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

Joo Hoon Kim; Jang Won Huh

doi:10.3341/jkos.2009.50.5.785

Journal List > J Korean Ophthalmol Soc > v.50(5) > 1008562

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Kim and Huh: A Case of Decompression Retinopathy After Resolution of Acute Primary Angle-Closure Glaucoma

Original Article

J Korean Ophthalmol Soc 2009;50(5):785-789.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.5.785

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

Joo Hoon Kim, MD^1,², Jang Won Huh, MD^1,²

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

²Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea

Address reprint requests to Jang Won Huh, MD Department of Ophthalmology, Seoul National University College of Medicine #28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Korea Tel: 82-2-2072-2438, Fax: 82-2-741-3187, E-mail: hjw68@snu.ac.kr

Received 10 June 2008 Accepted 16 December 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.

Keywords: Acute primary angle closure glaucoma, Decompression retinopathy, Laser peripheral iridotomy

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Figure 1.

(A) Fundus photograph of the right eye taken 3 days after laser peripheral iridotomy. Diffuse deep retinal hemorrhages with a white center are observed in the posterior pole. Optic nerve hemorrhages, disc edema and disc hyperemia were also present. There were dilations and slight tortuosity or irregularity of the veins compared to normal vasculature of the left eye (B). (C) Fluorescein angiogram also shows multiple, blocked fluorescence due to the deep retinal hemorrhages and pre-retinal hemorrhage but the vascular filling appears normal. (D) Hemorrhages, disc edema and disc hyperemia much resolved three months later in the right eye.

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