Four cases of traumatic hypotony maculopathy treated by various methods

Tetsuya Mutoh, Yukihiro Matsumoto, Makoto Chikuda
Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan

Abstract: Several reports have been published on methods for treating hypotony maculopathy. Currently, the preferred choice of treatment depends on the severity of the illness. We experienced four cases of traumatic hypotony maculopathy and treated them by various methods. Cases 1–3 were treated by various surgical treatments. Case 1 was treated by combined cataract surgery and pars plana vitrectomy. The vitreous cavity was replaced with 20% sulfur hexafluoride (SF6). Case 2 did not improve with laser trabeculoplasty, so further encircling was performed. Case 3 did not improve with photocoagulation of the ciliary body and injection of 20% SF6 into the vitreous cavity. Consequently, this case required suturing of the ciliary body to the sclera, cryopexy for the ciliary body, and injection of 100% SF6. Case 4 was treated only with eye drops. Intraocular pressure (IOP) increased in all cases as a result of treatment. Treatment improved hypotony maculopathy in all cases. Pre-treatment visual acuities ranged from 0.03 to 0.4, with IOP ranging from 2 to 10 mmHg. Post-treatment visual acuity ranged from 0.09 to 1.2, with IOP ranging from 14 to 16 mmHg. Only case 2 resulted in poor visual prognosis because of choroidal rupture near the foveola. The difficulty in choosing treatment methods lies in the need for multiple surgical treatments for some cases. Effective and noninvasive treatment methods are expected to be established in the future.

Keywords: traumatic hypotony maculopathy, surgical treatment, eye drops, treatment method