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Abstract #46275 Published in IGR 13-2
Macular changes detected by Fourier-domain optical coherence tomography in patients with hypotony without clinical maculopathy
Lima VC; Prata TS; Castro DPE; Castro LC; De Moraes CGV; Mattox C; Rosen RB; Liebmann JM; Ritch RActa Ophthalmologica 2011; 89: e274-277
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) (less-than or equal to) 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 (plus or minus) 17 [standard deviation (SD)] years (range 2-86 years). Mean central corneal thickness was 519 (plus or minus) 34 (mu)m [95% confidence interval (CI) 502-537] and mean IOP before surgery was 20 (plus or minus) 8 mmHg (95% CI 15-24). During the period of hypotony (mean 15 (plus or minus) 6 weeks), the average mean IOP was 4 (plus or minus) 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 ((less-than or equal to)yen; 2 lines; 63% versus 17%) and increased mean foveal thickness (250 (plus or minus) 26 versus 210 (plus or minus) 12 (mu)m; 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.
R. Ritch. Glaucoma Service, Department of Ophthalmology, New York Eye and Ear Infirmary, 310 East 14th Street, New York NY 10003, United States. Email: ritchmd@earthlink.net
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
