Question
The following picture of the eye was taken. It shows corneal abrasion, foreign body, corneal ulcer and perforation. Hypotonic maculopathy can result from all except:
| A. |
Suprachoroidal hemorrhage
|
| B. |
Uveal bleb leak
|
| C. |
Cyclodialysis
|
| D. |
Filtration site leak
|
Show Answer
|
Correct Answer � A
Explanation
|
|
suprachoroidal hemorrhage (SCH) is a rare sight-threatening complication associated with incisional intraocular surgery.
SCH may occur during several surgical procedures that result in significant fluctuations of the IOP (intraocular pressure).
The intraoperative acute hypotony is the triggering factor causing changes of the transluminal vascular pressure that may result in choroidal effusion with possible rupture of small arteries crossing the suprachoroidal space.
Systemic risk factors associated with SCH are advanced age, systemic hypertension, arteriosclerosis, blood coagulation defects, intraoperative tachycardia, and diabetes mellitus.
Ocular risk factors for the development of SCH during intraocular procedures comprise glaucoma, elevated IOP, high myopia, aphakia, and pseudophakia.
The surgical management of SCH includes drainage through posterior sclerotomies, often combined with vitrectomy, and silicone oil installation
Filtering bleb leaks can cause hypotony maculopathy, choroidal detachment, blebitis, and endophthalmitis.
Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an abnormal pathway for aqueous humor drainage that may lead to ocular hypotony.
Leakage of aqueous humor from the conjunctival filtration bleb is a common complication of trabeculectomy.
Complications of leaking blebs include hypotony, blebitis and endophthalmitis.
