Author: Mona Rekik (Tunisia)
Co-authors: Sonda Kammoun, Takwa Sammouda, Saloua Ben Amor, Omar Ayadi, Salma Gargouri, Amira Trigui
Purpose
To report a case of severe ocular hypotony following blunt ocular trauma and to demonstrate the interest of swept-source optical coherence tomography for the diagnosis and follow-up
Setting/Venue
Department of Ophthalmology, HabibBourguiba University Hospital, Faculty of Medicine, University of Sfax, Tunisia.
Methods
case report
Results
A 20-year-old woman presented with complains of visual loss in the left eye three days following blunt ocular trauma. Visual acuity was limited to light perceptions in the left eye and 10/10 the right eye. The examination found severe hypotonia, total hyphema and intravitreal hemorrhage without retinal detachment. After 7days, resorption of hyphema and intravitreal hemorrhage was noted and the fundus examination showed a centromacular hematoma, retinal folds macular and peripapillary and papillary edema. Swept-source optical coherence tomography confirmed retinal folds and showed associated choroidal folds. The patient received local and general corticosteroid therapy. After three months of treatement, a slight improvement was noted. Visual acuity was 2/10 associated to central scotoma, intraocular pressure was 8mmhg. Fundus examination showed disappearance of the macular hematoma but with the persistence of papillary edema, retinal and choroidal folds visualized by swept-source optical coherence tomography. After a year of follow up, visual acuity remained stable, central scotoma was definitive, intraocular pressure was normal at 11 mm Hg. Fundus examination and swept-source optical coherence tomography showed the persistence of choroidal and retinal folds with papillary hyperemia.
Conlusions
Hypotony following blunt ocular trauma is a severe complication whose exact pathogenesis is not clear. Persisting hypotony causes complications that involve all ocular tissues and leads to corresponding visual loss. The prognosis for Hypotony following blunt ocular trauma is usually poor, which results from associated traumatic lesions or specific complications of persisting hypotony such as maculopathy, disc edema, as seen in our patient. Non-invasive clinical imaging with swept-source optical coherence tomography is an important adjunctive imaging modality in the diagnosis and follow-up of these complications.
Financial Disclosure
Financial disclosure:None
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