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Abstract #18100 Published in IGR 9-2
Retrobulbar blood flow in idiopathic dilated episcleral veins and glaucoma
Grieshaber MC; Dubler B; Knodel C; Killer HE; Flammer J; Orgül SKlinische Monatsblätter für Augenheilkunde 2007; 224: 320-323
BACKGROUND: Dilated episcleral veins may occur in the presence of orbital tumors, carotid cavernous sinus fistula and other orbital obstructive lesions. HISTORY AND SIGNS: A 39-year-old man had a history of a red left eye for two years. The visual acuity was 20/20, episcleral and conjunctival veins were dilated, and both the intraocular (24 mmHg) and episcleral venous (18 mmHg) pressures were increased. Schlemm's canal was filled with blood, and glaucomatous damage was pronounced in the optic nerve head and the visual field of the left eye. The retrobulbar blood flow in the left eye was normal in the ophthalmic and central retinal arteries, but markedly decreased in the central retinal vein. There were no signs of fistula or shunts. The right eye was without any pathology. MR and catheter angiography of the head and orbit were both normal. THERAPY AND OUTCOME: Following trabeculectomy, the intraocular and episcleral venous pressures dropped to 9 mmHg and 8 mmHg, respectively, at 6 months follow-up. The episcleral and conjunctival venous congestion regressed, and the blood flow in the central retinal vein increased. CONCLUSION: The reason for the observed clinical picture (Radius-Maumenee syndrome) and haemodynamic improvement after reduction of the intraocular pressure is not clear. We outline a hypothesis involving an increase of the vascular resistance in the vortex veins and the superior ophthalmic vein with a shift in local blood volume and vascular pressure due to high intraocular pressure.
Dr. M.C. Grieshaber, Department of Ophthalmology, University Hospital Basel, Basel, Switzerland. mgrieshaber@uhbs.ch
Classification:
9.4.9 Glaucomas associated with elevated episcleral venous pressure (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
