of prematurity. The case underlines the notion that ROP patients may present very late complications of the disease.