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Beitragstitel | Unilateral episceral vessels engorgment combined with ocular hypertension- a case report |
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Beitragscode | P74 |
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Präsentationsform | ePoster |
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Abstract-Text |
Purpose We describe a case of unilateral increase of conjunctival vessel dilatation combined with an raise of ocular hypertension over a observational time of 2 ½ years. History and signs We report a case of an 70 year-old asymptomatic patient. He presented for a second opinion after being treated for more than a year with dorzolamid and timolol eye drops in boths eyes. He had no history of glaucoma or traumatic head injuries. The eye pressure was 15 mm Hg on both eyes. Biomicroscopy showed on the right eye discrete dilated episcleral veins and on both eyes a chronic blepharitis due to rosaceea. Intraocular no signs of pigment dispersion or pseudoexfoliatio lentis were present. The anterior chamber was normal, gonioscopy showed an open angle. All other examinations (fundus examination, OCT measurement of the optic nerve fibres, assessments of the visual field) were within normal range. During 6 and 12 months follow up the ocular pressure was still in normal range, with a slight difference of 19/ 15 mm Hg respectively 22 / 17 mm Hg. At 12 months follow up we observed an increase in dilatation of the episleral vessels on the right eye. Diagnostics including orbita MRI and angiography to exclude compression or drainage disorders, and blood tests to detect tyroid dysfunction, amyloidosis etc were unremarkable. Over the next period of time - due to an slight continuous increase of the ocular pressure on the right eye - we incresed the local therapy on this eye with brimonidin twice / daily, then additionally tafluprost at night. Under this maximal local therapy the ocular pressure remained under 20 mm Hg on the right eye and no glaucomatous signs on the optic disc or visual field were noticed till our last follow up of the patient. Conclusion In cases with presumed elevated episcleral venous pressure it is important to rule out intraorbital and intracranial etiologies of drainage disorders . In the absence of other pathologic findings, we considered in our presented case the idiopathic Radius- Maumenee syndrom. With an adequate treatment as early as possible and frequently follow ups we could impede untill now the development of a glaucomatous damage. |