Korean J Ophthalmol.  2006 Jun;20(2):109-112. 10.3341/kjo.2006.20.2.109.

Recurrent Intraocular Pressure Elevation during Hemodialysis in a Patient with Neovascular Glaucoma

• Song WK
• Ha SJ
• Yeom HY
• Seoung GJ
• Hong YJ

• KMID: 1099045
• DOI: http://doi.org/10.3341/kjo.2006.20.2.109

Abstract

PURPOSE: To report a patient with symptomatic intraocular pressure (IOP) elevation in an eye with neovascular glaucoma (NVG) during hemodialysis. METHODS: Case report. RESULTS: Recurrent episodes of severe ocular pain and elevated IOP in the NVG eye were noted during hemodialysis in a 29-year-old man. The patient was recently diagnosed at our ophthalmology clinic with NVG due to central retinal vein occlusion. IOP was temporarily controlled after the Ahmed valve implantation. However, after the fibrous membrane developed and occluded the tip of the Ahmed valve, IOP elevation during hemodialysis recurred. Further treatments with intravenous mannitol, oral carbonic anhydrase inhibitor, topical antiglaumatic agents and subconjunctival 5-fluorouracil (5-FU) injections all failed to control relapsing pain and IOP elevation. Eventually, evisceration and hydroxyappatite implantation were performed. CONCLUSIONS: Physicians must be alert to the possibility of IOP elevation in glaucomatous eyes during hemodialysis.

Keyword

Ahmed valve; Hemodialysis; Intraocular pressure (IOP); Neovascular glaucoma (NVG)

MeSH Terms

Renal Dialysis/*adverse effects
Recurrence
Male
Kidney Failure, Chronic/complications/*therapy
Intraocular Pressure/*physiology
Humans
Glaucoma, Neovascular/complications/*physiopathology/surgery
Glaucoma Drainage Implants
Follow-Up Studies
Filtering Surgery/instrumentation
Adult

Figure

• 

  Fig. 1 Intraocular pressure shifts according to dates and events. Intraocular pressures were checked by Goldmann applanation tonometry (mmHg). *ACP=anterior chamber paracentesis; †HD =hemodialysis; ‡5-FU=subconjuctival 5-fluorouracil injection; §man 400=intravenous mannitolization 400 cc; OD=right eye; OS =left eye. Intraocular pressure of the NVG eye (right eye) of the patient showed a marked increase after hemodialysis (p=0.028). The intraocular pressure of the left eye remained within the normal range without statistical change regarding hemodialysis (p=0.066).

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