scholarly journals Ocular Decompression Retinopathy with Macular Edema after Deep Sclerectomy with Intrascleral Implantation

2020 ◽  
Vol 11 (1) ◽  
pp. 151-155
Author(s):  
Pablo Diaz Aljaro ◽  
Jordi Loscos Arenas ◽  
Laura Broc Iturralde ◽  
Marc Carbonell Puig ◽  
Pau Romera Romero
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Medical Therapy ◽  
Open Angle Glaucoma ◽  
Retinal Hemorrhage ◽  
Eye Drops ◽  
Medical Procedure ◽  
Deep Sclerectomy ◽  
Pars Plana ◽  
Decompression Retinopathy

We report a case of ocular decompression retinopathy (ODR) with macular edema, diagnosed by optical coherence tomography, after a deep sclerectomy (DS) with an intrascleral implant, resolved with medical therapy 6 months later. The medical literature reports that in 14% of patients suffering from ODR, a pars plana vitrectomy was required, and 15% of patients had a poor final visual acuity. An otherwise healthy 75-year-old man with high myopia and a primary open-angle glaucoma, with previous intraocular pressure (IOP) of 24 mm Hg, underwent a DS with intrascleral implant without complications. The patient suffered postoperatively from ODR with macular edema that required medical therapy with nonsteroidal anti-inflammatory eye drops (Nepafenac® 0.3%) for a period of 6 months. ODR is an infrequent complication that may occur after any surgical or medical procedure that causes a sudden IOP decrease. The presence of macular edema is only reported in 5% of cases and can occur in patients who report a decreased visual acuity, commonly associated with a retinal hemorrhage. We have described a case of ODR with macular edema after DS with intrascleral implant. Although ODR is considered to cause a low level of morbidity, in some patients this may not be the case.

Cystoid Macular Edema Associated with Latanoprost Therapy in a Pseudophakic Vitrectomized Patient after Removal of Silicone Oil Endotamponade

2003 ◽  
Vol 13 (2) ◽  
pp. 221-222 ◽  
Author(s):  
M. Jäger ◽  
J.B. Jonas
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Silicone Oil ◽  
Open Angle Glaucoma ◽  
Vitreous Body ◽  
Corticosteroid Treatment ◽  
Posterior Chamber ◽  
Eye Drops

Purpose To describe the occurrence of cystoid macular edema in a pseudophakic vitrectomized patient following use of latanoprost (0.005%). Methods A 58-year-old patient underwent routine cataract surgery with posterior chamber lens implantation complicated by rhegmatogenous retinal detachment three months later. A pars plana vitrectomy was performed with silicone oil endotamponade which was removed six months later. Five months after oil removal, the patient presented with secondary open-angle glaucoma treated with latanoprost 0.005% eye drops once daily. Results Two weeks after initiation of latanoprost treatment, visual acuity dropped from 0.8 to 0.3 due to cystoid macular edema confirmed by fluorescein angiography. After discontinuing latanoprost therapy and with topical corticosteroid treatment, cystoid macular edema slowly resolved, and within 6 months, visual acuity improved to 0.8. Conclusions Despite its marked ocular hypotensive effect, latanoprost should be carefully used in patients after uncomplicated cataract surgery if the vitreous body was removed by pars piana vitrectomy.

scholarly journals Treatment of cystoid macular edema in a patient with primary open angle glaucoma and diabetic retinopathy by withdrawal of travoprost

2021 ◽  
Vol 7 (2) ◽  
pp. 180-183
Author(s):  
Shiv Sagar N ◽  
BN Kalpana ◽  
Shilpa YD
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Cystoid Macular Edema ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Antiglaucoma Medication ◽  
Micropulse Laser

To study the association of cystoid macular edema (CME) and Travoprost eye drops in a patient with diabetic retinopathy (DR).The study was carried out on a 65yr old patient on a regular follow up from 2009-2018.A 65yr old patient of a DR of both eyes who had received 3 sittings of pan retinal photocoagulation (PRP) laser in both eyes and grid laser to his right eye. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Patient was also on topical antiglaucoma medication and had prophylactic YAG-PI done both eyes. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Right eye showed macular edema (ME) in 2014 and underwent OCT and FFA. Patient refused for intravitreal injection and preferred laser treatment, so patient underwent micropulse laser treatment in 2014. His edema persisted even after micropulse treatment. His systemic control was good and patient continued to use Travoprost eye drops. So in 2017 suspected CME secondary to topical prostaglandin (PG) analogue as he had strict glycemic control and was no fluctuation in ME. Hence topical PG analogue was withdrawn and stopped. On subsequent follow up after 2 months CME had completely disappeared and the foveal contour returned to normal on OCT. LE was status quo. Patient was followed up for more than 1 year and continuously followed up, 15 days back in June 2018 had no evidence of CME and vision was 6/9 in both eyes.: Differentiation of DME and CME secondary to PG analogue should be made at the earliest.

scholarly journals Decompression Retinopathy Following Trabeculectomy: A Case Report

2020 ◽  
Vol 12 (2) ◽  
pp. 323-327
Author(s):  
Ekta Rishi ◽  
Gitanjli Sood ◽  
Mona Khurana ◽  
Pukhraj Rishi
Keyword(s):  
Macular Edema ◽  
Open Angle Glaucoma ◽  
Vitreous Hemorrhage ◽  
Venous Stasis ◽  
Topical Steroids ◽  
Choroidal Detachment ◽  
Vein Occlusion ◽  
Venous Stasis Retinopathy ◽  
The Right ◽  
Decompression Retinopathy

Introduction: Decompression retinopathy (DR) can have varied manifestations as retinal and vitreous hemorrhage, disc edema, and macular edema. Vein occlusion associated with choroidal detachment (CD) has not been reported so far as a feature of DR. Case: We report a case of a 78 year old male with bilateral primary open angle glaucoma (POAG) on maximal topical medication with progressive field loss. Trabeculectomy with mitomycin C was done in the left eye, and the patient developed hypotony in the immediate postoperative period which was managed conservatively. After six weeks he developed CD, vein occlusion and macular edema. Thus, Anti VEGF was given and in other eye filtration surgery was done with all measures to avoid sudden hypotony. Patient still developed CD in the right eye. For which, he was given oral and topical steroids in tapering dose. After one month there was resolution of macular edema in the left eye and choroidal detachment resolved in both eyes and IOP was in lower teens in both eyes. Conclusion: Venous stasis retinopathy and choroidal detachment can be the manifestations of decompression retinopathy following glaucoma filtering surgery. The advancement in imaging modalities now can help us find the pathogenesis of the condition and validation of previous hypothesis proposed. Early identification and management of retinopathy helps in resolution with good visual recovery.

scholarly journals Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Nontractional Diabetic Macular Edema

2017 ◽  
Vol 11 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Jan Niklas Ulrich
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Central Macular Thickness ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Pars Plana

Background: Diabetes mellitus remains the leading cause of blindness among working age Americans with diabetic macular edema being the most common cause for moderate and severe vision loss. Objective: To investigate the anatomical and visual benefits of pars plana vitrectomy with inner limiting membrane peeling in patients with nontractional diabetic macular edema as well as correlation of integrity of outer retinal layers on spectral domain optical coherence tomography to visual outcomes. Methods: We retrospectively reviewed the charts of 42 diabetic patients that underwent vitrectomy with internal limiting membrane peeling for nontractional diabetic macula edema. The integrity of outer retinal layers was evaluated and preoperative central macular thickness and visual acuity were compared with data at 1 month, 3 months and 6 months postoperatively. The student t-test was used to compare the groups. Results: 31 eyes were included. While no differences were seen at 1 and 3 months, there was significant improvement of both central macular thickness and visual acuity at the 6 months follow up visit compared to preoperatively (357, 427 microns; p=0.03. 20/49, 20/82; p=0.03) . Patients with intact external limiting membrane and ellipsoid zone had better preoperative vision than patients with outer retinal layer irregularities (20/54, 20/100; p=0.03) and greater visual gains postoperatively (20/33, p<0.001 versus 20/81; p=non-significant). Conclusion: Pars plana vitrectomy with internal limiting membrane peeling can improve retinal anatomy and visual acuity in patients with nontractional diabetic macular edema. Spectral domain optical coherence tomography may help identify patients with potential for visual improvement.

Non-Glaucomatous Causes of Decreased Vision in Glaucoma

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Uzma Fasih ◽  
Erum Shahid ◽  
Arshad Shaikh
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Optic Atrophy ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Age Related Macular Degeneration ◽  
Congenital Glaucoma ◽  
Angle Closure ◽  
Care Hospital ◽  
Age Related

Purpose:  To determine the non-glaucomatous causes of decreased visual acuity in glaucoma patients presenting in the eye OPD of a tertiary care hospital. Study Design:  Descriptive cross-sectional study. Place and Duration of Study:  Abbasi Shaheed Hospital from July 2019 to September 2020. Methods:  Patients above 18 years of age, visual acuity of less than 6/6 and diagnosed case of glaucoma were included in this study. Patients with congenital glaucoma and patients not willing to participate in the study were excluded. Detailed history was taken and ocular examination of the patient was done. Causes of decreased visual acuity were determined. Data was collected and analyzed on SPSS version 20. Results:  There were 369 glaucoma patients with a mean age of 58.2 ± 11.54 SD years. Males were 224 (60.4%), with mean duration of glaucoma as 5.4 ± 5.2 years. Primary open-angle glaucoma was seen in 209 (56.6%) and primary angle-closure glaucoma was in 96 (26%) of patients. Treatable causes were 119 (32.2%) and non-glaucomatous causes of decrease vision were 221 (59.9%). Glaucomatous optic atrophy was seen in 182 (49.3%) patients followed by cataract in 96 (26%). Patients with corneal pathologies were 38 (10.2%) and ARMD were 26 (7%). Conclusion:  The commonest cause of decreased visual acuity in glaucoma patients is irreversible glaucomatous optic atrophy. Age-related macular degeneration, corneal pathologies, and amblyopia also contribute to irreversibly decreased visual acuity in glaucoma patients. Reversible causes include cataract, refractive errors, cystoid macular edema and diabetic macular edema. Key Words:  Cataract, Glaucoma, Glaucomatous Optic Atrophy, Vision.

scholarly journals Relationship between electronically measured medication adherence and vision-related quality of life in a cohort of patients with open-angle glaucoma

2018 ◽  
Vol 3 (1) ◽  
pp. e000114 ◽  
Author(s):  
Atalie C Thompson ◽  
Sandra Woolson ◽  
Maren K Olsen ◽  
Susanne Danus ◽  
Hayden B Bosworth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Medication Adherence ◽  
Open Angle Glaucoma ◽  
Mean Difference ◽  
Eye Drops ◽  
Open Angle ◽  
Related Quality ◽  
Adjusted Model

ObjectiveTo investigate whether electronically measured medication adherence is associated with vision-related quality of life (VRQoL) in patients with open-angle glaucoma.Methods and analysisThis is a 3-year prospective cohort study of 79 subjects with open-angle glaucoma at a Veterans Affairs medical centre. Participants returned a medication event monitoring system (MEMS) for their glaucoma eye-drops and had at least two visits with glaucoma during the study period. Those taking less than 80% of prescribed glaucoma medication doses were considered to be non-adherent. Subjects were interviewed using the National Eye Institute’s Visual Function Questionnaire-25 (VFQ-25) at baseline and after 3 years.ResultsThirty per cent (n=24/79) of participants took less than 80% of prescribed doses of their glaucoma medications at baseline. Patients who did not adhere to their medications at baseline had lower mean composite VFQ-25 scores at baseline (70.66±20.50 vs 75.91±19.12, standardised mean difference=0.27) and after 3 years (71.68±21.93 vs 76.25±21.67, standardised mean difference=0.21). Visual acuity (P=0.03), but not visual field severity (P=0.13) or medication adherence (P=0.30), was significantly associated with composite VFQ-25 score in an adjusted model.ConclusionsSubjects who were non-adherent to their glaucoma medications at baseline as assessed by a MEMS device reported lower VRQoL than adherent subjects at baseline and after 3 years. However, visual acuity was significantly associated with VRQoL. Future studies should assess whether improved adherence to eye-drops impacts VRQoL in patients with glaucoma.

scholarly journals A Case of Cyclodialysis after Microhook Trabeculotomy Treated with Vitreous Surgery

2021 ◽  
pp. 83-91
Author(s):  
Takashi Kudo ◽  
Yukihiko Suzuki ◽  
Kodai Yamauchi ◽  
Toshio Tando ◽  
Kobu Adachi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Ciliary Body ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Vitreous Surgery ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
Pars Plana ◽  
Shallow Anterior Chamber

We report a case of cyclodialysis with decreased visual acuity after microhook trabeculotomy (mTLO) successfully treated by vitreous surgery. A 41-year-old man had been medically treated for primary open-angle glaucoma in both eyes. He was scheduled to undergo mTLO due to progression of visual field impairment and unstable intraocular pressure in his right eye. His preoperative best-corrected visual acuity (BCVA) was 0.4 OD, and the intraocular pressure was unstable, ranging from 12 to 27 mm Hg. On the day after the operation, a shallow anterior chamber developed, and a low intraocular pressure occurred. His visual acuity continued to decrease, and cyclodialysis was confirmed by ultrasonic biomicroscopy. No improvement was obtained with medical treatment, and his BCVA dropped to 0.08 OD, while his intraocular pressure remained at 2–3 mm Hg. Three months later, a second surgery was performed by combining cataract surgery with intraocular lens implantation, vitrectomy, cryopexy for the pars plana of the ciliary body, and 20% SF6 gas tamponade. Two weeks after the reoperation, the intraocular pressure had been normalized to 12 mm Hg, and the BCVA had returned to 0.3. We successfully treated cyclodialysis as a complication after mTLO by vitreous surgery that led to the recovery of the visual acuity and intraocular pressure.

scholarly journals Visual And Anatomical Outcomes of Pars Plana Vitrectomy in Refractory Diabetic Macular Edema

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Hussain Ahmad Khaqan ◽  
Usman Imtiaz ◽  
Husnain Muhammad Bukhsh ◽  
Hafiz Ateeq ur Rehman ◽  
Raheela Naz ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Pars Plana Vitrectomy ◽  
Visual Assessment ◽  
Macular Thickness ◽  
Ilm Peeling ◽  
Refractory Diabetic Macular Edema ◽  
Pars Plana ◽  
Anatomical Outcomes

Purpose:  To find the visual and anatomical outcomes of pars plana vitrectomy in cases of refractory diabetic macular edema. Study Design:  Quasi Experimental study. Place and Duration of Study:  Department of Ophthalmology, Lahore General Hospital from January 2013 to April 2019. Material and Methods:  Seventy-six patients between the age of 18 and 60 years of both genders having refractory diabetic macular edema with macular thickness of 400 micrometers or more on OCT were enrolled. Informed consent was taken. Detailed preoperative workup including visual assessment, examination on slit lamp using 90D or 78D lens for assessment of macular edema and OCT was done. Patients underwent pars plana vitrectomy, ERM, and ILM peeling. Visual assessment and macular thickness was recorded 4 weeks after surgery. Results:  This study included 76 patients with the mean age of 48.15 ± 8.16 years. Patients were further categorized according to age into 2 groups. The gender distribution of patients showed that most of the participants were female in this study.  Mean duration of Diabetes Mellitus was 9.95 ± 6.29 years. Most of the patients did not have previous history of laser and only three patients (3.9%) did not receive Intravitreal Anti-VEGF. Mean preoperative visual acuity was 0.44 ± 0.13 while postoperative visual acuity was 0.876 ± 0.18 (P = 0.000). Similarly, significant decrease in macular thickness was observed after the procedure (P = 0.000). Conclusion:  Pars plana vitrectomy, ERM and ILM peeling can be an effective treatment option for refractory diabetic macular edema.

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