Combined mechanism glaucoma asociated with Grave's Ophtalmopathy

A 69-year-old female presented marked vision loss in both eyes, intense photophobia and ocular pain. The patient had long history of uncompensated glaucoma, Graves ophtalmopathy, treated for several years with topical medication without normalizing the intraocular pressure. The patient undergo orbit...

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Main Authors: D. Costin, C. Constantin, M. P. Bucatariu, A. al Mousa, Andreea Dana Moraru
Format: Article
Language:English
Published: London Academic Publishing 2010-09-01
Series:Romanian Neurosurgery
Subjects:
Online Access:https://journals.lapub.co.uk/index.php/roneurosurgery/article/view/516
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author D. Costin
C. Constantin
M. P. Bucatariu
A. al Mousa
Andreea Dana Moraru
author_facet D. Costin
C. Constantin
M. P. Bucatariu
A. al Mousa
Andreea Dana Moraru
author_sort D. Costin
collection DOAJ
description A 69-year-old female presented marked vision loss in both eyes, intense photophobia and ocular pain. The patient had long history of uncompensated glaucoma, Graves ophtalmopathy, treated for several years with topical medication without normalizing the intraocular pressure. The patient undergo orbital decompression for Grave’s ophtalmopathy which ameliorated the exophthalmia. Visual assessment showed 0,08 best corrected visual acuity (BCVA) in the right eye respectively 0 in the left eye, posterior chamber pseudophakic implant both eyes, posterior capsular opacification left eye. The intraocular pressure was 18-25 mmHg in the right eye, respectively 14-19 mm Hg under topical medication. The cup-disc ratio was 0.8 in the RE respectively 0.9-1 in the LE. The visual field assessment in the RE showed relative central scotoma, complete lower arcuate (Bjerrum) scotoma, generalized depresion of VF. We performed RE trabeculectomy with 5 fluorouracil and collagen implant (OLOGEN®), with good postoperative evolution. The Visual Acuity improves significantly to 0.1, the IOP after a month was 15 mm Hg. The onset, symptomatology and general clinical context of the patient determined the focus on the neuro-ophthalmological aspect of the case, even if that meant that the control of the glaucoma, at times obviously inefficient, would remain second, from the perspective of its importance.
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spelling doaj.art-ffcd07fc812f44898223bdc0cb3357342022-12-22T02:04:10ZengLondon Academic PublishingRomanian Neurosurgery1220-88412344-49592010-09-01173Combined mechanism glaucoma asociated with Grave's OphtalmopathyD. CostinC. ConstantinM. P. BucatariuA. al MousaAndreea Dana MoraruA 69-year-old female presented marked vision loss in both eyes, intense photophobia and ocular pain. The patient had long history of uncompensated glaucoma, Graves ophtalmopathy, treated for several years with topical medication without normalizing the intraocular pressure. The patient undergo orbital decompression for Grave’s ophtalmopathy which ameliorated the exophthalmia. Visual assessment showed 0,08 best corrected visual acuity (BCVA) in the right eye respectively 0 in the left eye, posterior chamber pseudophakic implant both eyes, posterior capsular opacification left eye. The intraocular pressure was 18-25 mmHg in the right eye, respectively 14-19 mm Hg under topical medication. The cup-disc ratio was 0.8 in the RE respectively 0.9-1 in the LE. The visual field assessment in the RE showed relative central scotoma, complete lower arcuate (Bjerrum) scotoma, generalized depresion of VF. We performed RE trabeculectomy with 5 fluorouracil and collagen implant (OLOGEN®), with good postoperative evolution. The Visual Acuity improves significantly to 0.1, the IOP after a month was 15 mm Hg. The onset, symptomatology and general clinical context of the patient determined the focus on the neuro-ophthalmological aspect of the case, even if that meant that the control of the glaucoma, at times obviously inefficient, would remain second, from the perspective of its importance.https://journals.lapub.co.uk/index.php/roneurosurgery/article/view/516combined mechanism glaucomacompressive ischemic optic neuropathyGrave's orbitopathycollagen implant.
spellingShingle D. Costin
C. Constantin
M. P. Bucatariu
A. al Mousa
Andreea Dana Moraru
Combined mechanism glaucoma asociated with Grave's Ophtalmopathy
Romanian Neurosurgery
combined mechanism glaucoma
compressive ischemic optic neuropathy
Grave's orbitopathy
collagen implant.
title Combined mechanism glaucoma asociated with Grave's Ophtalmopathy
title_full Combined mechanism glaucoma asociated with Grave's Ophtalmopathy
title_fullStr Combined mechanism glaucoma asociated with Grave's Ophtalmopathy
title_full_unstemmed Combined mechanism glaucoma asociated with Grave's Ophtalmopathy
title_short Combined mechanism glaucoma asociated with Grave's Ophtalmopathy
title_sort combined mechanism glaucoma asociated with grave s ophtalmopathy
topic combined mechanism glaucoma
compressive ischemic optic neuropathy
Grave's orbitopathy
collagen implant.
url https://journals.lapub.co.uk/index.php/roneurosurgery/article/view/516
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AT aalmousa combinedmechanismglaucomaasociatedwithgravesophtalmopathy
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