Retinal pigment epithelium changes in pediatric patients with glaucoma drainage devices

Carla J. Osigian, Sara Grace, Maria P. Fernandez, Camila V. Ventura, Susan Azar, Ta C. Chang, Elizabeth Hodapp, Sander R. Dubovy, Audina Berrocal

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose: Retinal changes secondary to hypotony are usually described as wrinkling or folding of the inner portion of the choroid, the retinal pigment epithelium (RPE), and the outer retinal layers in the macular area due to scleral wall collapse. We describe a new retinal finding in children with suspected hypotony after implantation of Baerveldt Glaucoma Implant (BGI). Observations: Four patients in our series developed significant RPE defects after BGI implant. The RPE defects appeared as elongated white lines observed solely in the posterior pole, in no particular pattern, and seemed to be worse in infants with anterior segment dysgenesis and with collagen disorders. Conclusion and importance: Children have thinner and more elastic scleral walls than adults. This characteristic may cause the inward scleral wall to collapse when the eye is hypotonic. The resulting redundancy of the retina leads to wrinkling and RPE defects characterized by hypopigmented lines predominantly in the macular area. Such findings, to our knowledge, have not been previously reported in pediatric patients.

Original languageEnglish (US)
Pages (from-to)23-27
Number of pages5
JournalAmerican Journal of Ophthalmology Case Reports
StatePublished - Mar 2018


  • Baerveldt glaucoma implant
  • Hypopigmented lines
  • Hypotony
  • Retinal pigment epithelium
  • Scleral elasticity

ASJC Scopus subject areas

  • Ophthalmology


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