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Abstract #82768 Published in IGR 20-4
Changes on Confocal Scanning Laser Ophthalmoscopy with the Heidelberg Retinal Tomography after a Cardiac Catheterism in a Patient with Progressive Glaucoma
Valera-Cornejo DA; Loayza-Gamboa W; Herrera-Quiroz J; Alvarado-Villacorta R; Córdova-Crisanto L; Valderrama-Albino V; Pantoja-Dávalos NCase Reports in Ophthalmology 2019; 10: 256-266
PURPOSE: We present a case of a patient with progressive open angle glaucoma who presented changes suggestive of improvement in the Heidelberg retinal tomography 3 (HRT3) analysis after a cardiac catheterization. OBSERVATION: A 69-year-old woman presented with progressive open angle glaucoma despite maximum tolerable antiglaucomatous topical treatment. A filtering surgery (trabeculectomy) was performed and successfully achieved intraocular pressure (IOP) levels of 10 mm Hg on average. Despite this, changes were evidenced in the HRT3 protocols (trend analysis and topographic change analysis) suggesting marked progression. Brimonidine 0.2% twice a day was initiated, and a cardiovascular examination was requested. A cardiac catheterism was performed in the following weeks, and afterward, all structural parameters improved until the last control. Medication was not discontinued, and no signs of apparent progression on the HRT3 parameters have been evidenced up until the time of writing this case report. CONCLUSIONS AND IMPORTANCE: There was a marked improvement in the HRT3 parameters (trend and topographic change analysis), suggesting that the progression stopped after a cardiac catheterism in a patient with progressive glaucoma despite having the IOP controlled. To our knowledge, this is the first case of a patient with progressive glaucoma that was medically and surgically managed, and despite achieving low IOP levels, the progression detected by the HRT3 analysis could not be stopped until a cardiac catheterization was performed.
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Classification:
6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
6.20 Progression (Part of: 6 Clinical examination methods)
