R Greslechner1, I Oberacher-Velten2,3. 1. Klinik und Poliklinik für Augenheilkunde, Klinikum der Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. greslechner@eye-regensburg.de. 2. Klinik und Poliklinik für Augenheilkunde, Klinikum der Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. 3. Augenarztpraxis, Hoppestr. 5, 93049, Regensburg, Deutschland.
Abstract
BACKGROUND: Glaucoma due to elevated episcleral venous pressure is a rare and difficult to treat form of secondary open angle glaucoma. OBJECTIVE: The pathophysiology, clinical findings, differential diagnosis and treatment options are discussed. Radius-Maumenee syndrome, Sturge-Weber syndrome and carotid-cavernous sinus fistulas are covered in particular. MATERIAL AND METHODS: A literature search was conducted in the PubMed database. RESULTS: In the course of the diagnostics potentially severe diseases, such as carotid-cavernous sinus fistulas have to be ruled out. Treatment is based on the therapy of the underlying disease. Anti-glaucomatous medicinal treatment is often insufficient. In the case of surgery the increased risk for severe complications has to be taken into account. A variety of different surgical approaches have been reported in a number of small case series. CONCLUSION: Glaucoma due to elevated episcleral venous pressure can be idiopathic or secondary to another underlying disease. Although rare it should always be considered in the differential diagnosis. Treatment is challenging because of an increased risk for severe complications.
BACKGROUND:Glaucoma due to elevated episcleral venous pressure is a rare and difficult to treat form of secondary open angle glaucoma. OBJECTIVE: The pathophysiology, clinical findings, differential diagnosis and treatment options are discussed. Radius-Maumenee syndrome, Sturge-Weber syndrome and carotid-cavernous sinus fistulas are covered in particular. MATERIAL AND METHODS: A literature search was conducted in the PubMed database. RESULTS: In the course of the diagnostics potentially severe diseases, such as carotid-cavernous sinus fistulas have to be ruled out. Treatment is based on the therapy of the underlying disease. Anti-glaucomatous medicinal treatment is often insufficient. In the case of surgery the increased risk for severe complications has to be taken into account. A variety of different surgical approaches have been reported in a number of small case series. CONCLUSION:Glaucoma due to elevated episcleral venous pressure can be idiopathic or secondary to another underlying disease. Although rare it should always be considered in the differential diagnosis. Treatment is challenging because of an increased risk for severe complications.
Authors: Maya Eibschitz-Tsimhoni; Paul R Lichter; Monte A Del Monte; Steven M Archer; David C Musch; Robert M Schertzer; Sayoko E Moroi Journal: Ophthalmology Date: 2003-07 Impact factor: 12.079