Ying J. Khoo, Aulia A. H. Abdullah, Dao-Yi Yu, William H. Morgan
Importance: A new method to help diagnose suspected cyclodialysis clefts. Background: To study the use of trypan blue stained aqueous flow patterns in diagnosing causes of hypotony where cyclodialysis clefts were suspected. Design: A case series in a tertiary care centre. Participants: Ten subjects presenting with persistent hypotony and retinal changes. Methods: Trypan blue was injected into the anterior chamber. Main Outcome Measures: The pattern of dye flow in the anterior chamber was categorized. Intraocular pressure prior to surgery was recorded. Results: All seven subjects with cyclodialysis clefts had a preferential flow to the cleft region. Two hypotonous subjects post trabeculectomy had rapid (5 seconds) and extensive lymphatic staining (6 o'clock hours extent) without visible bleb formation. Conclusions and Relevance: Preferential flow of dye to the limbus is a reliable sign of cyclodialysis cleft and helps localize cleft extent. A new cause of hypotony, “lymphatic overdrain,” is identified. © 2019 Royal Australian and New Zealand College of Ophthalmologists
Lions Eye Institute, University of Western Australia, Perth, WA, Australia; Department of Ophthalmology, Faculty of Medicine, Brawijaya University Dr Saiful Anwar General Hospital, Malang, Indonesia
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