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Abstract #6439 Published in IGR 3-2
Acute angle-closure glaucoma resulting from spontaneous hemorrhagic retinal detachment in age-related macular degeneration: case reports and literature review
Chen SN; Ho CL; Ho JD; Guo YH; Chen TL; Chen PFJapanese Journal of Ophthalmology 2001; 45: 270-275
PURPOSE: Acute angle-closure glaucoma (ACG) resulting from massive subretinal hemorrhage is a rare and catastrophic complication in age-related macular degeneration. Anticoagulant usage had been strongly correlated with this complication in previously reported cases. PATIENTS: Four patients (four eyes), three males and one female, developed ACG with diffuse subretinal hemorrhage and total hemorrhagic retinal detachment. RESULTS: Serial funduscopic examinations and echographic studies in two eyes showed that the blood gradually accumulated in the subretinal space. It took more than ten days for the bleeding to build up to bullous hemorrhagic retinal detachment and secondary glaucoma. Antiglaucomatous agents were given, and sclerotomy was performed in three of the four patients. Phthisical changes were observed subsequently in these three eyes. The eye that received early drainage of blood was an exception, and a small degree of residual acuity was retained. Three of the four patients had diabetes mellitus, and hypertension and vascular diseases were also present in the same three patients. CONCLUSIONS: Diabetes mellitus might be a predisposing factor for impaired hemostasis. Antiglaucomatous agents had no effect in the management of intraocular pressure (IOP). Sclerotomy and drainage of blood help control IOP and relieve ocular pain. Poor final visual acuity is inevitable. However, phthisical changes may possibly be prevented with early sclerotomy and drainage of blood.
Dr S.N. Chen, Department of Ophthalmology, Chang-Gung Memorial Hospital, 5 Fu-Shing Street, Kewishan, Taoyuan 333, Taiway, R.O.C.
Classification:
9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
