Idopathic Elevated Episcleral Venous Pressure and Open Angle Glaucoma
- Douglas J Rhee (dougrhee{at}aol.com),
- Meenakashi Gupta (meenakashi_gupta{at}meei.harvard.edu),
- Melissa B Moncavage (melissa.moncavage{at}jefferson.edu),
- Mark L Moster (mmoster{at}aol.com),
- Marlene R Moster (marlenemoster{at}aol.com)
- Massachusetts Eye & Ear Infirmary, United States
- Massachusetts Eye & Ear Infirmary, United States
- Wills Eye Hospital, United States
- Albert Einstein Medical Center, United States
- Wills Eye Hospital, United States
- Published Online First 20 June 2008
Abstract
Background/Aims: To report a case series of Idiopathic Elevated Episcleral Venous Pressure (IEEVP).
Methods: Retrospective chart review of all cases of IEEVP seen over a 5 year period by 3 physicians.
Results: We add 6 cases (5 men and 1 woman) to the known 19 documented cases in the English literature, only 3 of which were reported in the last 10 years. By history, the onset of conjunctival injection of all patients was in early adulthood or late teens. None had an identifiable secondary by modern imaging techniques. All our cases had bilateral but asymmetric involvement. Four of the 6 required glaucoma surgery by the 5th to 7th decade of life. The three eyes that had glaucoma filtration surgery had good outcomes. Choroidal effusions occurred in the post-operative period of one eye which was not hypotonous.
Conclusion: IEEVP is a rare cause of glaucoma which is diagnosed by the clinical criteria of dilated episcleral vessels without an identifiable cause. If glaucoma filtration surgery is required, there are generally good results. However, clinicians must be cautious of choroidal effusions occurring at non-hypotonous intraocular pressures.
