Bilateral giant retinal pigment epithelial tears in hypertensive choroidopathy

Matsubara, Natsuki; Kato, Aki; Kominami, Aoi; Nozaki, Miho; Yasukawa, Tsutomu; Yoshida, Munenori; Ogura, Yuichiro

doi:10.1016/j.ajoc.2019.100525

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…RPE tears outside the macula, as in this case, are very rare. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 In particular, there have been only a few reports of RPE tears after glaucoma filtering surgery, 2 , 3 , 4 the pathophysiology has not been clearly described and the appropriate treatment has not been established. In this report, we showed that hypotony is central to the development of this condition and that elevating IOP is essential for the treatment.…”

Section: Discussionmentioning

confidence: 99%

Retinal detachment with retinal pigment epithelial tear under hypotony after trabeculectomy: A case report

Harada

Okumichi

Miyata

et al. 2020

American Journal of Ophthalmology Case Reports

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Purpose To report a case of retinal detachment with retinal pigment epithelium (RPE) tear, under hypotony after trabeculectomy, which immediately resolved upon elevation of intraocular pressure. Observations A 67-year-old man who had undergone trabeculectomy presented for treatment of a visual field defect in his left eye. His glaucoma surgery was uneventful. At his first visit to our clinic, the patient's visual acuity was 15/20 in the right eye and 20/40 in the left; intraocular pressure was 18 mmHg in the right and 5 mmHg in the left. Fundus examination of the left eye revealed a retinal detachment, overlying a choroidal detachment, and an RPE tear. The retinal detachment did not resolve with systemic steroid pulse therapy or vitrectomy. The patient was then diagnosed with an exudative retinal detachment with RPE tear under hypotony, and transconjunctival sutures were applied to tighten the scleral flap, to elevate intraocular pressure. After the transconjunctival sutures were applied, intraocular pressure increased to 10 mmHg and the exudative retinal detachment immediately resolved. There was no recurrence of retinal detachment after the intervention. Conclusions and importance Because there have been few case reports of retinal detachment with an RPE tear after glaucoma filtering surgery, no therapeutic strategy has yet been proposed. The findings in this case indicate that intraocular pressure elevation is effective for treating exudative retinal detachment with RPE tear in cases of hypotony after glaucoma filtering surgery.

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Section: Discussionmentioning

confidence: 99%

Retinal detachment with retinal pigment epithelial tear under hypotony after trabeculectomy: A case report

Harada

Okumichi

Miyata

et al. 2020

American Journal of Ophthalmology Case Reports

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“…Giant RPE rip has also been reported in patients with hypertensive choroidopathy. [ 7 8 ] The blood pressure of our patient was also high. However, unilateral presentation as well as the absence of other typical features such as retinal hemorrhages, hard exudates, disc edema, and exudative retinal detachment makes hypertensive choroidopathy in this patient unlikely.…”

Section: Discussionmentioning

confidence: 62%

Serpentine retinal pigment epithelial tear

Maitray¹,

Kohli²,

Babu³

2021

Taiwan Journal of Ophthalmology

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We report a case of retinal pigment epithelial tear in a patient with peripheral exudative hemorrhagic chorioretinopathy (PEHCR). A 60-year-old diabetic female presented with left eye metamorphopsia. Fundus examination showed bilateral peripheral retinal pigment epithelium (RPE) degeneration, and a large serpentine-shaped RPE degeneration tract extending from the superotemporal arcade to the inferior periphery with associated subretinal hemorrhages in her left eye. This tract curved around the fovea, just sparing it. Fundus fluorescein and indocyanine green angiographies showed bilateral polyps in the superotemporal periphery. Optical coherence tomography through the tract showed scrolled up RPE at its edges with bare underlying Bruch's membrane and choroid in the region of the rip. There was no sign of an underlying pigment epithelial detachment. The patients with PEHCR should be prognosticated about such a rare vision-threatening macular complication.

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“…4 Therefore, successful blood pressure management could contribute to the prompt resolution of exudative retinal detachment, as reported in previous cases. 8 In our case, several drugs were used to treat the aHUS and the hypertensive crisis. In particular, Eculizumab, which is a humanized monoclonal antibody against complement protein C5a.…”

Section: Discussionmentioning

confidence: 89%

Hypertensive choroidopathy in atypical hemolytic-uremic syndrome

Polito

Machetta

Fea

et al. 2019

European Journal of Ophthalmology

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Purpose: We present the case of a 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome with a hypertensive crisis, who presented a bilateral serous retinal detachment. Case Description: A 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome, was referred for blurred vision in both eyes, evolving over 7 days. Treatment including hemodialysis, plasma exchange, systemic steroids, antihypertensive medications and eculizumab was started 1 month prior to referral. At presentation, best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye. Retinal examination revealed bilateral serous retinal detachment in the posterior pole and some small, flat, variably pigmented lesions. Optical coherence tomography confirmed marked serous retinal detachment in both eyes. Fluorescein and indocyanine green angiography was performed. Treatment for systemic hypertension was changed. Seven days later, dilated fundus examination and optical coherence tomography demonstrated a significant regression of the serous retinal detachment. Her visual acuity improves in both eyes at the last control, showing at fundus examination a complete resolution of the exudative detachment but a persistence of variable flat pigmented lesion. Conclusion: Although multiple organ systems are commonly affected in hemolytic uremic syndrome, ocular involvement has only been described in very few cases. Ocular manifestations in atypical hemolytic uremic syndrome include retinal, choroidal and vitreal hemorrhages, retina and/or ischemic signs. Bilateral serous retinal detachment may also be a sign of atypical hemolytic uremic syndrome or even the first manifestation of a hypertensive event.

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Bilateral giant retinal pigment epithelial tears in hypertensive choroidopathy

Cited by 5 publications

References 15 publications

Retinal detachment with retinal pigment epithelial tear under hypotony after trabeculectomy: A case report

Retinal detachment with retinal pigment epithelial tear under hypotony after trabeculectomy: A case report

Serpentine retinal pigment epithelial tear

Hypertensive choroidopathy in atypical hemolytic-uremic syndrome

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