The British journal of ophthalmology · 2026
Novel therapeutic strategies to restore vision in ocular hypotony (STRETCH): results from a prospective pilot series.
СтатьяНазвание и аннотация: Перевод в очереди
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Orsine Murta Dias Karla, Yang Elizabeth, Calcagni Antonio, Kawa Jamal Riymon, Gooch James, Shah Diya, Khalil Rana, Sutaria Aman, Jayaram Hari, Gazzard Gus, Wickham Louisa, Petrushkin Harry
Аннотация
BACKGROUND/AIMS: To report visual and anatomical outcomes following intravitreal hydroxypropylmethylcellulose (HPMC) for the treatment of chronic structural hypotony.
METHODS: This study is a prospective interventional case series. Eight patients with chronic structural hypotony for more than 3 months, defined by an intraocular pressure (IOP) of <6.5 mm Hg. All patients had evidence of visual potential, clear cornea and a clear visual axis.Patients received multiple intravitreal HPMC injections (70 µL-1400 µL), administered every 2-4 weeks until either pre-morbid axial length was achieved, an IOP of 10-15 mm Hg was sustained for 4 weeks without signs of hypotony, or axial length of the contralateral eye was reached. They were followed up for 12 months after the first intravitreal injection.
RESULTS: Best corrected visual acuity (BCVA) logarithm of the minimum angle of resolution (LogMAR) improved in 87.5% of eyes, with one eye remaining stable. The initial BCVA range was 0.3-1.7 LogMAR, and the final range was 0.1-1.6 LogMAR. IOP increased in 87.5% of eyes, from an initial range of 1-5 mm Hg to 3-23 mm Hg. Axial length increased in 75% of eyes, with a median increase of 1 mm (range 0.6-2.9 mm).Two adverse events occurred: uveitis flare-ups leading to loss of HPMC clarity in two eyes, managed with topical and intravitreal steroids, and two cases of temporary vision loss post-injection, resolved after paracentesis.
CONCLUSION: This is the first case series to use a structured protocol for intravitreal HPMC in chronic hypotony management. The treatment improved vision and restored ocular anatomy, showing promise for managing structural hypotony in eyes with visual potential.
METHODS: This study is a prospective interventional case series. Eight patients with chronic structural hypotony for more than 3 months, defined by an intraocular pressure (IOP) of <6.5 mm Hg. All patients had evidence of visual potential, clear cornea and a clear visual axis.Patients received multiple intravitreal HPMC injections (70 µL-1400 µL), administered every 2-4 weeks until either pre-morbid axial length was achieved, an IOP of 10-15 mm Hg was sustained for 4 weeks without signs of hypotony, or axial length of the contralateral eye was reached. They were followed up for 12 months after the first intravitreal injection.
RESULTS: Best corrected visual acuity (BCVA) logarithm of the minimum angle of resolution (LogMAR) improved in 87.5% of eyes, with one eye remaining stable. The initial BCVA range was 0.3-1.7 LogMAR, and the final range was 0.1-1.6 LogMAR. IOP increased in 87.5% of eyes, from an initial range of 1-5 mm Hg to 3-23 mm Hg. Axial length increased in 75% of eyes, with a median increase of 1 mm (range 0.6-2.9 mm).Two adverse events occurred: uveitis flare-ups leading to loss of HPMC clarity in two eyes, managed with topical and intravitreal steroids, and two cases of temporary vision loss post-injection, resolved after paracentesis.
CONCLUSION: This is the first case series to use a structured protocol for intravitreal HPMC in chronic hypotony management. The treatment improved vision and restored ocular anatomy, showing promise for managing structural hypotony in eyes with visual potential.