Korean J Ophthalmol.  2006 Jun;20(2):128-130. 10.3341/kjo.2006.20.2.128.

Multiple Retinal Hemorrhage following Anterior Chamber Paracentesis in Uveitic Glaucoma

• Lee SJ
• Lee JJ
• Kim SD

• KMID: 1099049
• DOI: http://doi.org/10.3341/kjo.2006.20.2.128

Abstract

PURPOSE: We describe the occurrence of a massive retinal hemorrhage following anterior chamber paracentesis in uveitic glaucoma. METHODS: A 33-year-old man who suffered from uveitic glaucoma was transferred to our hospital. The IOP in both his eyes was documented to vary between 11 mmHg and 43 mmHg and remained at a continuously high level for 7 months despite maximally tolerable medical treatment. A paracentesis was performed bilaterally to lower the IOP. RESULTS: Immediately after the paracentesis, massive retinal hemorrhages occurred in the left eye. Multiple round blot retinal hemorrhages with white centers occurred in the equator and peripheral retina, and small slit hemorrhages were observed in the peripapillary area. A fluorescence angiography(FAG) showed no obstruction of retinal vessels but a slightly delayed arteriovenous time in the left eye. CONCLUSIONS: It is important to be aware that patients who have a persistent relatively high IOP are at an increased risk of developing decompression retinopathy due to paracentesis and filtering surgery.

Keyword

Ocular decompression syndrome; Paracentesis; Retinal hemorrhage; Uveitic glaucoma; glaucoma filtering surgery

MeSH Terms

Uveitis, Anterior/*surgery
Retinal Hemorrhage/*etiology/pathology
Paracentesis/*adverse effects
Male
Intraocular Pressure
Humans
Glaucoma/*surgery
Fundus Oculi
Follow-Up Studies
Fluorescein Angiography
Anterior Chamber/*surgery
Adult

Figure

• 

  Fig. 1 (A) This is a photograph of the fundus in the left eye after the first paracentesis. Scatter blot hemorrhages in the peripapillary and peripheral multiple preretinal and deep retinal hemorrhages can be seen. Visual acuity with correction was 0.16 and IOP 17 mmHg (OS). (B) Fluorescein angiography of the left eye after the first paracentesis. Multiple, blocked fluorescence due to the retinal hemorrhages and vascular filling appears delayed at 17 sec.

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  Fig. 2 This is a photograph of the fundus in the left eye two months after the multiple retinal hemorrhages. The hemorrhages are almost completely resolved. Visual acuity with correction was 0.16 (OS).

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