Venous stasis retinopathy in a ten-year-old boy with ocular hypertension: a case report

Abstract Background Central retinal vein occlusion is a variable disease pattern. Preliminary stages of a complete occlusion of the central vein, wich are subsumed under the term venous stasis retinopathy, may occur as transient blurred vision and with subtle alterations of the fundus. Course and prognosis are benign, visual acuity usually recovers. By now, venous stasis retinopathy in children due to Valsalva maneuver has not been described in literature yet. Case presentation We present an impressive case of venous stasis retinopathy in a 10-year-old boy with ocular hypertension and megalocornea due to increased intraocular pressure provoked by Valsalva maneuver. Main symptom was transient blurred vision in the left eye. The intraocular pressure was 28 mmHg, fundus exam revealed tortuous veins and a flame shaped hemorrhage at 7 o’clock. Total recovery under topical antiglaucomatous therapy could be observed after 1 month. Conclusions Acute increase in intraocular pressure, provoked by Valsalva maneuver is a risk factor for venous stasis retinopathy. Further general and vascular risk factors should be ruled out by extensive examination. Children with ocular hypertension might be at higher risk for impending vein occlusion as shown in this case.

Download Full-text

Decompression Retinopathy Following Trabeculectomy: A Case Report

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v12i2.29247 ◽

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.

Download Full-text

Adjunctive therapy with brinzolamide in patients on travoprost treatment

Medicinski pregled ◽

10.2298/mpns1106310b ◽

2011 ◽

Vol 64 (5-6) ◽

pp. 310-314

Author(s):

Nikola Babic ◽

Veljko Andreic ◽

Aleksandar Miljkovic ◽

Vladimir Canadanovic ◽

Sava Barisic

Keyword(s):

Intraocular Pressure ◽

Ocular Hypertension ◽

Adjunctive Therapy ◽

Open Angle Glaucoma ◽

Combined Therapy ◽

Previous Treatment ◽

Open Angle ◽

Open Label ◽

Blurred Vision ◽

Safety And Efficacy

Introduction. This study was aimed at evaluating the safety and efficacy of brinzolamide 1% suspension (Azopt? 1%) and travoprost 0.004% (Travatan?) combined therapy in patients with open-angle glaucoma or ocular hypertension who are in need of additional intraocular pressure lowering. Material and methods. This is a prospective, three-month, open-label, clinical study. Forty patients (80 eyes) with primary open-angle glaucoma or ocular hypertension on Travatan? treatment and with unsatis-factory results in lowering intraocular pressure were included in the study. The qualifying intraocular pressure on previous treatment with Travatan? (at least 6 weeks) was 22-36 mmHg in at least one eye at 8 a.m. intraocular pressure measurements at three eligibility visits. The patients received brinzolamide 1% twice a day in addition to travoprost 0.004% given once a day in the evening for 3 months. The follow-up examinations assessing the safety and efficacy of combined therapy of brinzolamide 1% and travoprost 0.004% were performed after 1 and 3 months. Results. Adjunctive therapy with brinzolamide resulted in statistically significant reductions in intraocular pressure from the travoprost baseline at all visits. Treatment with brinzolamide/travoprost caused statistically significant sustained reduction in intraocular pressure with the reduction of 17.39% (p<0.001) after 4 weeks and 20.08% (p<0.001) after 12 weeks. The intraocular pressure change from the baseline ranged from -3.9 mmHg after 4 weeks to -4.48 mmHg after 12 weeks. The most frequently related adverse effect was abnormal taste and blurred vision. Conclusion. Brinzolamide 1% (b.i.d.) used adjunctively with travoprost 0.004% (q.d.) lowers intraocular pressure significantly compared to travoprost alone. Both drugs were well tolerated and safe in the studied patients.

Download Full-text

Relationship between intraocular, blood and cerebrospinal fluid pressures: a theoretical approach

Modeling and Artificial Intelligence in Ophthalmology ◽

10.35119/maio.v2i3.93 ◽

2019 ◽

Vol 2 (3) ◽

pp. 9-13

Author(s):

Giovanna Guidoboni ◽

Fabrizia Salerni ◽

Rodolfo Repetto ◽

Marcela Szopos ◽

Alon Harris

Keyword(s):

Blood Pressure ◽

Blood Flow ◽

Cerebrospinal Fluid ◽

Intraocular Pressure ◽

Theoretical Approach ◽

Central Vein ◽

Csf Pressure ◽

Vein Occlusion ◽

Arterial Blood ◽

Pathological Conditions

Intraocular pressure (IOP), arterial blood pressure (PA), and cerebrospinal fluid (CSF) pressure have been identified as major players in several ocular pathologies, including glaucoma, central vein occlusion, and papilledema, to name a few. IOP, PA, and CSF pressures are not independent from each other. For example, aqueous humor and CSF flows, whose mechanics contribute to establish IOP and CSF pressure levels, originate from blood flow, which is driven by PA. As a consequence, it is difficult to experimentally isolate IOP, PA, and CSF pressure and to disentangle their effect in pathological conditions. Here we utilize a theoretical approach to address this issue.

Download Full-text

Intraocular Pressure Control for Patients Undergoing Combination Intravitreal Anti-VEGF and Dexamethasone Therapy for Macular Edema from Retinal Vein Occlusion

Journal of Pharmaceutics and Therapeutics ◽

10.18314/jpt.v4i1.1433 ◽

2018 ◽

Vol 4 (1) ◽

pp. 234-237

Author(s):

Michael Singer ◽

Darren Bell ◽

Joshua Singer ◽

Paul Woods ◽

Tyson R. Jergensen ◽

...

Keyword(s):

Intraocular Pressure ◽

Sustained Release ◽

Macular Edema ◽

Ocular Hypertension ◽

Retinal Vein Occlusion ◽

Retrospective Chart Review ◽

Dexamethasone Intravitreal Implant ◽

Vein Occlusion ◽

Anti Vegf ◽

Intravitreal Implant

Background and Objective: Sustained-release dexamethasone intravitreal implant is an effective treatment for macular edema secondary to retinal vein occlusion (RVO) but ocular hypertension is a side effect. This study evaluated whether the addition of a single combination IOP-lowering medication will reliably control intraocular pressure (IOP) for those patients. Study Design/Patients and Methods: Retrospective chart review of 62 patients that underwent multiple injections of combination anti-VEGF and sustained-release dexamethasone intravitreal implant for macular edema secondary to RVO. IOP spikes were treated with brimonidine 0.2% - timolol 0.5%. IRB approval was obtained. Results: The average elevated IOP requiring treatment was 28.6 mmHg. The average IOP after adding brimonidine 0.2% - timolol 0.5% was 16.7 mmHg. 100 percent of treatment cycles had an IOP< 30 mmHg after starting treatment. Conclusions: Using one combination IOP-lowering drop can reliably control the ocular hypertension that occurs secondary to combination therapy for macular edema in RVO.

Download Full-text

Faculty Opinions recommendation of Reduction in intraocular pressure after cataract extraction: the Ocular Hypertension Treatment Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717980404.793471642 ◽

2013 ◽

Author(s):

Peng T Khaw ◽

Hari Jayaram ◽

Alastair Lockwood

Keyword(s):

Intraocular Pressure ◽

Ocular Hypertension ◽

Cataract Extraction ◽

Hypertension Treatment

Download Full-text

Clinical characteristics and treatment of secondary glaucoma, glaucoma suspects and ocular hypertension after congenital cataract surgery

European Journal of Ophthalmology ◽

10.1177/1120672121991356 ◽

2021 ◽

pp. 112067212199135

Author(s):

Katharina Eibenberger ◽

Barbara Kiss ◽

Ursula Schmidt-Erfurth ◽

Eva Stifter

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Ocular Hypertension ◽

Congenital Cataract ◽

Case Series ◽

Secondary Glaucoma ◽

Visual Axis ◽

Retrospective Case ◽

Pediatric Cataract ◽

Congenital Cataract Surgery

Objective: To evaluate changes in intraocular pressure after congenital cataract surgery in a real-world setting. Methods: This retrospective case series included all children aged 0–2 years undergoing lens extraction due to congenital cataract. Development of an elevated intraocular pressure was divided into three groups: secG, suspG and OHT. Further, risk factors for IOP changes, the therapeutic approach and functional outcome were assessed during follow-up. Results: One hundred and sixty-one eyes of 110 patients aged 0–2 years were included, whereof 29 eyes of 17 children developed secondary glaucoma (secG; 11 eyes/8 patients), glaucoma suspect (suspG; three eyes/three patients) or ocular hypertension (OHT; 15 eyes/10 patients). No difference in surgrical procedure ( p = 0.62) was found, but age at cataract surgery differed significantly ( p = 0.048), with the secG group (1.74 ± 1.01 months) being the youngest (suspG: 3.93 ± 1.80 months; OHT group: 5.91 ± 5.36 months). Secondary surgical intervention was significantly higher in the secG (4.64 ± 3.41) followed by the suspG (2.00 ± 2.65) and OHT groups (0.40 ± 0.74; p < 0.001). Postoperative complications including nystagmus ( p = 0.81), strabismus ( p = 0.98) and amblyopia ( p = 0.73) showed no difference, in contrast to visual axis obscuration which was more common in the secG group ( p = 0.036). Conclusion: Initial lensectomy and anterior vitrectomy procedure together with or without IOL implantation seems to have no influence for the development of IOP changes after pediatric cataract surgery. However, children who developed secondary glaucoma had cataract surgery significantly earlier, within the first 2–3 months of life. Glaucoma surgery was required to achieve final IOP control in most eyes. The development of secondary glaucoma was also associated with a significant increase in surgical re-treatments.

Download Full-text