[Dramatic alteration in optic nerve head topography after filtering surgery in an adult patient with traumatic glaucoma].

OBJECTIVE

We treated an adult patient with traumatic glaucoma who exhibited dramatic elasticity in the topography of the optic nerve head, as shown in a Heidelberg Retina Tomograph (HRT) examination after filtering surgery.

METHODS

A 41-year-old man came to us with a right eye injury following an external blow. At the first examination, visual acuity was 0.4 (1.2) and intraocular pressure (IOP) was 11 mmHg in both eyes. Cells in the anterior chamber and angle dialysis were noted in all quadrants of the right eye, but there was no hyphema. Two weeks later, the patient returned to our hospital with pain in the right eye and a headache. Visual acuity in the right eye had decreased to 0.06 (0.1) and IOP was 50mmHg. A cilioconjunctival injection and corneal edema were observed. The patient was treated with medications, but IOP was uncontrollable and the optic disc cupping in the right eye was enlarged. Further, values for Cup Disc Area Ratio (C/D; 0.553) and Cup Volume (CV; 0.548) in the right eye were larger than those of the left (0.287 and 0.168, respectively) in an HRT examination. We performed a non-penetrating trabeculectomy 5 weeks after the injury. Two weeks after surgery, IOP was lowered to 7 mmHg, and C/D 0.122) and CV (0.062) were improved. Six months after the procedure, C/D (0.304) and CV (0.202) were nearly the same as those of the left eye (0.292 and 0.144).

CONCLUSIONS

Although the duration of high IOP was short, high elasticity in the optic disc morphology of this adult case was shown quantitatively in an HRT examination.