Idiopathic elevated episcleral venous pressure in a teenager

Catherine Q Sun; Charles M Medert; Ta Chen Chang

doi:10.1016/j.ajoc.2020.100712

Idiopathic elevated episcleral venous pressure in a teenager

Am J Ophthalmol Case Rep. 2020 Apr 15:18:100712. doi: 10.1016/j.ajoc.2020.100712. eCollection 2020 Jun.

Authors

Catherine Q Sun¹, Charles M Medert², Ta Chen Chang²

Affiliations

¹ Department of Ophthalmology, University of California, San Francisco, CA, USA.
² Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

Abstract

Purpose: To report a case of unilateral idiopathic elevated episcleral venous pressure (IEEVP) in a 15-year-old patient. We reviewed and summarized published case reports of IEEVP to determine how to manage this challenging and rare condition.

Observations: A 15-year-old Caucasian male presented with elevated intraocular pressures (IOP), blood in Schlemm canal in the left eye, and asymmetric cupping with corresponding glaucomatous findings on testing. We diagnosed the patient with IEEVP and describe successful surgical intervention with deep sclerectomy and viscocanalostomy.

Conclusions and importance: IEEVP is a diagnosis of exclusion and based on clinical findings of dilated episcleral veins, blood in Schlemm canal and glaucomatous changes. If glaucomatous progression occurs with medication, filtration surgery is usually required, and most patients have good results in the literature. Care should be taken to prevent post-operative hypotony and serous choroidal detachment.

Keywords: Deep sclerectomy; Idiopathic dilated episcleral veins; Idiopathic elevated episcleral venous pressure; Radius-Maumenee syndrome; Schlemm canal; Viscocanalostomy.

Publication types

Case Reports