Hypotony maculopathy is

maculopathy A maculopathy is any pathological condition of the macula, an area at the centre of the retina that is associated with highly sensitive, accurate vision. Forms of maculopathies * Age-Related Macular Degeneration is a degenerative maculopathy ass ...

due to very low

intraocular pressure Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. Most tonometers are calibrated to ...

known as

ocular hypotony Ocular hypotony, or ocular hypotension, or shortly hypotony, is the medical condition in which intraocular pressure (IOP) of the eye is very low. Description Normal IOP ranges between 10–20 mm Hg. The eye is considered hypotonous if the IOP is � ...

. Maculopathy occurs either due to increased outflow of

aqueous humor The aqueous humour is a transparent water-like fluid similar to plasma, but containing low protein concentrations. It is secreted from the ciliary body, a structure supporting the lens of the eyeball. It fills both the anterior and the posteri ...

through angle of anterior chamber or less commonly, due to decreased aqueous humor secretion by

ciliary body The ciliary body is a part of the eye that includes the ciliary muscle, which controls the shape of the lens, and the ciliary epithelium, which produces the aqueous humor. The aqueous humor is produced in the non-pigmented portion of the ciliar ...

Description

Hypotony maculopathy is maculopathy due to ocular hypotony. Fundus examination may reveal abnormalities like chorioretinal folds,

optic nerve In neuroanatomy, the optic nerve, also known as the second cranial nerve, cranial nerve II, or simply CN II, is a paired cranial nerve that transmits visual system, visual information from the retina to the brain. In humans, the optic nerve i ...

head swelling (

papilledema Papilledema or papilloedema is optic disc swelling that is caused by increased intracranial pressure due to any cause. The swelling is usually bilateral and can occur over a period of hours to weeks. Unilateral presentation is extremely rare. In ...

) and tortuosity of blood vessels.

Causes

Maculopathy occurs either due to increased outflow of

through angle of anterior chamber or less commonly, due to decreased aqueous humor secretion by

. Chronic inflammation within the eye including

iridocyclitis Uveitis () is inflammation of the uvea, the pigmented layer of the eye between the inner retina and the outer fibrous layer composed of the sclera and cornea. The uvea consists of the middle layer of pigmented vascular structures of the eye and ...

, medications including anti glaucoma drugs, or proliferative vitreoretinopathy causes decreased production. Increased outflow or aqueous loss may occur following a

glaucoma surgery Glaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). There are many glaucoma surgeries, and variations or combinations of those surgeries, that ...

, trauma, post-surgical wound leak from the eye, cyclodialysis cleft, tractional

detachment or

retinal detachment Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blin ...

. Use of anti fibrosis drugs like

mitomycin C Mitomycin C is a mitomycin that is used as a chemotherapeutic agent by virtue of its antitumour activity. Medical uses It is given intravenously to treat upper gastro-intestinal cancers (e.g. esophageal carcinoma), anal cancers, and breast ...

during glaucoma surgery will increase the risk of hypotony maculopathy development.

Investigations

Many ophthalmic imaging techniques are used in detecting hypotony maculopathy.

Indocyanine green angiography Indocyanine green angiography (ICGA) is a diagnostic procedure used to examine choroidal blood flow and associated pathology. Indocyanine green (ICG) is a water soluble cyanine dye which shows fluorescence in near-infrared (790–805 nm) range, wit ...

fluorescein angiography Fluorescein angiography (FA), fluorescent angiography (FAG), or fundus fluorescein angiography (FFA) is a technique for examining the circulation of the retina and choroid (parts of the fundus) using a fluorescent dye and a specialized camera. S ...

can help in early detection of choroidal disturbances and choroidal folds.

Medical ultrasound Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles ...

may be used to detect

sclera The sclera, also known as the white of the eye or, in older literature, as the tunica albuginea oculi, is the opaque, fibrous, protective, outer layer of the human eye containing mainly collagen and some crucial elastic fiber. In humans, and som ...

l and choroidal thickening,

anterior chamber The anterior chamber ( AC) is the aqueous humor-filled space inside the eye between the iris and the cornea's innermost surface, the endothelium. Hyphema, anterior uveitis and glaucoma are three main pathologies in this area. In hyphema, blood f ...

depth, ciliary detachment and cyclodialysis cleft. OCT scanning can be used in detecting abnormalities of

retina The retina (from la, rete "net") is the innermost, light-sensitive layer of tissue of the eye of most vertebrates and some molluscs. The optics of the eye create a focused two-dimensional image of the visual world on the retina, which then ...

and choroid.

Treatment

To prevent retinal dysfunction and vision loss, intraocular pressure should be normalised by treating the cause of hypotony. Delay in treatment results in permanent chorioretinal changes and permanent loss of vision.

History

Dellaporta first described the condition in 1954. Gass, in 1972, named it hypotony maculopathy.

References

{{Authority control Eye diseases Disorders of choroid and retina Blindness