Medical History
A 66-year-old male patient with vision loss in the right eye was examined in our clinic. He had a history of glaucoma surgery six years ago.
Diabetes mellitus (-)
Systemic hypertension (-)
Family history (-)
Smoking (-)
Trauma (-)
Examination Findings
Best corrected visual acuity was 4/10 in the right eye and 9/10 in the left eye. Intraocular pressure was 5 mmHg in the right eye and 17 mmHg in the left eye. Anterior segment examination revealed nuclear sclerosis and pseudoexfoliation in both eyes and filtering bleb in the right eye. Fundus examination revealed chorioretinal folds in the right eye.
Multicolor imaging shows chorioretinal folds and distrubtions of outer retina in the right eye (Figure 1).
Fundus autofluorescence imaging shows chorioretinal folds and hyperautofluorescence areas in the right eye (Figure 2).
SD-OCT imaging shows chorioretinal folds in the right eye (Figure 3).
Differantial Diagnosis
Choroidal melanoma or metastasis, posterior scleritis, retinal detachment
Daignosis
Hipotoni Makulopatisi
Hypotonia maculopathy is a clinical picture characterized by fundus anomalies such as chorioretinal folds, optic nerve edema, and increased vascular tortuosity due to intraocular pressure below 6.5 mmHg. Hypotonia maculopathy may develop due to ocular inflammation, trauma or previous eye surgery. The most common cause is previous glaucoma filtration surgery. Male gender, myopia, young age, primary glaucoma filtration surgery and preoperative high intraocular pressures are known risk factors for the development of hypotonia maculopathy.
