Optical Coherence Tomography Angiography Description of Ocul
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Ocular decompression retinopathy (ODR) is known as a syndrome related to acute decompression of the eye after a medical procedure, first described by Fechtner. It is defined as multiple retinal hemorrhages following surgery or medical treatment, that cause sudden and pronounced lowering of intraocular pressure (IOP). This rare complication has generally been described after trabeculectomy. 2,3,4 Here, we describe a case of ODR after deep sclerectomy with Mitomycin C using optical coherence tomography angiography.

A 55-year-old man with traumatic glaucoma in the right eye complained of blurred vision. Visual acuity was 20/25 and intraocular pressure (IOP) was 50 mm Hg. Deep sclerectomy with Mitomycin C was performed. On the first postoperative day, best-corrected visual acuity (BCVA) was light perception and IOP was 6 mm Hg. At 3 months follow-up, BCVA was 20/40 and IOP was 14 mm Hg. Fundoscopy showed multiple diffuse round retinal hemorrhages over the posterior pole, in all quadrants. On OCTA, hemorrhages were present in superficial and deep retinal layers, with a normal vascularization in the en face image. BCVA improved to 20/32 at postoperative month 4 with reduced but persistent retinal hemorrhages.

In conclusions, ODR is a rare complication of filtering surgery. To the best of our knowledge, this is the second reported case of ODR occurring after deep sclerectomy and first description using OCTA. OCTA showed superficial and deep retinal hemorrhages with a normal vascular configuration. High-preoperative IOP seems to be the most important risk factor for this complication.