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 Branch Retinal Vein Occlusion with Complications of Vitreus Bleeding Performed by Vitrectomy and Endolaser

2020 ◽  
Vol 1 (2) ◽  
pp. 37-44
Author(s):  
Faika Novadianaz ◽  
Ramzi Amin
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Ultrasound Examination ◽  
Vitreous Hemorrhage ◽  
Temporal Region ◽  
Retinal Blood Vessel ◽  
Case Presentation ◽  
Main Complaint ◽  
Vein Occlusion ◽  
The Right

Introduction. Retinal vein occlusion is the largest group of retinal blood vessel abnormalities after diabetic retinopathy. Macular edema and neovascularization are major complications in BRVO that require therapy. Vitrectomy is indicated in cases of vitreous hemorrhage that fail spontaneous resolution after 6 weeks to 3 months. The time to do vitrectomy depends on the tendency of the ophtalmologist and the patient's visual needs. Case Presentation. A woman, 59 years old, housewife, came to the Eye Clinic on July 2016. The main complaint history is that the right eye has become more blurred since ± 2 months ago. On examination of the posterior segment of the right eye the detail is difficult to assess. In this patient suspected turbidity of the vitreous cavity so that an ultrasound examination was performed. Vitreous bleeding is an indication for vitrectomy. Intraoperatively after the vitrectomy, bleeding and ghost vessels were found in the super-temporal region. Conclusion. The main goals of therapy in BRVO are to improve hemodynamics, overcome macular edema, and prevent neovascularization.

Retina Injury After Dexamethasone Injection Into a Vitrectomized Eye

2020 ◽  
Vol 4 (6) ◽  
pp. 538-540
Author(s):  
Michael S. Elliott ◽  
Sandra R. Montezuma
Keyword(s):  
Macular Edema ◽  
Vitreous Hemorrhage ◽  
Signs And Symptoms ◽  
Internal Limiting Membrane ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Patient Reported ◽  
Clinically Significant ◽  
The Right ◽  
Intravitreal Dexamethasone

Purpose: This work reports a case of retinal and vitreous hemorrhage after a dexamethasone (Ozurdex, Allergan) intravitreal implant injection to treat clinically significant macular edema (ME) in a patient with moderate nonproliferative diabetic retinopathy. Methods: A 61-year-old woman who had a vitrectomy 3 years prior in the right eye underwent intravitreal dexamethasone implant injection in the right eye. Immediately after the injection, the patient noted numerous floaters, with visual acuity decline from 20/30 before injection, to counting fingers at 3 feet after injection. Dilated examination revealed the dexamethasone implant resting against the retina, just inferior to the inferior arcade. On 360° fundus examination, the retina was found to be flat and attached. Optical coherence tomography of the macula demonstrated that the dexamethasone implant was preretinal, possibly having lifted the internal limiting membrane. Results: Thirty minutes after the injection, the patient reported that her vision was starting to clear. The patient was informed about what had transpired and warned about signs and symptoms of retinal detachment. She canceled her 1-week follow-up appointment because her vision returned to baseline. By 4 weeks post injection, her vision was 20/20 without macular edema. Conclusions: This case represents the first reported instance in which retinal impact by an Ozurdex implant was observed without treatment and vision recovered to baseline.

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.

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

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Julia V. Stingl ◽  
Laura Ponce Nunez ◽  
Alexander K. Schuster ◽  
Esther M. Hoffmann
Keyword(s):  
Intraocular Pressure ◽  
Ocular Hypertension ◽  
Valsalva Maneuver ◽  
Venous Stasis ◽  
Central Vein ◽  
Blurred Vision ◽  
Total Recovery ◽  
Vein Occlusion ◽  
Disease Pattern ◽  
Venous Stasis Retinopathy

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.

scholarly journals Non-Routine Therapies for the Treatment of Branched Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 120-128
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Treatment Modalities ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Emerging Therapies ◽  
Endothelial Growth Factors

Retinal vein occlusion is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. There are several treatment modalities for branch retinal vein occlusion and specifically for its complications, such as macular edema, vitreous hemorrhage, retinal neovascularization, and retinal detachment. These treatment modalities are anti-aggregative therapy and fibrinolysis, isovolemic hemodilution, vitrectomy with or without sheathotomy, peripheral scatter and macular grid retinal laser therapy, non-steroid agents, intravitreal steroids ( triamcinolone, and dexamethasone implants), and intravitreal anti-vascular endothelial growth factors (anti-VEGFs) (bevacizumab, ranibizumab, aflibercept). In this review, the treatment modalities other than routinely performed anti-VEGF, steroid, and laser therapy in macular edema secondary to branch retinal vein occlusion and emerging therapies will be overviewed.

scholarly journals Immediate Manifestation of Ocular Decompression Retinopathy following Anterior Chamber Paracentesis

2019 ◽  
Vol 10 (2) ◽  
pp. 287-291 ◽  
Author(s):  
Jamie Prince ◽  
David Fleischman
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Light Perception ◽  
Laser Trabeculoplasty ◽  
Anterior Chamber Paracentesis ◽  
The Right ◽  
Decompression Retinopathy

Ocular decompression retinopathy (ODR) is a complication of rapid lowering of intraocular pressure (IOP) resulting in hemorrhages in multiple retinal layers. We report a case of ODR that developed within minutes following anterior chamber paracentesis in an adult female with primary open-angle glaucoma. A 61-year-old Black woman with primary open-angle glaucoma presented with marked elevation of IOP (46 mm Hg in the right eye and 30 mm Hg in the left) despite maximal medical therapy and bilateral selective laser trabeculoplasty. Vision in the right eye decreased from counting fingers at 3 feet 1 week earlier to no light perception at the time of presentation. Anterior chamber paracentesis was performed on the right eye to reduce IOP and stabilize the eye until further surgical intervention could be performed. IOP in the right eye decreased to 6 mm Hg postoperatively. Within minutes of the procedure, several intraretinal blot hemorrhages appeared in the periphery of the right eye. During this time, visual acuity remained at no light perception. The findings were consistent with decompression retinopathy. By 12 weeks postoperatively, the ODR had resolved with visual acuity of light perception and normal fundoscopy except for profound cupping. Our case demonstrates how rapidly ocular decompression can form following IOP reduction.

Common and rare complications following filtering surgery for children with congenital glaucoma; a5 years study

2021 ◽  
pp. 112067212098637
Author(s):  
Khulood Muhammad Sayed
Keyword(s):  
Postoperative Complications ◽  
Cushing Syndrome ◽  
Vitreous Hemorrhage ◽  
Late Complications ◽  
Congenital Glaucoma ◽  
Choroidal Detachment ◽  
University Hospitals ◽  
Shallow Anterior Chamber ◽  
Toxic Keratopathy ◽  
Decompression Retinopathy

Purpose: To determine the incidence of postoperative complications following combined trabeculotomy trabeculectomy with mitomycin C (CTTM) for congenital glaucoma (CG), in addition to documentation of some unusual complications and possible ways to manage these complications safely with minimal morbidity. Methods: A retrospective observational study was performed on 190 eyes with CG had a CTTM procedure. Included eyes were operated upon between February 2015 and February 2020 in Sohag University Hospitals. Medical records were reviewed and postoperative complications were reported. Incidence of postoperative complications and their management were the main outcome measures Results: Early complications developed the form of shallow anterior chamber (AC) (16.3%), hyphema (10.5%), serous choroidal detachment (2%), hemorrhagic choroidal detachment (2%). Unusual and rare complications occurred in the form of iatrogenic Cushing syndrome, unilateral toxic keratopathy developed, vitreous hemorrhage (VH), intercalary staphyloma and decompression retinopathy Late complications included: high postoperative intraocular pressure (IOP) (16.5%), thin cystic blebs (13.1%), hypotony disc edema (2%), cataract (3.2%), one eye developed blebitis and one eye developed endophthalmitis. Conclusion: Surgical management of CG is full of complications in early and late postoperative periods such as shallow AC, hyphema and thin cystic blebs. Some unusual and rare complications developed such as iatrogenic Cushing syndrome, unilateral toxic keratopathy, vitreous hemorrhage, intercalary staphyloma and decompression retinopathy. If identified early; all these complications could be managed properly leading to a successful and favorable outcome.

scholarly journals Branch Retinal Vein Occlusion with Vitreous Hemorrhage Identified During Intraoperative Vitrectomy

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Nafila Mahida Sukmono ◽  
Ramzi Amin
Keyword(s):  
Visual Acuity ◽  
Blood Vessels ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Laser Action ◽  
Vitreous Hemorrhage ◽  
Posterior Segment ◽  
Vein Occlusion ◽  
The Right ◽  
Photocoagulation Laser

Introduction Retinal vein occlusion is the largest group of retinal blood vessels after diabetic retinopathy. Occlusion occurring in the retinal vein is divided into central retinal vein occlusion (CRVO) occlusion and branch retinal vein occlusion (BRVO) occlusion. The Beijing Eye Study, reported a higher incidence of BRVO than CRVO, where 10-year incidents for BRVO were 1.6 per 100 subjects, and CRVO was only 0.3% 100 subjects.1 To report a case of Branch Retinal Vein Occlusion with vitreous hemorrhage identified during intraoperative vitrectomy Method: A 49-year-old woman with a history of 15 years of hypertension had right eye vision complaints, increasingly blurred since last 2 months. The right eye visual acuity 2/60 cannot be corrected and left eye 6/30 cannot be corrected. The posterior segment on right eye is difficult to assess. USG B-Scan right eye found vitreous echospike appearance of vitreous bleeding. We manage with vitrectomy and during intraoperative we identified bleeding and ghost vessel in superotemporal area. Bleeding in the superotemporal quadrant is done by photocoagulation laser action. Results: First day postoperative there was increased in visual acuity to 6/60 with a posterior segment that could be assessed, obtained tortous blood vessels, slight bleeding and ghost vessel in the superotemporal area with laser injury. Conclusion: In this case report, patients with BRVO with complications of vitreous hemorrhage performed vitrectomy with additional endolaser in the ischemic area. The result of this action of visual acuity improvement in patient.

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