Research progress of ocular decompressive retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Ocular decompression retinopathy(ODR)is defined as multiple hemorrhagic retinopathy following abrupt lowering of intraocular pressure(IOP)that is not explained by another process. It is frequently associated with glaucoma surgeries, but also occurs in conjunction with other ocular surgical or medical procedures. Most patients are asymptomatic, so it may be difficult to detect clinically. We review the recent articles to better understand the risk factors, pathogenesis, clinical characteristics, imaging, differential diagnoses, management and prognosis of ODR.

A Case of Decompression Retinopathy After Resolution of Acute Primary Angle-Closure Glaucoma

PURPOSE:To report a case of ocular decompression retinopathy after resolution of acute primary angle closure (APAC) subsequent to medical treatment and laser peripheral iridotomy (LPI). CASE SUMMARY: A patient presented with APAC of the right eye with markedly elevated intraocular pressure (IOP) and a LPI was done after lowering the IOP with medical treatment. On presentation, visual acuity was 0.3 in the right eye (OD) and IOP was 74 mmHg OD. Two hours after medical treatment IOP was found to be 16 mmHg OD. Ten hours after resolution of the acute attack, the patient's visual acuity was 0.2 OD and IOP was 11 mmHg OD. LPI was subsequently performed in the right eye. The post-LPI IOP was 10 mmHg and the patient complained of visual disturbance and floaters OD. Three days after LPI the IOP was normal but her visual acuity had decreased to counting fingers OD. In addition, scattered retinal hemorrhages including alarge pre-retinal hemorrhage on the macula were found upon dilated funduscopic examination. After three months the retinal hemorrhage had been absorbed and her visual acuity was 0.7 OD. CONCLUSIONS: Decompression retinopathy can develop in the posterior pole of the retina in patients with APAC after medical treatment and LPI.

A Case of Decompression Retinopathy after Glaucoma Surgery

PURPOSE: Acute decompression of the eye in patients with high intraocular pressure (IOP) can lead to development of posterior pole hemorrhages. The courses of this rare syndrome is relatively benign. Herein we report a case of decompression retinopathy that developed diffuse retinal hemorrhages after glaucoma surgery in both eyes. METHODS: A 17-year-old male patient diagnosed with juvenile primary open angle glaucoma (JPOAG) underwent glaucoma surgery on both eyes at five months interval. Visual acuity on presentation was no light perception (NLP) in the right eye and 1.0 in the left eye. On the first postoperative day, IOP was 4 mmHg and diffuse retinal hemorrhages was found in the posterior pole after nonperforating trabecular surgery and triangular reticulated sodium hyaluronidate (SK GEL 3.5) implantation in the right eye. Trabeculectomy with 0.02% mitomycin C soaking (1 minute) was performed in the left eye 5 month after the right eye operation. On the second postoperative day, IOP was 5 mmHg and diffuse retinal hemorrhages was also observed in the posterior pole of the left eye. During the follow-up period (8 weeks), the retinal hemorrhage was absorbed without impairment of visual acuity. RESULTS: Decompression retinopathy developed in the posterior pole of the patient with JPOAG after glaucoma surgery, and the hemorrhages were absorbed over time with no visual impairment.