Idiopathic dilated episcleral vessels (Radius-Maumenee syndrome): case report

Stock, Ricardo Alexandre; Fernandes, Natalie Lucas; Pastro, Nathan Lopes; Oliveira, Rafaela Santini de; Bonamigo, Elcio Luiz

doi:10.1590/s0004-27492013000100013

Cited by 12 publications

(12 citation statements)

References 8 publications

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“…Because no clear aetiology has yet to be identified for IEEVP or IDEV, their treatments are similar to those for primary open angle glaucoma (POAG) [ 7 ]. Suppression of aqueous humor production, medication to increase uveoscleral outflow, trabeculectomy and sclerectomy all can be used on these patients.…”

Section: Discussionmentioning

confidence: 99%

Advanced glaucoma secondary to bilateral idiopathic dilated episcleral veins – a case report

Rong

Mei

2018

BMC Ophthalmol

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BackgroundIdiopathic elevated episcleral venous pressure (IEEVP) or idiopathic dilated episcleral veins (IDEV) is a rare abnormality, and thus therapeutic treatment for this condition rarely is discussed. We report a case of a patient with bilateral glaucoma secondary to IDEV for whom intraocular pressures (IOPs) were controlled successfully by trabeculectomy.Case presentationA 50 year-old female with a complaint of persistent red eyes for over 30 years, presented with numerous tortuous and engorged episcleral vessels in both eyes (OU), open angles OU with spontaneous blood in Schlemm’s canal 360 degrees bilaterally. Orbital color Doppler examination showed the superior ophthalmic veins to be of normal calibre, with no reversal of flow. Head MRI with contrast and cerebral angiography were negative for arteriovenous fistula. Coronary angiography, color Doppler echocardiography and chest radiographs were within normal limits. A diagnosis of secondary glaucoma and IDEV was made. Neither anti-glaucoma medications, nor laser trabeculoplasty reduced the patent’s IOP effectively. Only after trabeculectomy was performed in each eye, were IOPs successfully controlled.ConclusionsThis case serves to remind clinicians of the importance of identifying and evaluating thoroughly patients with episcleral vessel dilation in non-inflamed eyes with no known cause. A misdiagnosis or missed diagnosis of long-term elevated intraocular pressure may result in significant damage to the optic nerve. In addition, when performing filtration surgery it is crucial that the ophthalmologist control the IOP and make an effort to prevent choroidal effusion.

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Section: Discussionmentioning

confidence: 99%

Advanced glaucoma secondary to bilateral idiopathic dilated episcleral veins – a case report

Rong

Mei

2018

BMC Ophthalmol

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“…Choroidal effusion without hypotony is frequently described in Radius‐Maumenee patients with filtrating surgery in intraoperative 13 , 16 and postoperative period. 9 , 15 , 16 , 17 Parikh et al 16 reported intra‐ and postoperative choroidal effusion for the same patient. Authors suggested that an intraoperative choroidal effusion could be caused by rapid transudation from capillaries induced by pressure gradient in ciliary body, choroid and episcleral veins.…”

Section: Discussionmentioning

confidence: 81%

“…According to previous publications, topical treatment frequently is not enough and the Radius‐Maumenee syndrome predisposes these patients to possible complications of filtrating surgery. 9 , 13 , 15 , 16 Therefore, the surgical technique should be chosen carefully considering its possible risks and benefits.…”

Section: Discussionmentioning

confidence: 99%

Radius‐Maumenee syndrome: A case series with a long‐term follow‐up

Elksne

Steiner

Hohensinn

et al. 2023

Clinical Case Reports

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The aim of the case series is to highlight the surgical challenges experienced like failed intervention, choroidal effusion, a postoperative cystoid macular oedema, and describe treatment options for Radius‐Maumenee syndrome. Authors reported on 3 bilateral cases of Radius‐Maumenee syndrome which underwent medical treatment, trabeculectomy with Mitomycin C, implantation with XEN45, Ahmed glaucoma valve, Baerveldt glaucoma implant, and cyclophotocoagulation.

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“…Hypotheses include local blood volume and pressure shifts in periocular vasculature. 5 The evanescent ocular hypertension and venous congestion here is presumably due to transient obstruction or fistula, likely too small to be detected. Such explanation is supported by the resolution, even after repeated radiologic intervention, although we caution the over-interpretation as low osmolar load and distal location of contrast injection may not be sufficient enough to reverse the obstruction.…”

Section: Discussionmentioning

confidence: 88%

“…1–5,8 Severe surgical complications are common. 8 To the authors’ knowledge, this is the first spontaneous resolution of Radius-Maumenee syndrome, persisting after discontinuation of medications and without surgery.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Resolution of Presumed Idiopathic Elevated Episcleral Venous Pressure

Breazzano

Mawn

Kuchtey

2016

Journal of Glaucoma

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Purpose To report a case of presumed idiopathic elevated episcleral venous pressure initially requiring medical management. Methods We present a case report of a 28-year-old Caucasian male presenting with eye redness and soreness as a referral to the glaucoma service. He was diagnosed with IEEVP after systematic workup. Results Unilateral elevated intraocular pressure was detected along with dilated episcleral vessels, mild cupping of optic nerve head, and blood in Schlemm’s canal, yet negative angiographic imaging and hypercoagulable labs. Topical anti-glaucoma medication normalized intraocular pressure, which then maintained with resolution of episcleral vessel caliper and blood in Schlemm’s canal after discontinuation of medication. Conclusion This is the first reported case of spontaneous resolution of presumed idiopathic elevated episcleral venous pressure, persisting after discontinuation of medical therapy and without surgical intervention.

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Idiopathic dilated episcleral vessels (Radius-Maumenee syndrome): case report

Cited by 12 publications

References 8 publications

Advanced glaucoma secondary to bilateral idiopathic dilated episcleral veins – a case report

Advanced glaucoma secondary to bilateral idiopathic dilated episcleral veins – a case report

Radius‐Maumenee syndrome: A case series with a long‐term follow‐up

Spontaneous Resolution of Presumed Idiopathic Elevated Episcleral Venous Pressure

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