Abstract
IntroductionWe report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement. This represents a rare case in which a patient with no light perception vision was able to regain functional vision.Case presentationA 63-year-old Caucasian man with a 55-year history of long-standing retinal detachment after trauma presented to our facility with pain and redness, a total hyphema, no light perception vision and an intraocular pressure of 60 mmHg (right eye). He had a history of diabetes mellitus and coronary artery disease. Following anterior chamber washout, he was found to have neovascular glaucoma, for which intravitreal bevacizumab was administered. After washout and intraocular pressure control, his visual acuity improved to light perception. He subsequently underwent vitrectomy, membrane peeling, endolaser and silicone oil placement to reattach his retina, and then a second retinal reattachment procedure. Following these procedures, he had visual recovery to counting fingers vision in his right eye at five metres, complete regression of neovascularization, and intraocular pressure of 10 to 12 mmHg on one antiglaucoma medication.ConclusionFunctional vision can be regained despite long-standing retinal detachment.
Highlights
We report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement
Functional vision can be regained despite long-standing retinal detachment
We report the case of a patient with total hyphema, neovascular glaucoma (NVG), long-standing retinal detachment and no light perception (NLP) vision, who regained counting fingers (CF) vision with complete regression of the neovascularization following anterior chamber (AC) washout, intravitreal bevacizumab, and two retinal reattachment surgeries
Summary
Long-standing retinal detachments (over one year) with poor visual acuity are typically associated with cystic degeneration of the macula and retina, loss of pigment from the underlying retinal pigment epithelium, proliferative vitreoretinopathy, and poor visual outcome after retinal reattachment surgery [1]. At two months after AC washout and three months after presentation, pars plana vitrectomy, membrane peel, retinotomy with aspiration of subretinal blood, endolaser retinopexy, inferior iridotomy, air/fluid exchange and retinal reattachment with silicone oil were performed Following surgery, his vision improved to counting fingers vision in the right eye at five metres, with IOP of 12 to 17 mmHg (right eye) on two antiglaucoma medications. One year after retinal reattachment, he was noted to have an inferior tractional retinal detachment in the right eye with areas of subretinal fibrosis He subsequently had a second membrane peeling, removal of subretinal membranes, drainage of subretinal fluid, controlled retinectomy, and endolaser retinopexy. Our patient is currently being monitored with visual acuity of CF at five metres in the right eye and IOP 19 mmHg on timolol 0.25% once daily at last follow-up
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
