Optical Coherence Tomography Angiography Description of Ocular Decompression Retinopathy After Deep Sclerectomy in Traumatic Glaucoma

J Glaucoma. 2018 Mar;27(3):297-301. doi: 10.1097/IJG.0000000000000870.

Abstract

Purpose: The purpose of this article is to present a case of ocular decompression retinopathy (ODR) occurring after uncomplicated deep sclerectomy with Mitomycin C using optical coherence tomography angiography (OCTA).

Patient and method: This is a single case report.

Results: A 55-year-old man with traumatic glaucoma in the right eye complained of blurred vision. Visual acuity was 20/25 and intraocular pressure (IOP) was 50 mm Hg. Deep sclerectomy with Mitomycin C was performed. On the first postoperative day, best-corrected visual acuity (BCVA) was light perception and IOP was 6 mm Hg. At 3 months follow-up, BCVA was 20/40 and IOP was 14 mm Hg. Fundoscopy showed multiple diffuse round retinal hemorrhages over the posterior pole, in all quadrants. On OCTA (RTVue XR Avanti; Optovue Inc., Fremont, CA), hemorrhages were present in superficial and deep retinal layers, with a normal vascularization in the en face image. BCVA improved to 20/32 at postoperative month 4 with reduced but persistent retinal hemorrhages.

Conclusions: ODR is a rare complication of filtering surgery. To the best of our knowledge, this is the second reported case of ODR occurring after deep sclerectomy and first description using OCTA. OCTA showed superficial and deep retinal hemorrhages with a normal vascular configuration. High-preoperative IOP seems to be the most important risk factor for this complication.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alkylating Agents / administration & dosage
  • Decompression, Surgical / adverse effects*
  • Eye Injuries / surgery*
  • Fluorescein Angiography / methods*
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Retinal Diseases / diagnostic imaging*
  • Retinal Diseases / etiology
  • Sclera / surgery
  • Sclerostomy / adverse effects*
  • Tomography, Optical Coherence / methods*
  • Tonometry, Ocular / adverse effects
  • Visual Acuity
  • Wounds, Nonpenetrating / surgery*

Substances

  • Alkylating Agents
  • Mitomycin