Document Type
Article
Publication Date
2-4-2016
Abstract
BACKGROUND: After a successful trabeculectomy, a sudden intraocular pressure decrease may alter the intracranial to intraocular pressure ratio and cause decompression retinopathy. Frequent Valsalva maneuvers may also play a role in its pathogenesis. This condition may manifest as multiple retinal hemorrhages, edema of the optic disc, macular edema, or a sudden decrease in visual acuity postoperatively. Outcomes for patients are usually good, with spontaneous resolution occurring within a matter of weeks. It has been rarely reported in the literature as a bilateral condition.
CASE PRESENTATION: We present a case of consecutive bilateral decompression retinopathy in a 54-year-old severely obese Caucasian woman (body mass index 37 kg/m(2)) with open angle glaucoma and a poor history of medical therapeutic compliance, who chose surgical treatment based on her inability to consistently use ocular drops. Our patient underwent a trabeculectomy with mitomycin C in both eyes, with surgeries taking place 3 months apart. After the first surgery, 2 weeks postoperatively, she complained of decreased visual acuity. Examination of her right eye fundus revealed multiple retinal hemorrhages and disc edema. There was a similar pattern in her left eye, this time including maculopathy. Her visual acuity and fundoscopic changes resolved spontaneously over a period of a month in both cases. Currently, our patient has well-controlled bilateral intraocular pressure, ranging between 14 and 16 mmHg, without hypotensive medication.
CONCLUSIONS: Decompression retinopathy is a potential complication after glaucoma surgery, but has rarely been described as a bilateral consecutive condition. A comprehensive approach could help to anticipate its occurrence and manage it.
Recommended Citation
Figueiredo, Ana Raquel Marcos; Sampaio, Isabel Coutinho; Menéres, Maria João Fernandes Dos Santos; and Spaeth, George L., "Consecutive bilateral decompression retinopathy after mitomycin C trabeculectomy: a case report." (2016). Wills Eye Hospital Papers. Paper 55.
https://jdc.jefferson.edu/willsfp/55
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
26846338
Comments
This article has been peer reviewed. It was published in: Journal of Medical Case Reports.
Volume 10, Issue 1, 4 February 2016, Article number 814.
The published version is available at DOI: 10.1186/s13256-016-0814-x
Copyright © 2016 Figueiredo et al.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.