Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy
Purpose: To describe the diagnosis and management of a patient with primary open angle glaucoma (POAG) who developed suprachoroidal hemorrhage (SCH) after micropulse cyclophotocoagulation (MPCPC) therapy. Observations: A 77 year-old Caucasian man with end-stage POAG and multiple medical comorbiditie...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-06-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993618303396 |
| _version_ | 1818287422828445696 |
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| author | Alisa J. Prager Anupama R. Anchala |
| author_facet | Alisa J. Prager Anupama R. Anchala |
| author_sort | Alisa J. Prager |
| collection | DOAJ |
| description | Purpose: To describe the diagnosis and management of a patient with primary open angle glaucoma (POAG) who developed suprachoroidal hemorrhage (SCH) after micropulse cyclophotocoagulation (MPCPC) therapy. Observations: A 77 year-old Caucasian man with end-stage POAG and multiple medical comorbidities including coronary artery disease on anticoagulation presented with 2 days of episodic, severe left eye pain 2 weeks after undergoing MPCPC diode in the left eye. His visual acuity was count fingers at 2 feet and his intraocular pressure (IOP) was 44. He had a shallow anterior chamber that was open to trabecular meshwork on gonioscopy. His dilated fundus exam showed large, dome-shaped hemorrhagic choroidals, which were confirmed on ultrasound. He was medically managed with analgesics, cycloplegics, topical steroids and IOP lowering medications. He was closely followed with serial b-scans and the SCH decreased in size without surgical intervention, however, his visual acuity did not improve from presentation. Conclusions and importance: MPCPC diode has been increasingly used in refractory glaucoma and is considered to be a relatively safe procedure. Suprachoroidal hemorrhage has not yet been reported after MPCPC diode. This case demonstrates how devastating complications such as SCH can still occur with lower energy CPC therapy especially in the setting of post-procedural hypotony, and emphasizes the importance of prevention especially in high-risk patients. |
| first_indexed | 2024-12-13T01:40:14Z |
| format | Article |
| id | doaj.art-b4fe7bdb7ac041e5bb0d8f55a532abe0 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-13T01:40:14Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-b4fe7bdb7ac041e5bb0d8f55a532abe02022-12-22T00:03:47ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-06-0118Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapyAlisa J. Prager0Anupama R. Anchala1Department of Ophthalmology, Northwestern Feinberg School of Medicine, Chicago, IL, USACorresponding author. 645 N Michigan Avenue Suite 440 Chicago, IL, 60611, USA.; Department of Ophthalmology, Northwestern Feinberg School of Medicine, Chicago, IL, USAPurpose: To describe the diagnosis and management of a patient with primary open angle glaucoma (POAG) who developed suprachoroidal hemorrhage (SCH) after micropulse cyclophotocoagulation (MPCPC) therapy. Observations: A 77 year-old Caucasian man with end-stage POAG and multiple medical comorbidities including coronary artery disease on anticoagulation presented with 2 days of episodic, severe left eye pain 2 weeks after undergoing MPCPC diode in the left eye. His visual acuity was count fingers at 2 feet and his intraocular pressure (IOP) was 44. He had a shallow anterior chamber that was open to trabecular meshwork on gonioscopy. His dilated fundus exam showed large, dome-shaped hemorrhagic choroidals, which were confirmed on ultrasound. He was medically managed with analgesics, cycloplegics, topical steroids and IOP lowering medications. He was closely followed with serial b-scans and the SCH decreased in size without surgical intervention, however, his visual acuity did not improve from presentation. Conclusions and importance: MPCPC diode has been increasingly used in refractory glaucoma and is considered to be a relatively safe procedure. Suprachoroidal hemorrhage has not yet been reported after MPCPC diode. This case demonstrates how devastating complications such as SCH can still occur with lower energy CPC therapy especially in the setting of post-procedural hypotony, and emphasizes the importance of prevention especially in high-risk patients.http://www.sciencedirect.com/science/article/pii/S2451993618303396GlaucomaSuprachoroidal hemorrhageMicropulse cyclophotocoagulation diode |
| spellingShingle | Alisa J. Prager Anupama R. Anchala Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy American Journal of Ophthalmology Case Reports Glaucoma Suprachoroidal hemorrhage Micropulse cyclophotocoagulation diode |
| title | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
| title_full | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
| title_fullStr | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
| title_full_unstemmed | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
| title_short | Suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
| title_sort | suprachoroidal hemorrhage after micropulse cyclophotocoagulation diode therapy |
| topic | Glaucoma Suprachoroidal hemorrhage Micropulse cyclophotocoagulation diode |
| url | http://www.sciencedirect.com/science/article/pii/S2451993618303396 |
| work_keys_str_mv | AT alisajprager suprachoroidalhemorrhageaftermicropulsecyclophotocoagulationdiodetherapy AT anupamaranchala suprachoroidalhemorrhageaftermicropulsecyclophotocoagulationdiodetherapy |