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Hypotonic maculopathy
Last reviewed: 23.04.2024
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Hypotonic maculopathy is a condition in which folds of choroid and / or retina are formed with involvement of the macular area, leading to a decrease in vision against the background of hypotension. A likely mechanism of development is scleral contraction. Maculopathy develops in hypotension not in all cases, more often in young patients with myopia and in patients with a significant decrease in intraocular pressure. Such a condition should be treated quickly, as there is a tendency to a chronic course of the process. However, there are reports of successful treatment of patients and after several years of the course of the disease.
The best treatment is prevention, for example, paracentesis with a safe valve method developed by Palmberg. In addition, to prevent maculopathy, Palmberg described the technique of revising the filtration pads with the help of two groups of additional sutures. The first group of two sutures regulates outflow from the flap with intraocular pressure from 8 to 12 mm Hg. The second group is applied at a pressure of 20 to 25 mm Hg. It is important to remember that during the revision of the flap, donor tissue may be needed.
Causes of changes in intraocular pressure and the formation of a small anterior chamber
High intraocular pressure and small chamber
- The syndrome of disturbance of watery moisture current (ie malignant glaucoma)
- Hemorrhage in the suprachoroidal space
- Pupil block
Low intraocular pressure and small chamber
- Hyperfiltration with insufficient valve resistance
- Apoc in the uveoscleral tract due to choroid detachment
- Cyclodialysis
- A true shallow chamber with a contact between the lens and the cornea or between the surface of the intraocular lens and the cornea (treatment should be started immediately)
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