Background: Cyclodialysis lowers the intraocular pressure (IOP), leading to hypotony maculopathy and thus to impaired visual acuity (VA); therefore, prompt diagnosis and treatment are necessary to improve VA. Ultrasound biomicroscopy (UBM) has been used for the diagnosis of cyclodialysis. However, concerns have been raised regarding the excessive burden on the affected eyes because of the direct contact with the eyes due to probe manipulation.
Subjects: This study included four cases (3 traumatic and 1 iatrogenic) of cyclodialysis along the whole circumference.
Findings: Image findings of cyclodialysis obtained with anterior segment optical coherence tomography (AS-OCT) in cases 2, 3, and 4 were almost the same as those obtained with UBM in case1. All 4 cases showed low IOP and decreased VA, and a minimally invasive surgery, transscleral ciliary body suturing, was selected. When this surgery was ineffective, or a certain amount of time had passed since the onset of cyclodialysis, vitreous surgery with gas tamponade (including intraocular lens insertion) was performed instead. Eventually, IOP was increased and VA was restored in all patients, demonstrating the effectiveness of AS-OCT in postoperatively confirming cyclodialysis closure.
Conclusions: Findings obtained with AS-OCT were almost equivalent to those obtained from the conventional UBM for the diagnosis of cyclodialysis. Because of the simplicity and non-invasive nature of AS-OCT, it should be actively used for patients with suspected cyclodialysis. In addition, transscleral ciliary body suturing may be an effective treatment option for cyclodialysis among the various surgical treatments.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 875-887, 2018.