Macular changes detected by Fourier-domain optical coherence tomography in patients with hypotony without clinical maculopathy.
OBJECTIVE
To investigate macular changes in eyes with postoperative hypotony without clinical maculopathy using high-resolution Fourier-domain optical coherence tomography (FD-OCT).


METHODS
Fourteen eyes of 12 patients with postoperative intraocular pressure (IOP) ￡ 6 mmHg for at least 4 weeks but with no detectable clinical features associated with hypotony maculopathy were imaged by FD-OCT prospectively. Images were analysed by two retina specialists masked to clinical findings.


RESULTS
Most patients were female (83%) and myopic (75%) with a mean age of 65 ± 17 [standard deviation (SD)] years (range 2–86 years). Mean central corneal thickness was 519 ± 34 lm [95% confidence interval (CI) 502–537] and mean IOP before surgery was 20 ± 8 mmHg (95% CI 15–24). During the period of hypotony (mean 15 ± 6 weeks), the average mean IOP was 4 ± 1 mmHg (95% CI 3–5). Abnormal FD-OCT findings (retinal folds and ⁄ or intraretinal fluid) were present in eight eyes. These patients had a higher rate of visual symptoms (75% versus 17%), visual acuity loss (‡ 2 lines; 63% versus 17%) and increased mean foveal thickness (250 ± 26 versus 210 ± 12 lm; p < 0.01, Mann–Whitney U-test) compared with those with normal FD-OCT.


CONCLUSIONS
FD-OCT identified subclinical macular abnormalities in over half of the eyes with postoperative hypotony. These findings were accompanied by visual disturbances and central macular thickening. FD-OCT can be an important diagnostic tool for this disorder when clinical features are absent.
Lima
Verônica C
VC
Retina Service, New York Eye and Ear Infirmary, New York, NY 10003, USA.
Prata
Tiago S
TS
Castro
Dinorah P E
DP
Castro
Leonardo C
LC
De Moraes
Carlos G V
CG
Mattox
Cynthia
C
Rosen
Richard B
RB
Liebmann
Jeffrey M
JM
Ritch
Robert
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D018463:Filtering Surgery / Q000009:adverse effects; D005583:Fourier Analysis; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology*; D011183:Postoperative Complications; D011446:Prospective Studies; D012164:Retinal Diseases / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014792:Visual Acuity; D055815:Young Adult