Abstract

Volume.123 Number.6

Original article : Clinical science

Investigation of Six Cases of Traumatic Hypotensive Maculopathy
Kobu Adachi, Yukihiko Suzuki, Kaori Suzuki, Takashi Kudo, Mitsuru Nakazawa
Department of Ophthalmology, Hirosaki University Graduate School of Medicine

Purpose: To investigate cases of traumatic hypotensive maculopathy reported at the Department of Ophthalmology, Hirosaki University Hospital, over the last 15 years.
Methods: This retrospective study investigated the medical records of six male patients (six eyes) diagnosed with hypotensive maculopathy caused by traumatic ciliary detachment during the period 2001 to 2016.
Results: The patients were aged between 18 and 52 (mean: 32.5±10.7) years, and the follow-up period ranged between 3 and 110 (mean: 33.6±41.0) months. Intraocular pressure (IOP) ranged between 4 and 7 (mean: 6.1±1.1) mmHg and visual acuity ranged between hand motion and 1.2 at the onset of maculopathy. Macular puckering was observed in all patients. Three patients demonstrated improvement within 3 months of the onset of hypotensive maculopathy over the natural course. The remaining three patients required surgery. Ultrasound biomicroscopy (UBM) revealed extensive ciliary detachment in all patients who required surgery. In these three patients, vitrectomy was conducted with cryopexy and gas tamponade on the pars planar, which was the location of detachment. Postoperatively, UBM revealed the disappearance of detached ciliary bodies in all patients. Final IOP ranged between 10 and 20 (mean: 15.0±3.4) mmHg. In three of the four patients with a maculopathy duration of ≤4 months (natural improvement: 2 patients, surgery: 1 patient) the final visual acuity was found to be satisfactory (≥1.2).
Conclusion: Vitrectomy with cryopexy of the detachment site of ciliary bodies was found to be effective in the cases of traumatic hypotensive maculopathy, where improvement was not observed over the natural course of the disease during follow-up.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 712-718, 2019.

Key words
Traumatic ciliary body detachment, Traumatic hypotensive maculopathy, Vitrectomy, Cryopexy, Gas tamponade
Reprint requests to
Kobu Adachi, M.D. Department of Ophthalmology, Hirosaki University Graduate School of Medicine. 5 Zaifu-cho, Hirosaki-shi 036-8562, Japan