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PHOTO ESSAY
Year : 2022  |  Volume : 2  |  Issue : 2  |  Page : 575-576

Decompression retinopathy following self sealing open globe injury


Vitreo Retina Services, Aravind Eye Hospital, Thavalakuppam, Pondicherry, India

Date of Submission02-Sep-2021
Date of Acceptance06-Oct-2021
Date of Web Publication13-Apr-2022

Correspondence Address:
Divya Yadav
Vitreo Retina Services, Aravind Eye Hospital, Thavalakuppam - 605 007, Pondicherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2267_21

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  Abstract 


Keywords: Decompression retinopathy, open globe injury


How to cite this article:
Yadav D, Sonawane N, Ramesh S. Decompression retinopathy following self sealing open globe injury. Indian J Ophthalmol Case Rep 2022;2:575-6

How to cite this URL:
Yadav D, Sonawane N, Ramesh S. Decompression retinopathy following self sealing open globe injury. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 May 18];2:575-6. Available from: https://www.ijoreports.in/text.asp?2022/2/2/575/342940



A 15-year-old male presented with complaints of pain and blurring of vision in left eye following injury with stick 2 days before. The best corrected visual acuity was 20/20 in right eye and 20/60 in left eye. Left eye slit-lamp examination showed sealed full thickness paracentral corneal tear, anterior chamber flare 1+, and normal intraocular pressure. Fundus examination revealed hyperemic and edematous disc, peripapillary hemorrhages, dilated tortuous veins with intraretinal, preretinal, and mild vitreous hemorrhage in left eye [Figure 1]a. Optical coherence tomography showed disc and peripapillary edema, as well as intraretinal and subretinal fluid at fovea [Figure 1]c. On follow-up 9 days later, disc edema and hemorrhages reduced significantly [Figure 1]b and [Figure 1]d.
Figure 1: (a) Fundus photo showing ONH edema, peripapillary hemorrhages, macular edema, dilated and tortuous veins. (b) Fundus photo showing resolving ONH edema, peripapillary hemorrhages and macular edema. (c) Optical coherence tomography showing peripapillary retinal edema, sub-ILM hemorrhage and subretinal fluid at fovea. (d) Optical coherence tomography showing resolving peripapillary edema and subfoveal detachment

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  Discussion Top


Decompression retinopathy usually occurs after intraocular pressure (IOP) lowering procedures such as glaucoma drainage implant insertions, trabeculectomy, iridotomy for angle closure glaucoma, and so on. It has also been described to occur after procedures like paracentesis, cataract surgeries, vitrectomy, silicone oil removal, and rarely with orbital decompression.[1],[2],[3]

Sudden hypotony results in scleral deformity and subsequent shearing of fragile capillaries as postulated by Gupta et al.[4] Forward displacement of vitreous, which tends to get detached due to rapid reduction of posterior chamber volume, acute expansion, and anterior shift of lamina cribrosa, causing reduction in axoplasmic flow, and subsequently optic nerve edema leading to compression of central retinal vein and reduction in retinal arterial resistance leading to increased flow and leakage through fragile capillaries have been suggested as other mechanisms. Fundus manifestations can be multilevel hemorrhages including vitreous, subhyaloid, preretinal, intraretinal, disc and/or peripapillary hemorrhages, disc edema, macular edema, and rarely exudative retinal and choroidal detachment.[5] Being usually self-resolving in nature, it does not require treatment. Our patient too presumably had sudden IOP lowering due to full thickness corneal tear, which eventually got self-sealed with corresponding fundus manifestations leading to a diagnosis of decompression retinopathy.

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.
Ramtohul P, Chardavoine M, Beylerian M, Aziz A, Matonti F, Denis D. Decompression retinopathy following nonpenetrating deep sclerectomy for primary congenital glaucoma. BMC Ophthalmol 2018;18:240.  Back to cited text no. 1
    
2.
Rezende FA, Regis LGT, Kickinger M, Alcântara S. Decompression retinopathy after 25-gauge transconjunctival sutureless vitrectomy: Report of 2 cases. Arch Ophthalmol 2007;125:699-700.  Back to cited text no. 2
    
3.
Ben Simon GJ, Goldberg RA, McCann JD. Bilateral decompression retinopathy after orbital decompression surgery. Br J Ophthalmol 2004;88:1605-6.  Back to cited text no. 3
    
4.
Gupta R, Browning AC, Amoaku WM. Multiple retinal haemorrhages (decompression retinopathy) following paracentesis for macular branch artery occlusion. Eye 2005;19:592-3.  Back to cited text no. 4
    
5.
Mukkamala SK, Patel A, Dorairaj S, McGlynn R, Sidoti PA, Weinreb RN, et al. Ocular decompression retinopathy: A review. Surv Ophthalmol 2013;58:505-12.  Back to cited text no. 5
    


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