Ocular Decompression Retinopathy Research Articles

Ocular decompression retinopathy after phacoemulsification in a patient with primary acute angle-closure glaucoma undergoing chemotherapy.

Ocular decompression retinopathy after phacoemulsification in a patient with primary acute angle-closure glaucoma undergoing chemotherapy.

Ocular decompression retinopathy with branch retinal venous occlusion MTHFR genetic mutation.

We report an atypical case of a sectorial decompression retinopathy with branch retinal venous occlusion (BRVO) following trabeculectomy, diagnosed with optical coherence tomography angiography (OCTA) for which systemic genetic assessment revealed a MTHF-R mutation. Single case report. A 68 year-old woman diagnosed with an uncontrolled bilateral creeping angle glaucoma, went through an uncomplicated trabeculectomy in both eyes. Best corrected visual acuity (BCVA) was 20/20. Intraocular pressure (IOP) changed from 28 mmHg preoperatively to 5 mmHG postoperatively in the right eye (OD). On the first post-operative day, BCVA was 20/32 with IOP measured to 5 mmHg. Fundus exam revealed sectorial temporal hemorrhages with tortuous temporal superior retinal vein arcade, and choroidal folds. Fluorescein angiography evidenced a slight delay in venous filling along the supra-temporal arcade. Three months later, optical coherence tomography (OCTA) showed macular capillary loops in the supero-temporal area of the retina. This sectorial decompression retinopathy was evocative of a BRVO. At 6 months, BCVA returned to 20/20, with full regression of the hemorrhages. Systemic work-up was normal, but genetic assessment revealed a MTHF-R mutation. Retinal vein occlusion can be considered as a feature of ocular decompression retinopathy (ODR). The present case is the first case to associate BRVO secondary to ODR to a MTHF-R mutation.

Multimodal Imaging Techniques in Monitoring a Patient with Ocular Decompression Retinopathy

Ocular decompression retinopathy (ODR) is characterized by multiple retinal hemorrhages. It is a rare complication associated with rapid decrease of intraocular pressure (IOP). The course of ODR is usually asymptomatic and self-limiting, which was confirmed by the observation of our patient. In this study, we present a 5-month follow up of a 77-year-old woman with acute right eye (RE) filtration angle closure who developed symptoms of ODR. Clinical examination and multimodal imaging modalities, including color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA) and fluorescein angiography (FA), were used to confirm the diagnosis and performed regularly in monitoring the course of the disease. Fundus lesions in the RE included diffuse intraretinal hemorrhages in the posterior pole, which gradually resolved during follow-up time. The fundus of the left eye (LE) was normal. The patient underwent conservative therapy, laser therapy and surgery, achieving stabilization of the IOP and improvement of the local condition in the RE. Of the various multimodal imaging techniques, color fundus photography and OCT seemed to be the most specific and helpful in monitoring the patient with ODR.

Bilateral ocular decompression retinopathy after trabeculectomy in steroid-induced glaucoma

Bilateral ocular decompression retinopathy after trabeculectomy in steroid-induced glaucoma

Posterior segment complications of Ahmed valve implantation

BackgroundTo assess the time, incidence, and outcome of posterior segment complications of Ahmed valve implantation (AVI).Methods248 eyes that underwent AVI were reviewed retrospectively. Visual acuity, preoperative characteristics, and postoperative posterior segment complications were assessed.ResultsThe incidence of posterior segment complications of AVI was 31.4% (78/248). The mean follow-up period was 97.4 ± 53.5 months. The mean time to occur posterior segment complication was 1.5 months. The most common posterior segment complication was choroidal detachment (17.7%) and others included ocular decompression retinopathy (3.2%), hypotonic maculopathy (2.8%), vitreous hemorrhage (2.0%), retinal detachment (1.2%), endophthalmitis (1.2%), suprachoroidal hemorrhage (1.2%), epiretinal membrane (0.8%), cystoid macular edema (0.8%), and proliferative vitreoretinopathy (0.4%). Older age, hypertension, and postoperative hypotony had an increased risk of posterior segment complications of AVI.ConclusionsThe overall incidence of posterior segment complications of AVI was 31.4%. Older age, hypertension, and postoperative hypotony were significantly associated with posterior segment complications of AVI.

Weather as a possible risk factor for massive ocular decompression retinopathy: A case report.

Numerous studies described a link between weather phenomena and an increased incidence of cardiovascular and cerebrovascular events. We report a case of ocular decompression retinopathy with massive premacular haemorrhage secondary to acute intraocular pressure reduction in a patient with acute primary angle closure. At the time of admission, a change in weather conditions occurred with high temperatures and a strong Foehn wind known locally as halny. A healthy 56-year-old man with acute primary angle closure who developed severe ocular decompression retinopathy with large prefoveal subhyaloid haemorrhage after pharmacological treatment was admitted to the hospital. The patient was elected for surgery and underwent vitrectomy with improvement of visual acuity to the baseline vision. This report suggests that, in addition to an abrupt reduction in intraocular pressure as a causative factor, massive ocular decompression retinopathy may be significantly influenced also by environmental factors such as halny.

眼减压性视网膜病变临床研究进展

眼减压性视网膜病变临床研究进展

Ocular decompression retinopathy after laser iridotomy in a patient with acute angle closure

A 65-year-old female developed elevated intraocular pressure (IOP) with angle closure in the right eye. The fundus examination revealed vitreo-retinal hemorrhage that had occurred after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser iridotomy. The retinal hemorrhage resolved spontaneously. This is a rare complication that occurs when the IOP is lowered rapidly. Ocular decompression retinopathy (ODR) was identified. We reviewed several cases of ODR that were treated by various interventions. We also discuss the possible pathogenesis, prognosis, and treatment strategy.

Long-term outcomes and complications of trabeculectomy for secondary glaucoma in patients with familial amyloidotic polyneuropathy.

ObjectiveSecondary glaucoma is a serious complication in patients with transthyretin (TTR)-related familial amyloidotic polyneuropathy (FAP). We assessed the long-term outcomes and complications of trabeculectomy with mitomycin C (MMC) for secondary glaucoma associated with FAP.MethodsMedical case records of Kumamoto University Hospital were retrospectively reviewed. Twenty-one eyes of 13 patients (10 with FAP ATTR Val30Met; 3 with FAP ATTR Tyr114Cys) underwent trabeculectomy with MMC and follow-up of at least 2 years. The primary outcome measure was Kaplan-Meier survival, with failure of this treatment being defined as an intraocular pressure (IOP) of ≤5 mm Hg or ≥22 mm Hg on two consecutive visits or as additional operations needed to reduce IOP. Secondary outcome measures included complications, bleb characteristics, and additional postoperative interventions required.ResultsThe mean postoperative follow-up period was 5.7 years (range, 2.2–12.7 years). Kaplan-Meier analysis indicated probabilities of success of 0.76, 0.67, and 0.53 at 1, 2, and 3 years after operation, respectively. Significant complications included ocular decompression retinopathy in 7 eyes (33%) and bleb encapsulation in 10 eyes (48%). Twelve eyes (57%) needed additional surgery, such as bleb revision or trabeculectomy with MMC, to reduce IOP.ConclusionsTrabeculectomy with MMC may not be optimal for patients with FAP-related glaucoma and may have several significant complications.

Ocular decompression retinopathy after bleb needling in a patient with extremely high intraocular pressure.

To report a case of ocular decompression retinopathy after bleb needling in a patient with extremely high intraocular pressure. Case report of a 55-year-old man who had undergone trabeculectomy for neovascular glaucoma and bleb needling to lower intraocular pressure. During the procedure, the anterior chamber collapsed suddenly as a result of overdrainage, and the intraocular pressure decreased rapidly from 60 mmHg to 2 mmHg. Funduscopy performed the next day showed multiple intraretinal hemorrhages in all quadrants. Fluorescein angiography showed no evidence of occluded retinal vessels. He had no history of any bleeding disorder. Decompression retinopathy was diagnosed. Decompression retinopathy can occur after bleb needling, which is often required after trabeculectomy to restore bleb function.

Ocular decompression retinopathy following post-trabeculectomy suture lysis and management with triamcinolone acetonide

Ocular decompression retinopathy (ODR) is a rare complication of sudden lowering of intraocular pressure (IOP) in glaucoma and ocular hypertension. An 80-year-male, a known case of chronic open-angle glaucoma for 13years, had his IOP controlled by multiple topical antiglaucoma medications. There was an increase in IOP, progression of optic disc cupping and visual field loss along with cataract over the past 6months. The patient underwent uneventful phacoemulsification with posterior chamber intraocular lens (PCIOL) and penetrating trabeculectomy. Postoperatively, the trabeculectomy bleb was flat and IOP was 44mmHg and was not controlled by bleb massage. Bleb needling and suture lysis were performed after 2weeks. The IOP dropped from 44 to 6mmHg. Three days later the patient presented with a sudden decline in visual acuity (VA) from 0.5 to 1.225 logMAR. The fundus showed multiple retinal haemorrhages resembling ODR. Choroidal detachment also occurred after 3weeks. Optical coherence tomography confirmed the presence of macular oedema which was treated with an orbital floor triamcinolone acetonide injection (OFTA). The haemorrhages, choroidal detachment and macular oedema resolved and VA improved in 6months. This is the first case report of ODR following suture lysis and needling after an uneventful combined phacoemulsification with PCIOL implant and trabeculectomy. It also highlights the role of OFTA injections in the management of ODR.

Ocular Decompression Retinopathy after Deep Sclerectomy with Mitomycin C in an Eye with Exfoliation Glaucoma

To present a case of ocular decompression retinopathy occurring after an uncomplicated nonpenetrating glaucoma procedure (deep sclerectomy with mitomycin C). A 52-year-old man with medically uncontrolled exfoliation glaucoma in the left eye underwent uneventful deep sclerectomy with mitomycin C. The patient had no history or laboratory evidence of any bleeding disorder. On the first postoperative day, visual acuity fell from the preoperative level of Snellen 0.2 to hand movement and the intraocular pressure was 5 mmHg. Funduscopy revealed a small intravitreal hemorrhage and multiple, extended retinal hemorrhages in all quadrants of the fundus. After standard postoperative medication with antibiotic/steroid eyedrops, the patient's visual acuity returned to preoperative levels and the retinal hemorrhages were absorbed. Three and a half months postoperatively, the fundus was free of bleedings. Although decompression retinopathy has previously been described after penetrating glaucoma surgery, the condition can also occur after uncomplicated deep sclerectomy. Despite the dramatic presentation, the prognosis remains favorable.

Ocular decompression retinopathy after trabeculectomy with mitomycin-C for angle recession glaucoma

A 45-year-old male presented with intractable glaucoma following 360-degree angle recession after blunt trauma. He underwent an uncomplicated trabeculectomy with mitomycin-C (MMC). Adequate precautions were taken to reduce the chances of sudden lowering of intraocular pressure (IOP). He did not have any intraoperative shallowing of the anterior chamber or postoperative hypotony, but still developed ocular decompression retinopathy. On detailed review of the previously reported cases we discovered that besides a large IOP drop after surgery, either the preoperative rise of IOP in all these cases was over a relatively short period or the course of their glaucomatous process was likely to have exposed them to intermittent spikes of high IOP. To our knowledge this factor has not been previously postulated in the pathophysiology of ocular decompression retinopathy. We illustrate this with a rare case of ocular decompression retinopathy after trabeculectomy with MMC for post-traumatic angle recession glaucoma.

A Case of Decompression Retinopathy After Resolution of Acute Primary Angle-Closure Glaucoma

Purpose: To report a case of ocular decompression retinopathy after resolution of acute primary angle closure (APAC) subsequent to medical treatment and laser peripheral iridotomy (LPI). Case summary: A patient presented with APAC of the right eye with markedly elevated intraocular pressure (IOP) and a LPI was done after lowering the IOP with medical treatment. On presentation, visual acuity was 0.3 in the right eye (OD) and IOP was 74 mmHg OD. Two hours after medical treatment IOP was found to be 16 mmHg OD. Ten hours after resolution of the acute attack, the patient’s visual acuity was 0.2 OD and IOP was 11 mmHg OD. LPI was subsequently performed in the right eye. The post-LPI IOP was 10 mmHg and the patient complained of visual disturbance and floaters OD. Three days after LPI the IOP was normal but her visual acuity had decreased to counting fingers OD. In addition, scattered retinal hemorrhages including alarge pre-retinal hemorrhage on the macula were found upon dilated funduscopic examination. After three months the retinal hemorrhage had been absorbed and her visual acuity was 0.7 OD. Conclusions: Decompression retinopathy can develop in the posterior pole of the retina in patients with APAC after medical treatment and LPI.

Optical Coherence Tomography Findings in Ocular Decompression Retinopathy

Three days following trabeculectomy surgery, a 47-year-old woman experienced a decline in visual acuity to 20/400. Fundus findings were consistent with decompression retinopathy, and optical coherence tomography revealed macular thickening, cystoid macular edema, and neurosensory macular detachment. The foveal anatomy normalized following topical treatment, and visual acuity returned to 20/30 by 10 weeks postoperatively. Both macular detachment and cystoid macular edema may contribute to acute decline in visual acuity in decompression retinopathy. Optical coherence tomography facilitated the prompt detection of treatable pathology, which resolved following appropriate medical therapy.