Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes

Figures & data

Table 1 Summary of cases with hypotony maculopathy treated with vitreoretinal surgery

Case	Age in years	Etiology	Glaucoma stage	SE (Diopters)	IOP s	TH s	Measures taken to increase IOP	IOP c	TH c	IOP post	T-HPL	BCVA at baseline	BCVA at 4 months	BCVA at 12 months
1	62	TBC hyperfiltration	M	−7	–	–	Topical dexamethasone	7–10	28	11	56	0.260	0.301	0.398
2	59	TBC hyperfiltration	M	−16	5–6	4	CD drainage Topical dexamethasone Subtenonian triamcinolone	10	20	12	30	0.699	0.699	1
3	62	TBC hyperfiltration	M	−15.75	2–3	2	Supplementary scleral suture	10–12	16	18	NO	0.301	0.699	0.699
4	62	Post-traumatic TBC hyperfiltration	M	−19	0	2	Subtenonian triamcinolone	–	–	12	NO	2.3	0.602	0.222
5	32	Cyclodialysis	–	−7.7	5–6	8	Subtenonian triamcinolone CCG + SF6	16–18	16	18	32	0.824	0.523	0.523

Abbreviations: TBC, trabeculectomy; M, moderate-stage glaucoma; SE, spherical equivalent; IOP, initial intraocular pressure at baseline (s, statistical hypotony in diagnosis of HM; c, clinical hypotony IOP before PPV; post, 12 months after PPV); CCG, cryocoagulation; TH, time (weeks) with hypotony before vitrectomy (c, with clinical hypotony; s, with statistical hypotony); CD, choroidal detachment; T-HP, time (weeks) from diagnosis of HM to the appearance of hyperpigmentation lines; BCVA, best corrected visual acuity (preoperative, m, months after surgery); HM, hypotony maculopathy; PPV, pars plana vitrectomy; T-HPL, time in months of hyperpigmentation lines.

Figure 1 (A) Preoperative hypotony maculopathy shown by posterior pole biomicroscopy (A1) and by optical coherence tomography (A2) in case 1. (B) Biomicroscopy (B1) and optical coherence tomography obtained one year after vitreoretinal surgery (B2) in case 1. Note the increase of hyperpigmentation (B1) despite resolution of the retinal folds, but not the choroidal folds (B2) in case 1.