Retina

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Case 42

Patient Presentation: A 54-year-old male presented for his 1-week follow-up appointment after undergoing left eye trabeculectomy surgery. On exam, visual acuity is 20/20 OD, 20/60 OS. The anterior chamber appears deep and the filtering bleb appears elevated, diffuse and is Seidel negative. IOP is 4 mmHg OS. OCT macula OS is shown below:

Question: What is the main abnormality seen on the OCT above?

Question: What is the most likely diagnosis?

Question: What is the likely cause of hypotony maculopathy in this patient?

References:​

1. Budenz DL, Schwartz K, Gedde SJ. Occult Hypotony Maculopathy Diagnosed With Optical Coherence Tomography. Arch Ophthalmol. 2005;123(1):113–114.

2. Thomas M, Vajaranant TS, Aref AA. Hypotony Maculopathy: Clinical Presentation and Therapeutic Methods. Ophthalmol Ther. 2015;4(2):79-88.

Learning Objectives:

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1. To diagnose and recognize hypotony maculopathy on OCT

2. To understand the different causes of hypotony maculopathy on OCT

3. To understand the treatment of hypotony maculopathy following filtration surgery