PL EN
PRACA ORYGINALNA
Hypotony Maculopathy
 
Więcej
Ukryj
1
Department of Glaucoma Diagnostics and Microsurgery, Medical University of Lublin, Poland Head: Professor Tomasz Żarnowski, PhD, MD
 
 
Data nadesłania: 25-11-2025
 
 
Data akceptacji: 29-11-2025
 
 
Data publikacji: 15-01-2026
 
 
Ophthalmology 2025;28(3):30-34
 
SŁOWA KLUCZOWE
STRESZCZENIE
Hypotony maculopathy may have multiple causes; however, it most commonly develops as a complication of filtration procedures, particularly those performed with antimetabolites. A characteristic feature of this condition is the presence of chorioretinal folds in the macular region, resulting from scleral wall collapse secondary to hypotony. Additional findings on ophthalmoscopic examination may include vascular tortuosity, optic disc edema, and cystoid macular edema. The primary goal of treatment is to restore normal intraocular pressure; however, effective management requires accurate identification of the underlying cause of ocular hypotony. Prognosis largely depends on the duration of hypotony, as prolonged persistence of these changes may lead to permanent fibrosis of the retina and sclera.
REFERENCJE (36)
1.
Dellaporta A: Creasing of retina in hypotonia. Klin Monatsblatter Augenheilkd. Augenarztliche Fortbild. 1954; 125: 672–678.
 
2.
Gass JD: Contemporary ophthalmology, honoring Sir Steward Duke-Elder. 1972; 343.
 
3.
Fannin LA, Schiffman JC, Budenz DL: Risk factors for hypotony maculopathy. Ophthalmology. 2003; 110: 1185–1191.
 
4.
Rasheed el-S: Initial trabeculectomy with intraoperative mitomycin-C application in primary glaucomas. Ophthalmic Surg Lasers. 1999; 30: 360–366.
 
5.
de Fendi LI, Arruda GV, Scott IU, et al.: Mitomycin C versus 5-fluorouracil as an adjunctive treatment for trabeculectomy: a meta-analysis of randomized clinical trials. Clin Experiment Ophthalmol. 2013; 41: 798–806.
 
6.
Dhingra S, Khaw PT: The Moorfields Safer Surgery System. Middle East Afr J Ophthalmol. 2009; 16: 112–115.
 
7.
Rulli E, Biagioli E, Riva I, et al.: Efficacy and safety of trabeculectomy vs nonpenetrating surgical procedures: a systematic review and meta-analysis. JAMA Ophthalmol. 2013; 131: 1573–1582.
 
8.
Gedde SJ, Schiffman JC, Feuer WJ, et al.: Three-year follow-up of the tube versus trabeculectomy study. Am J Ophthalmol. 2009; 148, 670–684.
 
9.
Budenz DL, Barton K, Gedde SJ, et al.: Five-year treatment outcomes in the Ahmed Baerveldt comparison study. Ophthalmology. 2015; 122: 308–316.
 
10.
González-Martín-Moro J, Contreras-Martín I, Muñoz-Negrete FJ, et al.: Cyclodialysis: an update. Int Ophthalmol. 2017; 37: 441–457.
 
11.
Ding C, Zeng J: Clinical study on Hypotony following blunt ocular trauma. Int J Ophthalmol. 2012; 5: 771–773.
 
12.
Mermoud A, Baerveldt G, Minckler DS, et al.: Prostaglandines E2 et F2-alpha au cours du glaucome uvéitique chez le rat Lewis. Klin Monbl Augenheilkd. 1995; 206(5): 409–412.
 
13.
Bowling B: Kański Okulistyka Kliniczna. (Edra Urban & Partner, Wrocław 2017, dodruk 2021).
 
14.
Schubert HD: Postsurgical hypotony: relationship to fistulization, inflammation, chorioretinal lesions, and the vitreous. Surv Ophthalmol. 1996; 41: 97–125.
 
15.
Sakamoto M, Matsumoto Y, Mori S, et al.: Excessive scleral shrinkage, rather than choroidal thickening, is a major contributor to the development of hypotony maculopathy after trabeculectomy. PloS One. 201813; e0191862.
 
16.
Kokame GT, de Leon MD, Tanji T: Serous retinal detachment and cystoid macular edema in hypotony maculopathy. Am J Ophthalmol. 2001; 131: 384–386.
 
17.
Budenz DL, Schwartz K, Gedde SJ: Occult hypotony maculopathy diagnosed with optical coherence tomography. Arch Ophthalmol Chic. 2005; 123: 113–114.
 
18.
Azuma K, Saito H, Takao M, et al.: Frequency of hypotonic maculopathy observed by spectral domain optical coherence tomography in post glaucoma filtration surgery eyes. Am J Ophthalmol Case Rep. 2020; 19: 100786.
 
19.
Norton EW: A characteristic fluorescein angiographic pattern in choriodal folds. Proc R Soc Med. 1969; 62: 119–128.
 
20.
Matsuo H, Tomidokoro A, Tomita G, et al.: Topical application of autologous serum for the treatment of late-onset aqueous oozing or point-leak through filtering bleb. Eye Lond Engl. 2005; 19: 23–28.
 
21.
Hamard P, Tazartes M, Ayed T, et al.: Prognostic outcome of leaking filtering blebs reconstruction with rotational conjunctival flaps. J Fr Ophtalmol. 2001; 24: 482–490.
 
22.
Panday M, Shantha B, George R, et al.: Outcomes of bleb excision with free autologous conjunctival patch grafting for bleb leak and hypotony after glaucoma filtering surgery. J Glaucoma. 2011; 20: 392–397.
 
23.
Eha J, Hoffmann EM, Wahl J, et al.: Flap suture--a simple technique for the revision of hypotony maculopathy following trabeculectomy with mitomycin C. Graefes Arch Clin Exp Ophthalmol. Albrecht von Graefes Arch Klin Exp Ophthalmol. 2008; 246: 869–874.
 
24.
Shirato S, Maruyama K, Haneda M: Resuturing the scleral flap through conjunctiva for treatment of excess filtration. Am J Ophthalmol. 2004; 137: 173–174.
 
25.
Kosior-Jarecka E, Wróbel-Dudzińska D, Święch A, et al.: Bleb Compressive Sutures in the Management of Hypotony Maculopathy after Glaucoma Surgery. J Clin Med. 2021; 10: 2223.
 
26.
Haynes WL, Alward WL: Rapid visual recovery and long-term intraocular pressure control after donor scleral patch grafting for trabeculectomy-induced hypotony maculopathy. J Glaucoma. 1995; 4: 200–201.
 
27.
Tanito M, Okada A, Mori Y, et al.: Subconjunctival implantation of Ologen Collagen Matrix to treat ocular hypotony after filtration glaucoma surgery. Eye Lond Engl. 2017; 31: 1475–1479.
 
28.
Dietlein TS, Lappas A, Rosentreter A: Secondary subconjunctival implantation of a biodegradable collagen-glycosaminoglycan matrix to treat ocular hypotony following trabeculectomy with mitomycin C. Br J Ophthalmol. 2013; 97: 985–988.
 
29.
Rękas M: Strategie Leczenia Jaskry. Monografia. wyd. 1. Grupa wydawnicza Medical Education; 2020: 193–203.
 
30.
Yieh FS, Lu DW, Wang HL, et al.: The use of autologous fibrinogen concentrate in treating ocular hypotony after glaucoma filtration surgery. J Ocul Pharmacol Ther Off J Assoc Ocul Pharmacol Ther. 2001; 17: 443–448.
 
31.
Gupta P, Gupta A, Gupta V, et al.: Successful outcome of pars plana vitreous surgery in chronic hypotony due to uveitis. Retina Phila. 2009; 29: 638–643.
 
32.
Dayani PN, Chow J, Stinnett SS, et al.: Pars plana vitrectomy, fluocinolone acetonide implantation, and silicone oil infusion for the treatment of chronic, refractory uveitic hypotony. Am J Ophthalmol. 2011; 152: 849–856.e1 (2011).
 
33.
Kato T, Hayasaka S, Nagaki Y, et al.: Management of traumatic cyclodialysis cleft associated with ocular hypotony. Ophthalmic Surg Lasers. 1999; 30: 469–472.
 
34.
Benson SE, Barton K, Gregor ZJ: Vitrectomy for a persisting macular fold in a case of resolved hypotony maculopathy. Am J Ophthalmol. 2004; 138: 487–489.
 
35.
Duker JS, Schuman JS: Successful surgical treatment of hypotony maculopathy following trabeculectomy with topical mitomycin C. Ophthalmic Surg. 1994; 25: 463–465.
 
36.
Oyakhire JO, Moroi SE: Clinical and anatomical reversal of long-term hypotony maculopathy. Am J Ophthalmol. 2004; 137: 953–955.
 
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