Cargando…

Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy

We report a challenging case of recurrent flat anterior chamber without hypotony after trabeculectomy in a 54-year-old Black male with a remote history of steroid-treated polymyositis, cataract surgery, and uncontrolled open angle glaucoma. The patient presented with a flat chamber on postoperative...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Shaohui, Sun, Lisa L., Kavanaugh, A. Scott, Langford, Marlyn P., Liang, Chanping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843902/
https://www.ncbi.nlm.nih.gov/pubmed/24348402
http://dx.doi.org/10.1159/000356166
_version_ 1782293110191030272
author Liu, Shaohui
Sun, Lisa L.
Kavanaugh, A. Scott
Langford, Marlyn P.
Liang, Chanping
author_facet Liu, Shaohui
Sun, Lisa L.
Kavanaugh, A. Scott
Langford, Marlyn P.
Liang, Chanping
author_sort Liu, Shaohui
collection PubMed
description We report a challenging case of recurrent flat anterior chamber without hypotony after trabeculectomy in a 54-year-old Black male with a remote history of steroid-treated polymyositis, cataract surgery, and uncontrolled open angle glaucoma. The patient presented with a flat chamber on postoperative day 11, but had a normal fundus exam and intraocular pressure (IOP). Flat chamber persisted despite treatment with cycloplegics, steroids, and a Healon injection into the anterior chamber. A transverse B-scan of the peripheral fundus revealed a shallow annular peripheral choroidal detachment. The suprachoroidal fluid was drained. The patient presented 3 days later with a recurrent flat chamber and an annular peripheral choroidal effusion. The fluid was removed and reinforcement of the scleral flap was performed with the resolution of the flat anterior chamber. A large corneal epithelial defect developed after the second drainage. The oral prednisone was tapered quickly and the topical steroid was decreased. One week later, his vision decreased to count fingers with severe corneal stromal edema and Descemet's membrane folds that improved to 20/50 within 24 h of resumption of the oral steroid and frequent topical steroid. The patient's visual acuity improved to 20/20 following a slow withdrawal of the oral and topical steroid. Eight months after surgery, the IOP was 15 mm Hg without glaucoma medication. The detection of a shallow anterior choroidal detachment by transverse B-scan is critical to making the correct diagnosis. Severe cornea edema can occur if the steroid is withdrawn too quickly. Thus, steroids should be tapered cautiously in steroid-dependent patients.
format Online
Article
Text
id pubmed-3843902
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-38439022013-12-12 Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy Liu, Shaohui Sun, Lisa L. Kavanaugh, A. Scott Langford, Marlyn P. Liang, Chanping Case Rep Ophthalmol Published online: October, 2013 We report a challenging case of recurrent flat anterior chamber without hypotony after trabeculectomy in a 54-year-old Black male with a remote history of steroid-treated polymyositis, cataract surgery, and uncontrolled open angle glaucoma. The patient presented with a flat chamber on postoperative day 11, but had a normal fundus exam and intraocular pressure (IOP). Flat chamber persisted despite treatment with cycloplegics, steroids, and a Healon injection into the anterior chamber. A transverse B-scan of the peripheral fundus revealed a shallow annular peripheral choroidal detachment. The suprachoroidal fluid was drained. The patient presented 3 days later with a recurrent flat chamber and an annular peripheral choroidal effusion. The fluid was removed and reinforcement of the scleral flap was performed with the resolution of the flat anterior chamber. A large corneal epithelial defect developed after the second drainage. The oral prednisone was tapered quickly and the topical steroid was decreased. One week later, his vision decreased to count fingers with severe corneal stromal edema and Descemet's membrane folds that improved to 20/50 within 24 h of resumption of the oral steroid and frequent topical steroid. The patient's visual acuity improved to 20/20 following a slow withdrawal of the oral and topical steroid. Eight months after surgery, the IOP was 15 mm Hg without glaucoma medication. The detection of a shallow anterior choroidal detachment by transverse B-scan is critical to making the correct diagnosis. Severe cornea edema can occur if the steroid is withdrawn too quickly. Thus, steroids should be tapered cautiously in steroid-dependent patients. S. Karger AG 2013-10-24 /pmc/articles/PMC3843902/ /pubmed/24348402 http://dx.doi.org/10.1159/000356166 Text en Copyright © 2013 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Published online: October, 2013
Liu, Shaohui
Sun, Lisa L.
Kavanaugh, A. Scott
Langford, Marlyn P.
Liang, Chanping
Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy
title Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy
title_full Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy
title_fullStr Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy
title_full_unstemmed Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy
title_short Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy
title_sort recurrent annular peripheral choroidal detachment after trabeculectomy
topic Published online: October, 2013
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843902/
https://www.ncbi.nlm.nih.gov/pubmed/24348402
http://dx.doi.org/10.1159/000356166
work_keys_str_mv AT liushaohui recurrentannularperipheralchoroidaldetachmentaftertrabeculectomy
AT sunlisal recurrentannularperipheralchoroidaldetachmentaftertrabeculectomy
AT kavanaughascott recurrentannularperipheralchoroidaldetachmentaftertrabeculectomy
AT langfordmarlynp recurrentannularperipheralchoroidaldetachmentaftertrabeculectomy
AT liangchanping recurrentannularperipheralchoroidaldetachmentaftertrabeculectomy