First Author: A.Cabugueira PORTUGAL
Co Author(s): A. Vicente R. Anjos L. Pinto R. Flores M. Reina 0 0 0 0 0 0 0 0 0
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To describe a case of bilateral hypotony maculopathy after trabeculectomy with mitomycin C.
The hypotony maculopathy is characterized by a low intraocular pressure (IOP) with associated fundus changes, including chorioretinal folds, optic nerve swelling and vascular tortuosity.
The authors reported a case of a 52 years old Caucasian woman with bilateral advanced primary open-angle glaucoma uncontrolled by medical therapy, submitted to a trabeculectomy in the right eye (RE) and 6 months later in the left eye (LE).
Visual acuity (VA) was 0,5 in RE and 0,4 in LE and IOP in RE 9 mmHg and 8 mmHg. Fundus examination revealed chorioretinal folds in the posterior pole and vascular tortuosity. In the angiography, there was an increase in the choroidal fluorescence along the crest of each fold and relative hypofluorescence in the troughs. The OCT was compatible with the diagnosis. To resolve the clinical situation, therapy with oral and topical steroids, cycloplegic, injection of ophthalmic viscosurgical device in the anterior chamber, autologous blood injection into the bleb and resuturing of the trabeculectomy flap with conjucntival advancement, were performed. However, final VA and IOP were similar.
The development of hypotony maculopathy leads to impairment of VA. When the condition is maintained for long periods of time, chorioretinal fibrosis may lead to permanent structural changes.