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Original Article
Idiopathic elevated episcleral venous pressure and open-angle glaucoma
  1. D J Rhee1,
  2. M Gupta1,
  3. M B Moncavage2,
  4. M L Moster3,
  5. M R Moster2
  1. 1
    Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
  2. 2
    Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
  3. 3
    Neuro-ophthalmology Service, Albert Einstein Medical Center and Wills Eye Hospital, Philadelphia, Pennsylvania, USA
  1. Dr D J Rhee, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA; dougrhee{at}aol.com

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 three physicians.

Results: Six cases (five men and one woman) are added to the known 19 documented cases in the English literature, only three 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 lesion by modern imaging techniques. All cases had bilateral but asymmetric involvement. Four of the six 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 postoperative 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.

http://dx.doi.org/10.1136/bjo.2007.126557

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    Footnotes

    • Funding: National Eye Institute, Bethesda, MD, EY 13997 (to DJR).

    • Competing interests: None.

    • Ethics approval: Ethics approval was obtained from the institutional review board of Wills Eye Institute.

    • Detail has been removed from these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

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    2009 BMJ Publishing Group