Sun Catherine Q, Medert Charles M, Chang Ta Chen
Department of Ophthalmology, University of California, San Francisco, CA, USA.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Am J Ophthalmol Case Rep. 2020 Apr 15;18:100712. doi: 10.1016/j.ajoc.2020.100712. eCollection 2020 Jun.
To report a case of unilateral idiopathic elevated episcleral venous pressure (IEEVP) in a 15-year-old patient. We reviewed and summarized published case reports of IEEVP to determine how to manage this challenging and rare condition.
A 15-year-old Caucasian male presented with elevated intraocular pressures (IOP), blood in Schlemm canal in the left eye, and asymmetric cupping with corresponding glaucomatous findings on testing. We diagnosed the patient with IEEVP and describe successful surgical intervention with deep sclerectomy and viscocanalostomy.
IEEVP is a diagnosis of exclusion and based on clinical findings of dilated episcleral veins, blood in Schlemm canal and glaucomatous changes. If glaucomatous progression occurs with medication, filtration surgery is usually required, and most patients have good results in the literature. Care should be taken to prevent post-operative hypotony and serous choroidal detachment.
报告一例15岁患者单侧特发性巩膜静脉压升高（IEEVP）的病例。我们回顾并总结了已发表的IEEVP病例报告，以确定如何处理这种具有挑战性的罕见病症。
一名15岁的白种男性患者出现眼压升高、左眼施莱姆管内有血液，以及不对称的视盘凹陷，并在检查中发现相应的青光眼表现。我们诊断该患者为IEEVP，并描述了通过深层巩膜切除术和粘小管成形术进行的成功手术干预。
IEEVP是一种排除性诊断，基于巩膜静脉扩张、施莱姆管内有血液以及青光眼性改变等临床表现。如果药物治疗出现青光眼进展，通常需要进行滤过手术，并且文献报道大多数患者效果良好。应注意预防术后低眼压和浆液性脉络膜脱离。
