Ramtohul Prithvi, Chardavoine Maëva, Beylerian Marie, Aziz Aurore, Matonti Frédéric, Denis Danièle
Centre Hospitalier Universitaire de l'Hôpital Nord, chemin des Bourrely, 13015, Marseille, France.
Centre Hospitalier Henri Duffaut d'Avignon, 305 rue Raoul Follereau, 84000, Avignon, France.
BMC Ophthalmol. 2018 Sep 5;18(1):240. doi: 10.1186/s12886-018-0906-z.
To describe a unique case of decompression retinopathy manifesting as pre-macular subhyaloid hemorrhage that occurs in a nine-day old child after undergoing a non-penetrating deep sclerectomy for primary congenital glaucoma.
We report a single case of a 9-day-old boy who was referred to our department of ophthalmology for bilateral buphtalmia and corneal edema. He presented marked elevation of the intraocular pressure in both eyes (22 mmHg and 26 mmHg, in the right eye and left eye respectively) associated with significant optic nerve cupping. Non-penetrating deep sclerectomy was performed for each eye, with effective reduction of the intraocular pressure during the first week postoperatively (11 mmHg and 7 mmHg in the right eye and left eye respectively). The right eye presented an isolated subhyaloid hemorrhage located in the pre-macular area, persisting 3 weeks after the initial surgery and requiring pars-plana vitrectomy to clear the visual axis. This uncommon complication was identified as decompression retinopathy. The intraocular pressure remained controlled in the normal range three years after initial surgery in both eyes, with reversal of optic disc cupping.
Decompression retinopathy is a potential complication after non-penetrating deep sclerectomy in primary congenital glaucoma, requiring prompt treatment strategy to prevent potential organic amblyopia.
描述一例独特的减压性视网膜病变，表现为黄斑前玻璃体下出血，发生在一名9天大的儿童身上，该儿童因原发性先天性青光眼接受了非穿透性深层巩膜切除术。
我们报告一例9天大的男孩，因双眼眼球增大和角膜水肿被转诊至我们的眼科。他双眼眼压显著升高（右眼和左眼分别为22 mmHg和26 mmHg），伴有明显的视神经杯状凹陷。对每只眼睛进行了非穿透性深层巩膜切除术，术后第一周眼压有效降低（右眼和左眼分别为11 mmHg和7 mmHg）。右眼在黄斑前区出现孤立的玻璃体下出血，在初次手术后持续3周，需要进行玻璃体切除术以清除视轴。这种罕见的并发症被确定为减压性视网膜病变。初次手术后三年，双眼眼压仍控制在正常范围内，视神经盘杯状凹陷得到逆转。
减压性视网膜病变是原发性先天性青光眼非穿透性深层巩膜切除术后的一种潜在并发症，需要及时的治疗策略以预防潜在的器质性弱视。
