Hypotony Maculopathy | ScienceGate

Background/AimsDetermine the efficacy of stand-alone implantation of the ab externo SIBS or poly(styrene-block-isobutylene-block-styrene) microshunt with mitomycin C in glaucomatous eyes, refractory to previous subconjunctival filtering surgery, over 1 year of follow-up.MethodsConsecutive retrospective cohort of patients with intraocular pressure (IOP) above target and previous subconjunctival filtering surgery, who received the microshunt between July 2015 and April 2019. Primary outcome was a complete success, with failure defined as IOP <6 mm Hg with vision loss, >17 mm Hg or <20% reduction in IOP without medications. Secondary outcomes included thresholds of 6 to 14 mm Hg and 6 to 21 mm Hg for both complete (no medications) and qualified (with medications) success as well as qualified success for thresholds of 6 to 17 mm Hg. Risk factors for failure, IOP, medications and complications were also assessed.Results85 eyes of 79 patients with a preoperative median IOP of 22.0 mm Hg (IQR 18.0–29.0) on four (IQR 3–4) medications were included. Postoperative median IOP was 13.0 mm Hg (IQR 10.0–17.0) on zero (IQR 0–2) medication at 1 year. 61.0% achieved complete success and 79.7% achieved qualified success. Mild-to-moderate disease was associated with failure (adjusted HR 2.37; 95% CI 1.23 to 4.59). Needling was performed in 11.8%, and 8.2% underwent anterior chamber reformation. Complications were transient, consisting of hyphaema, choroidal detachment and hypotony maculopathy, with 7.1% of patients undergoing reoperation.ConclusionsIn a group of high-risk eyes that had already failed at least one subconjunctival filtering surgery, the SIBS microshunt demonstrates reasonable surgical success over 1-year follow-up, with relatively few complications.

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Risk factors for hypotony maculopathy

Ophthalmology ◽

10.1016/s0161-6420(03)00227-6 ◽

2003 ◽

Vol 110 (6) ◽

pp. 1185-1191 ◽

Cited By ~ 68

Author(s):

Lilia A Fannin ◽

Joyce C Schiffman ◽

Donald L Budenz

Keyword(s):

Risk Factors ◽

Hypotony Maculopathy

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Hypotony Maculopathy: A Silent Mimicker of Common Macular Diseases With Nonspecific Optical Coherence Tomography Findings

Journal of VitreoRetinal Diseases ◽

10.1177/2474126418764955 ◽

2018 ◽

Vol 2 (3) ◽

pp. 155-159 ◽

Cited By ~ 1

Author(s):

Ramon Lee ◽

Hossein Ameri

Keyword(s):

Optical Coherence Tomography ◽

Subretinal Fluid ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Diagnostic Challenge ◽

Hypotony Maculopathy ◽

Age Related ◽

Macular Diseases ◽

Oct Imaging ◽

Chorioretinal Folds

Purpose: To highlight the diagnostic challenge of eyes with hypotony maculopathy with concurrent macular diseases and to present optical coherence tomography (OCT) imaging findings in hypotony maculopathy. Methods: Retrospective review of 15 eyes of 12 patients with hypotony maculopathy at a single institution. Results: Low intraocular pressure (IOP) was caused by overfiltration from trabeculectomy in 9 eyes (of 15, 60%), overtreatment with topical aqueous suppressants after trabeculectomy in 3 eyes (of 15, 20%), bleb leak in 1 eye (of 15, 7%), and treatment with topical aqueous suppressants alone in 2 eyes (of 15, 13%). On OCT imaging, 7 eyes (of 15, 47%) had chorioretinal folds without intraretinal fluid (IRF) or subretinal fluid (SRF), 5 eyes (of 15, 33%) had either IRF or SRF with chorioretinal folds, and 3 eyes (of 15, 20%) had IRF or SRF without chorioretinal folds. The majority of eyes (11 of 15 eyes, 73%) had additional diagnoses apart from hypotony maculopathy that could have potentially caused IRF or SRF, which included epiretinal membrane, retinal vein occlusion, and age-related macular degeneration. Two eyes (of 15, 13%) were initially erroneously managed for a nonhypotony maculopathy pathology due to the diagnostic challenge in eyes with hypotony maculopathy. Conclusion: Hypotony maculopathy demonstrates nonspecific OCT findings such as IRF and SRF that are commonly seen in other macular diseases. In eyes with these macular diseases, diagnosing hypotony maculopathy may be challenging; thus, attention to past ocular history and IOP must always be part of evaluation.

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Concurrent Phacoemulsification and Encircling for Hypotony Maculopathy after Blunt Trauma

Case Reports in Medicine ◽

10.1155/2020/6594170 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Takayuki Baba ◽

Hirotaka Yokouchi ◽

Shuichi Yamamoto

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Blunt Trauma ◽

Intraocular Lens ◽

Secondary Cataract ◽

Hypotony Maculopathy ◽

Uveoscleral Outflow ◽

Old Japanese ◽

One Year

A 37-year-old Japanese man had his right eye hit by a fist. His right eye developed hypotony maculopathy and secondary cataract, and his visual acuity decreased to 20/200 with an intraocular pressure of 4 mmHg. He underwent phacoemulsification and aspiration, implantation of the intraocular lens, and encircling with a silicone tire. His visual acuity improved to 20/20 and stable for more than one year postoperatively. The intraocular pressure in his right eye increased to 12 mmHg, and maculopathy was resolved entirely. It was suggested that an encircling buckle obstructed the uveoscleral outflow through the cyclodialysis and increased intraocular pressure. Concurrent cataract surgery and encircling was sufficient to improve the vision.

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