Klin Monbl Augenheilkd
DOI: 10.1055/a-1332-1734
Kasuistik

Posttraumatic Ocular Hypotony Through Epithelial Downgrowth

Article in several languages: English | deutsch
1  Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Deutschland
,
Celestina Schober
1  Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Deutschland
,
Andrea Huth
1  Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Deutschland
,
Udo Siebolts
2  Institut für Pathologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
,
Arne Viestenz
1  Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Deutschland
› Author Affiliations

Abstract

Background Intraocular epithelial downgrowth is a rare but potentially devastating posttraumatic complication. If left untreated, this may result in corneal decompensation, secondary angle-closure glaucoma, retinal detachment and blindness.

Patient and Method A 10-year-old patient with penetrating globe injury and delayed wound management elsewhere presented with corneal melting and decompensation, retinal detachment and ocular hypotony. Following penetrating keratoplasty, cyclopexy and vitrectomy, corneal melting in the interface with renewed retinal detachment was noted within days. The hopeless prognosis required enucleation of the globe.

Results Optical coherence tomography revealed not only corneal melting, but also markedly hyperreflective structures posterior to the cornea. Immunohistology demonstrated diffuse multi-layered nonkeratinised squamous cell epithelium on the posterior corneal surface, iris, ciliary bodies, and retina, as well as below the choroid, with renewed tractional retinal detachment.

Conclusion Posttraumatic epithelial downgrowth may result in tractional retinal detachment, cyclodialysis cleft and/or corneal melting. Hyperreflective membrane deposits on OCT may be indicative of diffuse epithelial downgrowth. Especially in children, prompt wound closure in globe injuries is vital to avoid this serious posttraumatic complication.



Publication History

Received: 17 September 2020

Accepted: 30 November 2020

Publication Date:
04 February 2021 (online)

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