Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy
Purpose: To report a case of retinal pigment epithelial (RPE) tear after trabeculectomy combined with pars plana vitrectomy (PPV). Observations: A 65-year-old man with neovascular glaucoma due to proliferative diabetic retinopathy presented with visual impairment and elevated intraocular pressure (I...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993622004091 |
| _version_ | 1818513591412719616 |
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| author | Miyo Yoshida Yoshikatsu Hosoda Masayuki Akimoto |
| author_facet | Miyo Yoshida Yoshikatsu Hosoda Masayuki Akimoto |
| author_sort | Miyo Yoshida |
| collection | DOAJ |
| description | Purpose: To report a case of retinal pigment epithelial (RPE) tear after trabeculectomy combined with pars plana vitrectomy (PPV). Observations: A 65-year-old man with neovascular glaucoma due to proliferative diabetic retinopathy presented with visual impairment and elevated intraocular pressure (IOP) in the right eye and underwent trabeculectomy combined with PPV. Three weeks after surgery, the best-corrected visual acuity (logarithm of minimal angle of resolution) improved from 3.0 to 0.30, and the IOP was controlled within normal limits. Four weeks after the surgery, he noticed visual impairment and ocular pain in the right eye after continuous coughing associated with asthma. Fundus examination revealed bullous retinal detachment, choroidal detachment, and submacular hemorrhage (SMH) due to a giant RPE tear at the posterior pole. Visual acuity worsened considerably to 1.7, while IOP was not elevated (6 mmHg). The patient received PPV with recombinant tissue plasminogen activator (rt-PA) and fluid/air exchange for internal tamponade and achieved anatomic retinal and choroidal attachments. Conclusions and importance: The acute increase in hydrostatic pressure in the choroidal interstitium due to continuous coughing induces an RPE tear. Vitrectomy with rt-PA and fluid/air exchange may be a favorable treatment for exudative retinal detachment and SMH due to RPE tears. |
| first_indexed | 2024-12-11T00:03:33Z |
| format | Article |
| id | doaj.art-f3aa24d3e78a4c6d850846b1b0f111ef |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-11T00:03:33Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-f3aa24d3e78a4c6d850846b1b0f111ef2022-12-22T01:28:24ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362022-09-0127101663Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomyMiyo Yoshida0Yoshikatsu Hosoda1Masayuki Akimoto2Department of Ophthalmology, Japanese Red Cross Osaka Hospital, Osaka, JapanDepartment of Ophthalmology, Japanese Red Cross Osaka Hospital, Osaka, JapanCorresponding author. Department of Ophthalmology Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho Tennoji-ku, Osaka, 543-8555, Japan.; Department of Ophthalmology, Japanese Red Cross Osaka Hospital, Osaka, JapanPurpose: To report a case of retinal pigment epithelial (RPE) tear after trabeculectomy combined with pars plana vitrectomy (PPV). Observations: A 65-year-old man with neovascular glaucoma due to proliferative diabetic retinopathy presented with visual impairment and elevated intraocular pressure (IOP) in the right eye and underwent trabeculectomy combined with PPV. Three weeks after surgery, the best-corrected visual acuity (logarithm of minimal angle of resolution) improved from 3.0 to 0.30, and the IOP was controlled within normal limits. Four weeks after the surgery, he noticed visual impairment and ocular pain in the right eye after continuous coughing associated with asthma. Fundus examination revealed bullous retinal detachment, choroidal detachment, and submacular hemorrhage (SMH) due to a giant RPE tear at the posterior pole. Visual acuity worsened considerably to 1.7, while IOP was not elevated (6 mmHg). The patient received PPV with recombinant tissue plasminogen activator (rt-PA) and fluid/air exchange for internal tamponade and achieved anatomic retinal and choroidal attachments. Conclusions and importance: The acute increase in hydrostatic pressure in the choroidal interstitium due to continuous coughing induces an RPE tear. Vitrectomy with rt-PA and fluid/air exchange may be a favorable treatment for exudative retinal detachment and SMH due to RPE tears.http://www.sciencedirect.com/science/article/pii/S2451993622004091Choroidal detachmentExudative retinal detachmentRetinal pigment epithelial tearGlaucoma filtering surgerySubmacular hemorrhageRecombinant tissue plasminogen activator |
| spellingShingle | Miyo Yoshida Yoshikatsu Hosoda Masayuki Akimoto Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy American Journal of Ophthalmology Case Reports Choroidal detachment Exudative retinal detachment Retinal pigment epithelial tear Glaucoma filtering surgery Submacular hemorrhage Recombinant tissue plasminogen activator |
| title | Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy |
| title_full | Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy |
| title_fullStr | Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy |
| title_full_unstemmed | Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy |
| title_short | Coughing-induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy |
| title_sort | coughing induced retinal pigment epithelial tear after trabeculectomy combined with pars plana vitrectomy |
| topic | Choroidal detachment Exudative retinal detachment Retinal pigment epithelial tear Glaucoma filtering surgery Submacular hemorrhage Recombinant tissue plasminogen activator |
| url | http://www.sciencedirect.com/science/article/pii/S2451993622004091 |
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