MR Imaging Features of Giant Reservoir Formation in the Orbit: An Unusual Complication of Ahmed Glaucoma Valve Implantation

Jeon, Tae Yeon; Kim, Hyungjin; Kim, S. T.; Chung, Tae‐Young; Kee, Changwon

doi:10.3174/ajnr.a0610

Cited by 20 publications

(15 citation statements)

References 13 publications

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“…In our case, the motility restriction is probably caused by giant bleb formation, as shown on MRI. This complication has also been described by Jeon and Kim [7].…”

Section: Discussionsupporting

confidence: 70%

Management of congenital glaucoma in neurofibromatosis type 1: a report of two cases

et al. 2009

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The most frequent ophthalmic lesions associated to neurofibromatosis type 1 include iris Lisch nodules, optic nerve gliomas, and neurofibromas located on the eyelid, conjunctiva or orbit. Glaucoma is much less frequent, and it may be difficult to diagnose and treat. We present two patients with neurofibromatosis type 1 and associated congenital glaucoma. In case 1, the glaucoma was present at birth, and was the first symptom of the disease. It was surgically treated by means of an Ahmed glaucoma valve implantation, with good intraocular pressure (IOP) control after 13 months of follow-up. In case 2, the glaucoma appeared at 5 months old, and a trabeculectomy was initially performed; it failed 2 years later and an Ahmed glaucoma valve was then implanted, with adequate IOP control after 7 years of follow-up. Both children were males, and in both cases there were orbital neurofibromas and a dysplasia of the greater wing of the sphenoid of the same side. In case 2, orbital enlargement surgery was also performed at 4 years old. Congenital glaucoma management in the context of neurofibromatosis is very complex due to the frequent association of orbital and eyelid tumors and bone dysplasia, and its prognosis is usually poor. We present two cases in which good control of IOP has been achieved with Ahmed glaucoma valve implantation after 13 months and 7 years of follow-up.

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“…In our case, the motility restriction is probably caused by giant bleb formation, as shown on MRI. This complication has also been described by Jeon and Kim [7].…”

Section: Discussionsupporting

confidence: 70%

Management of congenital glaucoma in neurofibromatosis type 1: a report of two cases

et al. 2009

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“…A gadolinium-enhanced T1-weighted image was used to evaluate the status of the extraocular muscles around the BGI plate [ 22 ] and the fibrosis of the bleb wall around the AGV plate [ 23 ]. A T2-weighted image was used to visualize filtering blebs in eyes implanted with the AGV [ 24 – 26 ] or Molteno implant [ 25 ]. In the current study, MR image were obtained by 3D-FIESTA that enables acquiring high signal-to-noise ratio images with excellent spatial and temporal resolutions [ 27 ] to visualize and quantitate filtering bleb formation and endplate positioning in eyes implanted with the AGV and BGI.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Filtration Bleb and Endplate Positioning Using Magnetic Resonance Imaging in Eyes Implanted with Long-Tube Glaucoma Drainage Devices

et al. 2015

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BackgroundTo evaluate ocular fluid filtration and endplate positioning in glaucomatous eyes with long-tube glaucoma drainage devices (GDDs) using magnetic resonance imaging (MRI) and the effects of various factors on postoperative intraocular pressure (IOP).MethodsThis observational case series included 27 consecutive glaucomatous eyes (18 men, 7 women; mean age ± standard error, 63.0±2.0 years) who underwent GDD implantation (n = 8 Ahmed Glaucoma Valves [AGV] and n = 19 Baerveldt Glaucoma Implants [BGI]). Tubes were inserted into the pars plana in 23 eyes and anterior chamber in 4 eyes. Six months postoperatively, high-resolution orbital images were obtained using 3-Tesla MRI with head-array coils, and the filtering bleb volume, bleb height, and distances between the anterior endplate edge and corneal center or limbus or between the endplate and orbital wall were measured.ResultsIn MR images obtained by three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) sequences, the shunt endplate was identified as low-intensity signal, and the filtering bleb was identified as high-intensity signals above and below the endplate in all eyes. The 6-month-postoperative IOP level was correlated negatively with bleb volume (r = -0.4510, P = 0.0182) and bleb height (r = -0.3954, P = 0.0412). The postoperative IOP was significantly (P = 0.0026) lower in BGI-implanted eyes (12.2±0.7 mmHg) than AGV-implanted eyes (16.7±1.2 mmHg); bleb volume was significantly (P = 0.0093) larger in BGI-implanted eyes (478.8±84.2 mm3) than AGV-implanted eyes (161.1±52.3 mm3). Other parameters did not differ.ConclusionsThe presence of intraorbital/periocular accumulation of ocular fluid affects postoperative IOP levels in eyes implanted with long-tube GDDs. Larger filtering blebs after BGI than AGI implantations explain lower postoperative IOP levels achieved with BGI than AGV. The findings will contribute to better understanding of IOP reducing mechanism of long-tube GDDs.

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“…The Ahmed Glaucoma Valve is designed to limit flow through the tube if IOP becomes too low, a result of use of a valve with a set resistance. This characteristic prevents hypotony as a potential complication (6). The Baerveldt Glaucoma Implant and Molteno implant are both valveless.…”

Section: Teaching Pointsmentioning

confidence: 99%

“…In addition to a bleb secondary to a GDD, the differential diagnosis for a cystic orbital lesion includes dermoid cyst, lymphangioma, lacrimal gland cyst, and abscess. The size of the bleb is variable, ranging from imperceptible to larger than 1 cm ( Fig 6) (6). Blebs are best depicted on T2-weighted images.…”

Section: Teaching Pointsmentioning

confidence: 99%

Postoperative Imaging of the Orbital Contents

Reiter¹,

Schwope²,

Kini³

et al. 2015

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Ophthalmologists perform a wide array of interventions on the orbital contents. The surgical treatment of glaucoma, cataracts, retinal detachment, and ocular trauma or malignancy results in alteration of the standard anatomy, which is often readily evident at radiologic examinations. The ability to accurately recognize the various imaging manifestations after orbital surgery is critical for radiologists to avoid misdiagnosis. Of particular importance is familiarity with the numerous types of implanted devices, such as glaucoma drainage devices, orbital implants, and eyelid weights. Although knowledge of patients' surgical history is helpful, this information is often not available at the time of interpretation. Fortunately, there are characteristic posttreatment findings that enable diagnosis. The imaging features of the most commonly performed ophthalmologic procedures are highlighted, with emphasis on computed tomography and magnetic resonance (MR) imaging, because they are currently the primary modalities involved in evaluating the orbits. Glaucoma drainage devices and orbital implants after enucleation are two of the more pertinent implanted devices because their composition has substantially evolved over the past 2 decades, which affects their imaging appearance. Some devices, such as the Baerveldt Glaucoma Implant and platinum-weighted eyelid implants, may distort radiologic images. The MR imaging safety profiles of numerous implanted devices are also reported.

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MR Imaging Features of Giant Reservoir Formation in the Orbit: An Unusual Complication of Ahmed Glaucoma Valve Implantation

Cited by 20 publications

References 13 publications

Management of congenital glaucoma in neurofibromatosis type 1: a report of two cases

Management of congenital glaucoma in neurofibromatosis type 1: a report of two cases

Assessment of Filtration Bleb and Endplate Positioning Using Magnetic Resonance Imaging in Eyes Implanted with Long-Tube Glaucoma Drainage Devices

Postoperative Imaging of the Orbital Contents

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