Idiopathic elevated episcleral venous pressure and open-angle glaucoma

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.