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Abstract #109853 Published in IGR 24-1
Severe macular complications in glaucoma: high-resolution multimodal imaging characteristics and review of the literature
Lama H; Pâques M; Brasnu E; Vu J; Chaumette C; Dupas B; Fardeau C; Chehaibou I; Chehaibou I; Rouland JF; Besombes G; Labetoulle M; Labbé A; Rousseau ABMC Ophthalmology 2023; 23: 318
PURPOSE: To describe imaging characteristics of severe macular complications occurring in glaucoma and discuss available treatments. METHODS: Retrospective case series of glaucomatous patients with macular retinoschisis (MR) and/or serous retinal detachment (SRD). Patients underwent a complete ophthalmological examination and multimodal imaging including retinography, SD-OCT, fluorescein and indocyanine green angiography (FA & ICGA) and adaptive optics (AO). RESULTS: Ten eyes (8 patients) were included. Initial BCVA was 1.04 ± 1.12 logMAR and IOP was 24.0 ± 9.3mmHg. All eyes presented with MR while SRD was present in 5 eyes (5 patients), with a central macular thickness of 573 ± 152 μm. FA and ICGA allowed to exclude leakage in all cases. A focal lamina cribrosa defect (LCD) was found in four eyes (4 patients) using OCT, with AO providing en-face visualization of the defect in one eye. Outer retinal hole was present in 3 eyes (3 patients). No visual improvement or resolution of the macular retinoschisis was observed in eyes with medical or surgical IOP control (N = 9). Vitrectomy with internal membrane limiting peeling and gas tamponade was performed in one eye with good visual results. CONCLUSIONS: Multimodal high-resolution imaging is essential to diagnose severe macular complications associated with advanced glaucoma.
Department of Ophthalmology, Assistance Publique - Hôpitaux de Paris - Université Paris Saclay, 78, rue du Général Leclerc, Le Kremlin Bicêtre, 94275, France.
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