Detecção de maculopatia hipotônica subclínica pelo OCT III após cirurgia filtrante

Weyll, Mônica; Gilio, A. R. Di; Barbosa, Aline Silva; Nicoli, Aguida Aparecida; Silveira, Regina Cele

doi:10.1590/s0004-27492006000600008

Arq. Bras. Oftalmol.

2006

DOI: 10.1590/s0004-27492006000600008

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Detecção de maculopatia hipotônica subclínica pelo OCT III após cirurgia filtrante

Mônica Weyll¹,

A. R. Di Gilio²,

Aline Silva Barbosa³

et al.

Abstract: OCT III examination seems to be a good diagnostic method to detect subclinical hypotony maculopathy after filtration surgery.

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Cited by 3 publications

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“…ne of the postoperative complications of trabeculectomy is the occurrence of eye hypotonia (intraocular pressure less than 6 mmHg), which can be caused by: increasing the flow of aqueous humor (AH) as in cases of hyperfunctioning bubble; conjunctival leakage of AH (positive Seidel); reducing the production of AH resulting from ciliocoroidal detachment or some inflammatory process (1)(2) .…”

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confidence: 99%

“…Extended hypotension can result in the development of hypotonic maculopathy, characterized by low visual acuity (LVA), and characteristic signs in the eye fundus examination, as retinal streaks, coroidal effusion, and papilla edema. (1)(2)(3) . The use of antiproliferative medication in the filtering surgeries such as 5fluorouracil and mitomycin C greatly increased the incidence of these complications (2) .…”

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confidence: 99%

See 1 more Smart Citation

Scleral patch as a definitive treatment for hypotonic maculopathy after trabeculectomy

Oliveira¹,

Silveira²,

Jeha³

et al. 2016

Revista Brasileira De Oftalmologia

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Paciente do sexo feminino, portadora de glaucoma juvenil sem controle clínico adequado, foi submetida à trabeculectomia com mitomicina C, após a qual, desenvolveu hipotensão ocular refratária às medidas conservadoras, evoluindo com um quadro de maculopatia hipotônica. Foi realizado um implante de enxerto de retalho escleral de doador sobre a fístula, com resolução do quadro e ganho de acuidade visual. A enxertia de retalho escleral de doador mostrou-se uma terapia adequada para correção da hipotensão ocular por bolha hiperfiltrante pós trabeculectomia. O cirurgião deve considerar o emprego dessa técnica ao programar a revisão destes casos.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Scleral patch as a definitive treatment for hypotonic maculopathy after trabeculectomy

Oliveira¹,

Silveira²,

Jeha³

et al. 2016

Revista Brasileira De Oftalmologia

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Macular changes detected by Fourier‐domain optical coherence tomography in patients with hypotony without clinical maculopathy

Lima

Prata

Castro

et al. 2011

Acta Ophthalmologica

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. Purpose: To investigate macular changes in eyes with postoperative hypotony without clinical maculopathy using high‐resolution Fourier‐domain optical coherence tomography (FD‐OCT). Methods: Fourteen eyes of 12 patients with postoperative intraocular pressure (IOP) ≤ 6 mmHg for at least 4 weeks but with no detectable clinical features associated with hypotony maculopathy were imaged by FD‐OCT prospectively. Images were analysed by two retina specialists masked to clinical findings. Results: Most patients were female (83%) and myopic (75%) with a mean age of 65 ± 17 [standard deviation (SD)] years (range 2–86 years). Mean central corneal thickness was 519 ± 34 μm [95% confidence interval (CI) 502–537] and mean IOP before surgery was 20 ± 8 mmHg (95% CI 15–24). During the period of hypotony (mean 15 ± 6 weeks), the average mean IOP was 4 ± 1 mmHg (95% CI 3–5). Abnormal FD‐OCT findings (retinal folds and/or intraretinal fluid) were present in eight eyes. These patients had a higher rate of visual symptoms (75% versus 17%), visual acuity loss (≥ 2 lines; 63% versus 17%) and increased mean foveal thickness (250 ± 26 versus 210 ± 12 μm; p < 0.01, Mann–Whitney U‐test) compared with those with normal FD‐OCT. Conclusion: FD‐OCT identified subclinical macular abnormalities in over half of the eyes with postoperative hypotony. These findings were accompanied by visual disturbances and central macular thickening. FD‐OCT can be an important diagnostic tool for this disorder when clinical features are absent.

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Prospective evaluation of wipe-out after glaucoma filtration surgery in eyes with split fixation

Bhadra

Ghosh

Saurabh

et al. 2022

Indian J Ophthalmol

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Purpose: To assess the incidence and cause of idiopathic, irreversible loss of vision (“wipe-out”) in the early post-operative period after glaucoma-filtration surgery in advanced glaucoma. Methods: It was a prospective, interventional cohort study. Patients with advanced glaucoma and macular split fixation underwent either only trabeculectomy (group A) or combined phaco-emulsification with trabeculectomy (group B). The incidence and cause of visual loss, changes in intra-ocular pressure, visual acuity, and visual field indices during 2 months post surgery were assessed. Results: Thirty patients (30 eyes) were divided in two groups. No significant difference was noted between the pre-operative and post-operative mean deviations in both groups ( P = 0.41, P = 0.65). Two eyes in group A and one eye in group B had visual loss of two lines or more at the end of 2 months because of cataract and choroidal detachment. None of the eyes showed “wipe-out”. Conclusion: “Wipe-out” is a rare phenomenon after surgery in advanced glaucoma.

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Detecção de maculopatia hipotônica subclínica pelo OCT III após cirurgia filtrante

Abstract: OCT III examination seems to be a good diagnostic method to detect subclinical hypotony maculopathy after filtration surgery.

Cited by 3 publications

References 7 publications

Scleral patch as a definitive treatment for hypotonic maculopathy after trabeculectomy

Scleral patch as a definitive treatment for hypotonic maculopathy after trabeculectomy

Macular changes detected by Fourier‐domain optical coherence tomography in patients with hypotony without clinical maculopathy

Prospective evaluation of wipe-out after glaucoma filtration surgery in eyes with split fixation

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