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Abstract #6065 Published in IGR 2-2
Early and late findings with optical coherence tomography (OCT) in patients with postoperative hypotonia
Klink T; Lieb WE; Goebel WOphthalmologe 2000; 97: 353-358
PURPOSE: To study early and late findings of macular retinal thickness in patients with hypotony following filtering procedures. PATIENTS AND METHODS: Thirteen patients who had undergone trabeculectomy (nine with antimetabolites) developed ocular hypotony. The macular region appeared normal during biomicroscopy in eight patients. In the hypotensive phase, macular thickness was measured using optical coherence tomography (OCT). Directly after attempted and successful normalization of intraocular pressure (seven spontaneous, five operative, one failure) as well as six months later, OCT measurements were repeated. Foveal thickness in the hypotonous eye was correlated with visual acuity and foveal thickness in the fellow eye. RESULTS: Intraocular pressure could be raised from a mean of 2.5 ± 1.3 mmHg to 11.5 ± 5.5 mmHg and later on to 13 ± 3.7 mmHg (follow-up). Mean foveal thickness was reduced from 211 ± 73 μm during hypotony to 170 ± 44 μm after normalization of intraocular pressure, and to 171 ± 38 μm at late follow-up. Mean visual acuity improved from 0.17-0.33 and finally to 0.6. CONCLUSIONS: Despite the normal appearance of the macula (eight patients), by using biomicroscopy in patients with hypotony, retinal thickness in the fovea is increased. Apart from refractive changes, this retinal thickening can be held responsible for the deterioration of visual acuity in eyes with hypotony. OCT analysis and measurements may be useful to distinguish between retinal thickening that is reversible after normalization of the intraocular pressure and cystoid macular edema that leads to permanent visual impairment. LA: German
Dr. T. Klink, Universitäts-Augenklinik Würzburg, Würzburg, Germany
Classification:
6.9.2 Optical coherence tomography (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis)
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)