Treatment Of Ocular Hypotony Research Articles

Severe Hypotony Maculopathy in Anterior Uveitis Associated with Hodgkin Lymphoma

ABSTRACT Purpose: To describe the clinical course and management of anterior uveitis complicated by ocular hypotony associated with Hodgkin lymphoma. Design: Case report. Methods: Chart and multimodal imaging review, including ultrasound biomicroscopy, widefield fundus pictures, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography. Results: A 44-year-old female with progressive visual deterioration and history of low-grade fever developed bilateral granulomatous anterior uveitis complicated by severe hypotony maculopathy, not improving with systemic and topical steroids. After starting ibopamine 2% eye drops, ocular hypotony progressively resolved with visual recovery. Histologic examination of a biopsied enlarged lymph node of the neck revealed the presence of Hodgkin lymphoma, for which the patient underwent systemic chemotherapy. Conclusion: Severe hypotony maculopathy complicating anterior uveitis can be associated with Hodgkin lymphoma. Topical ipobamine 2% was safe and effective in the treatment of ocular hypotony in this case.

Ibopamine Stimulates α-Adrenergic Receptors and D1 Dopaminergic Receptors in the Eye

Ibopamine stimulates α-adrenergic receptors and D1-dopaminergic receptors in the eye. Ibopamine is a dopamine analogue and it is hydrolysed to epinine by the esterases in the aqueous humor. Adrenergic stimulation determines the non-cycloplegic mydriatic effect, while the D1-dopaminergic activity is responsible for an increase in aqueous humor production. Ibopamine is effective as a mydriatic before and after surgical procedures. Its main uses are: provocative test in glaucoma; treatment of ocular hypotony; evaluation of the outflow pathways of the aqueous humor. Ibopamine test is positive in 92% of patients affected by primary open-angle glaucoma (POAG), while it is negative in healthy eyes. It is useful in relatives of glaucomatous patients.

The use of autologous fibrinogen concentrate in treating ocular hypotony after glaucoma filtration surgery.

Antimetabolite therapy with 5-fluouracil (5-FU) or mitomycin-C (MMC) has significantly improved the success rate of glaucoma filtration surgery. However, in some eyes, when filtration is excessive, persistent hypotony may develop. In this study, we describe the experience of using autologous fibrinogen concentrate (AFC) to treat patients with persistent hypotony after glaucoma filtration surgery. Among seven MMC-augmented trabeculectomy patients who developed persistent postoperative hypotony, the effects of AFC intrableb injections were evaluated. Under a microscope, 0.2 ml AFC and bovine thrombin were injected into the blebs of the patients from both sides of the filtering blebs. Postoperative best-corrected visual acuity, anterior chamber status, intraocular pressure (IOP) and fundus examination were followed and compared with those preoperative. On the second day, the mean IOP of seven eyes elevated from preoperative 3.4 +/- 2.1 mmHg to 12.6 +/- 4.2 mmHg, and the anterior chamber became deep without obvious inflammatory response. Within two weeks, macular edema and visual acuity were noted to improve in six eyes (85.7%). In addition, after a mean follow-up of 25 months, the trabeculectomy procedure remained successful in all eyes. AFC appears to be safe and effective in the treatment of ocular hypotony after glaucoma filtration surgery.