title: Late-onset Hypotony Maculopathy After Trabeculectomy in a Highly Myopic Patient With Juvenile Open-angle Glaucoma.
abstract: Hypotony maculopathy is a sight-threatening complication after trabeculectomy. We report on a 34-year-old man with juvenile open-angle glaucoma and high myopia, who developed hypotony maculopathy 14 years after trabeculectomy without bleb leak. This represents the longest known period from trabeculectomy to the development of hypotony maculopathy without bleb leak. The possible mechanisms for the development of late-onset hypotony maculopathy in the highly myopic patient are progressive scleral thinning, reduced scleral rigidity, and scleral morphologic change with aging. These changes might weaken the biomechanical properties of sclera and then contribute to the collapse of the scleral wall during hypotony. This case serves as a reminder that hypotony maculopathy can happen up to 14 years after tabeculectomy even without bleb leak and hypotony should be avoided after trabeculectomy in highly myopic patients with juvenile open-angle glaucoma.
authors.affiliation: Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Shu-Ting
authors.initials: ST
authors.lastname: Kao
authors.forename: Shwu-Huey
authors.initials: SH
authors.lastname: Lee
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D047728:Myopia, Degenerative / Q000503:physiopathology / Q000601:surgery*; D015814:Ocular Hypotension / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014031:Tobramycin / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D001623:Betamethasone; D014031:Tobramycin