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   Table of Contents      
OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 11  |  Page : 1882

Retinal vascular changes after sudden intraocular pressure reduction


1 Sita Lakshmi Glaucoma Center, Hyderabad, Telangana, India
2 Department of Retina, Anand Eye Institute, Hyderabad, Telangana, India

Date of Web Publication22-Oct-2019

Correspondence Address:
Dr. Tarannum Mansoori
Sita Lakshmi Glaucoma Centre, Anand Eye Institute, Habsiguda, Hyderabad - 500 007, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_821_19

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How to cite this article:
Mansoori T, Agraharam SG, Rao A, Macha D. Retinal vascular changes after sudden intraocular pressure reduction. Indian J Ophthalmol 2019;67:1882

How to cite this URL:
Mansoori T, Agraharam SG, Rao A, Macha D. Retinal vascular changes after sudden intraocular pressure reduction. Indian J Ophthalmol [serial online] 2019 [cited 2019 Nov 18];67:1882. Available from: http://www.ijo.in/text.asp?2019/67/11/1882/269641



A 33-year-old man, diagnosed with angle recession glaucoma in the left eye, had intraocular pressure (IOP) of 54 mmHg. Fundus examination showed dilated, engorged, and tortuous retinal vessels, average size disc, 0.6: 1 cup disc ratio (CDR) and thinning of superior and inferior neuroretinal rim (NRR) [Figure 1]a He underwent trabeculectomy augmented with Mitomycin C. Two weeks later, IOP was 10 mmHg, a decrease in the caliber and tortuosity of the major retinal vessels was noted, optic disc showed diffuse a pallor, 0.4:1 CDR, coiled, large collateral vessels on the supero-nasal NRR (white arrow), fine capillaries tuft on the inferior NRR (blue arrow), and fine collaterals on the inner border of temporal NRR (black arrow) [Figure 1]b.
Figure 1:(a) Fundus photograph of the left eye shows dilated and tortuous retinal vessels, 0.6:1 cup disc ratio and thin superior and inferior neuroretinal rim (NRR). (b) Fundus photo of the left eye shows a decrease in the major retinal vessels tortuosity. Optic disc shows diffuse pallor, 0.4: 1 CDR, coiled collateral vessels on the supero-nasal neuroretinal rim (white arrow), fine collaterals (blue arrow), and tuft of capillaries on the border of temporal NRR

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Disc collaterals or retino choroidal collaterals at the optic disc are found in ocular conditions such as central retinal vein occlusion or glaucoma.[1],[2] In this patient, IOP reduction caused gradual reversal of the venous stasis, as seen clinically by a decrease in the venous tortuosity and caliber. This interesting finding of newly formed disc collaterals, which became visible at 2 weeks after trabeculectomy, can possibly be explained by gradual and slow development of collaterals, probably a few months after the onset of venous stasis, which was secondary to the high IOP.[3]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Dobree JH. Venous obstruction and neovascularisation at the disc in chronic glaucoma. Trans Ophthalmol Soc UK 1957;77:229-37.  Back to cited text no. 1
    
2.
Varma R, Spaeth GL, Katz LJ, Feldman RM. Collateral vessel formation in the optic disc in glaucoma. Arch Ophthalmol 1987;105:1287.  Back to cited text no. 2
    
3.
Klien BA. Spontaneous vascular repair. Arteriolar and venous cilioretinal communications. Am J Ophthalmol 1960;50:691-701.  Back to cited text no. 3
    


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