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Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy
PURPOSE: To describe the diagnosis and management of a patient with primary open angle glaucoma (POAG) who developed suprachoroidal hemorrhage (SCH) after micropulse cyclophotocoagulation (MPCPC) therapy. OBSERVATIONS: A 77 year-old Caucasian man with end-stage POAG and multiple medical comorbiditie...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082505/ https://www.ncbi.nlm.nih.gov/pubmed/32211563 http://dx.doi.org/10.1016/j.ajoc.2020.100659 |
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author | Prager, Alisa J. Anchala, Anupama R. |
author_facet | Prager, Alisa J. Anchala, Anupama R. |
author_sort | Prager, Alisa J. |
collection | PubMed |
description | PURPOSE: To describe the diagnosis and management of a patient with primary open angle glaucoma (POAG) who developed suprachoroidal hemorrhage (SCH) after micropulse cyclophotocoagulation (MPCPC) therapy. OBSERVATIONS: A 77 year-old Caucasian man with end-stage POAG and multiple medical comorbidities including coronary artery disease on anticoagulation presented with 2 days of episodic, severe left eye pain 2 weeks after undergoing MPCPC diode in the left eye. His visual acuity was count fingers at 2 feet and his intraocular pressure (IOP) was 44. He had a shallow anterior chamber that was open to trabecular meshwork on gonioscopy. His dilated fundus exam showed large, dome-shaped hemorrhagic choroidals, which were confirmed on ultrasound. He was medically managed with analgesics, cycloplegics, topical steroids and IOP lowering medications. He was closely followed with serial b-scans and the SCH decreased in size without surgical intervention, however, his visual acuity did not improve from presentation. CONCLUSIONS AND IMPORTANCE: MPCPC diode has been increasingly used in refractory glaucoma and is considered to be a relatively safe procedure. Suprachoroidal hemorrhage has not yet been reported after MPCPC diode. This case demonstrates how devastating complications such as SCH can still occur with lower energy CPC therapy especially in the setting of post-procedural hypotony, and emphasizes the importance of prevention especially in high-risk patients. |
format | Online Article Text |
id | pubmed-7082505 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-70825052020-03-24 Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy Prager, Alisa J. Anchala, Anupama R. Am J Ophthalmol Case Rep Case Report PURPOSE: To describe the diagnosis and management of a patient with primary open angle glaucoma (POAG) who developed suprachoroidal hemorrhage (SCH) after micropulse cyclophotocoagulation (MPCPC) therapy. OBSERVATIONS: A 77 year-old Caucasian man with end-stage POAG and multiple medical comorbidities including coronary artery disease on anticoagulation presented with 2 days of episodic, severe left eye pain 2 weeks after undergoing MPCPC diode in the left eye. His visual acuity was count fingers at 2 feet and his intraocular pressure (IOP) was 44. He had a shallow anterior chamber that was open to trabecular meshwork on gonioscopy. His dilated fundus exam showed large, dome-shaped hemorrhagic choroidals, which were confirmed on ultrasound. He was medically managed with analgesics, cycloplegics, topical steroids and IOP lowering medications. He was closely followed with serial b-scans and the SCH decreased in size without surgical intervention, however, his visual acuity did not improve from presentation. CONCLUSIONS AND IMPORTANCE: MPCPC diode has been increasingly used in refractory glaucoma and is considered to be a relatively safe procedure. Suprachoroidal hemorrhage has not yet been reported after MPCPC diode. This case demonstrates how devastating complications such as SCH can still occur with lower energy CPC therapy especially in the setting of post-procedural hypotony, and emphasizes the importance of prevention especially in high-risk patients. Elsevier 2020-03-14 /pmc/articles/PMC7082505/ /pubmed/32211563 http://dx.doi.org/10.1016/j.ajoc.2020.100659 Text en © 2020 Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Prager, Alisa J. Anchala, Anupama R. Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
title | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
title_full | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
title_fullStr | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
title_full_unstemmed | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
title_short | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
title_sort | suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082505/ https://www.ncbi.nlm.nih.gov/pubmed/32211563 http://dx.doi.org/10.1016/j.ajoc.2020.100659 |
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