Ocular Decompression Retinopathy with Macular Edema after Deep Sclerectomy with Intrascleral Implantation

Abstract

We report a case of ocular decompression retinopathy (ODR) with macular edema, diagnosed by optical coherence tomography, after a deep sclerectomy (DS) with an intrascleral implant, resolved with medical therapy 6 months later. The medical literature reports that in 14% of patients suffering from ODR, a pars plana vitrectomy was required, and 15% of patients had a poor final visual acuity. An otherwise healthy 75-year-old man with high myopia and a primary open-angle glaucoma, with previous intraocular pressure (IOP) of 24 mm Hg, underwent a DS with intrascleral implant without complications. The patient suffered postoperatively from ODR with macular edema that required medical therapy with nonsteroidal anti-inflammatory eye drops (Nepafenac ® 0.3%) for a period of 6 months. ODR is an infrequent complication that may occur after any surgical or medical procedure that causes a sudden IOP decrease. The presence of macular edema is only reported in 5% of cases and can occur in patients who report a decreased visual acuity, commonly associated with a retinal hemorrhage. We have described a case of ODR with macular edema after DS with intrascleral implant. Although ODR is considered to cause a low level of morbidity, in some patients this may not be the case.

Multimodal Imaging Techniques in Monitoring a Patient with Ocular Decompression Retinopathy

“…Non-invasive OCTA and invasive UWF-FA were performed to assess the vascular structure of the posterior pole of the eye (Figure 3). In most of the previous reports, OCT scans of ODR were not included; therefore, a decrease in BVCA has been attributed to macular blot hemorrhage [12]. Mukkamala et al found macular edema in 5% of the ODR cases [3].…”

“…In most of the previous reports, OCT scans of ODR were not included; therefore, a decrease in BVCA has been attributed to macular blot hemorrhage [ 12 ]. Mukkamala et al found macular edema in 5% of the ODR cases [ 3 ].…”