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Ophthalmic Images

Ultra-widefield image of choroidal detachment after combined glaucoma filtration surgery

Senthilkumar, Vijayalakshmi A; Mishra, Chitaranjan1

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Indian Journal of Ophthalmology: August 2020 - Volume 68 - Issue 8 - p 1669
doi: 10.4103/ijo.IJO_2092_19
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A 65-year male presented with ocular hypotony after 8 months of glaucoma filtration surgery with 0.2 mg/ml Mitomycin -C in the left eye (OS). His best-corrected visual acuity (BCVA) and IOP were 20/30 and 4 mmHg in OS, respectively. Slit-lamp examination revealed overfiltering bleb, negative Siedel test with shallow anterior chamber. Fundus evaluation revealed a cup/disc ratio of 0.9 with 360° peripheral choroidal detachments [Fig. 1]. He was treated conservatively with systemic and topical corticosteroids. Hypotony is a sight-threatening complication following glaucoma filtration surgery with a reported incidence rate between 1.3% and 18%.[12] Bleb leak, an important risk factor, was ruled out in our case.[3] Though the majority of the cases improved with conservative management, wide-angle fundus imaging helps in patient counselling in these cases.

Figure 1
Figure 1:
Wide-angle fundus photography (Optos Daytona) OS showing 360° peripheral choroidal detachments with advanced glaucomatous cupping

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

1. Akarsu C, Onol M, Hasanreisoglu B. Postoperative 5- fluorouracil versus intraoperative mitomycin C in high-risk glaucoma filtering surgery: Extended follow up Clin Exp Ophthalmol. 2003;31:199–205
2. Megevand GS, Salmon JF, Scholtz RP. The effect of reducing the exposure time of mitomycin C in glaucoma filtering surgery Ophthalmol. 1995;102:84–90
3. Karolina C, Baril C, Bourret-Massicotte D, Anctil JL, Caron L, Goyette A, et al Risk factors for a severe bleb leak following trabeculectomy: A retrospective case-control study J Glaucoma. 2015;24:493–7
© 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow