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Jaskra wtórna otwartego kąta spowodowana idiopatycznym podwyższonym ciśnieniem w żyłach nadtwardówkowych – opis przypadku
Idiopathic Open Angle Glaucoma Secondary to Elevated Episcleral Veins Pressure – Case Report
Paweł Reisner, Adriana Laudencka, Grażyna Malukiewicz
Klinika Chorób Oczu Wydziału Lekarskiego Uniwersytetu Mikołaja Kopernika w Toruniu Collegium Medicum
im. Ludwika Rydygiera w Bydgoszczy, Szpital Uniwersytecki nr 1 im. A. Jurasza w Bydgoszczy
Kierownik: prof. dr hab. n. med. Grażyna Malukiewicz
Summary: Purpose: The purpose of this paper is to present a case of unilateral idiopathic open angle glaucoma secondary to elevated episcleral veins pressure in a 38-year-old patient. The paper also concentrates on the clinical symptoms, etiology and available treatment options.
Material and Methods: We performed a review of literature on the PubMed and Clinical Key database to thoroughly search and collect reported cases using the key words: elevated episcleral veins pressure, idiopathic dilated episcleral veins, Radius-Maumenee syndrome. A 38-year-old healthy woman was admitted to the Ophthalmology Department due to dilated episcleral veins and a high intraocular pressure in the left eye. A diagnosis of left idiopatic dilated episcleral vein with secondary open angel glaucoma (Radius-Maumenee syndrome) was made.
Results: The patient was treated medically with hypotensive eyedrops and trabeculectomy was performed. Postoperatively, she developed choroidal effusion, which resolved with conservative management. After surgery intraocular pressure dropped to the normal level although episcleral veins were chronically dilated and tortuous.
Discussion: Dilated episcleral vein with secondary glaucoma is always difficult to diagnose and manage. The diagnosis of Radius-Maumenee syndrome is based on clinical findings characteristic of episcleral vessel dilation and increased intraocular pressure, corresponding to a picture of open-angle glaucoma. Glaucoma surgeries, such as trabeculectomy, sclerectomy and sinusotomy, performed at the appropriate time, can provide good treatment results, although they do not always result in the reduction of episcleral vessels. During the postoperative period, as in this case, there can be more frequent choroidal effusion than normal.
Conclusions: Idiopatic dilated episcleral veins is a rare case of secondary glaucoma. Glaucoma surgeries, such as trabeculectomy, sclerectomy and sinusotomy, are usually necessary. During the postoperative period can be more frequent choroidal effusion than normal.
Słowa kluczowe: idiopatyczna jaskra otwartego kąta, ciśnienie w żyłach nadtwardówkowych.
Keywords: idiopathic open angle glaucoma, episcleral veins pressure.