A Case of Macular Serous Retinal Detachment after Ahmed Valve Implantation in an Eye with Pachychoroid
10.3341/jkos.2023.64.5.451
- Author:
EunAh KIM
1
;
Iksoo BYON
;
Jiwoong LEE
Author Information
1. Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
- Publication Type:Case Report
- From:Journal of the Korean Ophthalmological Society
2023;64(5):451-457
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose:We report a case of macular, serous retinal detachment associated with hypotony in a patient with pachychoroid disease developing after Ahmed valve implantation.Case summary: A 77-year-old male visited our clinic with uncontrolled intraocular pressure (IOP; 32 mmHg) in his left eye despite maximal tolerable medical therapy. A prolapsed vitreous filled the anterior chamber. Swept-source optical coherence tomography (SS-OCT) revealed that the subfoveal choroidal thickness was about 510 μm, indicating pachychoroid. Vitrectomy was performed to remove the prolapsed vitreous. The IOP remained 32 mmHg 3 weeks after vitrectomy. Ahmed valve implantation was performed and hypotony developed 10 days postoperatively. Choroidal detachment was apparent and SS-OCT revealed macular accumulation of subretinal fluid. The subfoveal choroidal thickness increased to a level beyond the SS-OCT measurement range. Partial tube ligation was performed to treat the hypotony 18 days after Ahmed valve implantation; the IOP decreased to 14 mmHg at 6 weeks postoperatively. The macular, serous retinal detachment disappeared and the subfoveal choroidal thickness fell to the preoperative value.
Conclusions:Hypotony after Ahmed valve implantation can manifest as serous retinal detachment under the fovea accompanied by an increase in choroidal thickness in an eye with underlying pachychoroid.