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Case Reports
. 2016 Mar 5:16:23.
doi: 10.1186/s12886-016-0199-z.

Management of intraocular pressure elevation during hemodialysis of neovascular glaucoma: a case report

P Frezzotti  1 , C Menicacci  2 , S A Bagaglia  2 , P Mittica  2 , F Toto  2 , I Motolese  2
Affiliations
Case Reports

Management of intraocular pressure elevation during hemodialysis of neovascular glaucoma: a case report

P Frezzotti et al. BMC Ophthalmol. .

Abstract

Background: It is generally accepted that dialysis may lower plasma osmolality at a faster rate than changes in ocular osmolality. This osmotic difference causes water to migrate from the plasma into the aqueous humor, increasing intraocular pressure. Certain authors have described IOP increase in patients with narrow angles.

Case presentation: Here we report a neovascular glaucoma patient who experienced a substantial increase in IOP associated with severe eye pain and blurred vision during sessions of dialysis. The patient had been refractory to several antiglaucoma drugs and improved after intravenous administration of 20% hyperosmotic glucose solution with dialysis and pan-retinal photocoagulation.

Conclusion: It is the first report in which intravenous glucose administration and reduction of neovascularization by argon laser pan-retinal photocoagulation successfully managed IOP increase during dialysis in neovascular glaucoma. Further clinical studies are required to confirm our results.

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Figures

Fig. 1
Fig. 1
Biomicroscopic (a) and OCT (b) images of anterior chamber showing angle closure due to neovascularization of the angle
Fig. 2
Fig. 2
Appearance of ONH in right eye
Fig. 3
Fig. 3
Differences between IOP before and after i.v. glucose and panretinal photocoagulation treatments
See this image and copyright information in PMC

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