A case of Exudative Retinal Detachment after Fistulizing Antiglaucoma Surgery in a Patient with Sturge — Weber Syndrome

A clinical case of exudative retinal detachment after trabeculectomy for secondary glaucoma with Sturge-Weber syndrome is presented. A 50-year-old female patient with Sturge-Weber syndrome sought help for secondary glaucoma with elevated intraocular pressure on maximum drug hypotensive therapy. According to these indications, she was offered trabeculectomy with posterior trepanation of the sclera. Surgical treatment was without intraoperative complications. However, in the early postoperative period flat choroidal detachment and widespread retinal detachment involving the macular region were detected. During observation and prescription of anti-inflammatory and cycloplegic therapy, resolution of the exudative process was noted 1 month after surgery. 

Conclusion. Despite the peculiarities of the postoperative course, trabeculectomy is one of the effective methods of surgical treatment of secondary glaucoma in Sturge-Weber syndrome.

1. Davletshina LM, Zagidullina ASh, Batyrshin RA. Ophthalmological manifestations of Sturge-Weber syndrome. Bulletin of Pirogov National Medical & Surgical Center. 2023;18(S4):80–81 (In Russ.). doi: 10.25881/20728255_2023_18_4_S1_80.

2. Savranova TN, Rozukulov VU, Yusupov AF, Asadov DA, Saidzhonov SS. Surgical treatment of glaucoma with filtration bleb activation of a patient with Sturge-Weber syndrome: a clinical case. Russian Ophthalmological Journal. 2022;15(3):128–135 (In Russ.). doi: 10.21516/2072-0076-2022-15-3-128-135.

3. Comi AM. Update on Sturge-Weber syndrome: diagnosis, treatment, quantitative measures, and controversies. Lymphat Res Biol. 2007;5(4):257–264. doi: 10.1089/lrb.2007.1016.

4. Gadzhieva NM. Sturge-Weber syndrome (clinical case). Azerbaijan Ophthalmological Journal. 2024;50(3):44–46 (In Russ./Azer.).

5. Shirley MD, Tang H, Gallione CJ, Baugher JD. Sturge-Weber syndrome and portwine stains caused by somatic mutation in GNAQ. N Engl J Med. 2013;368(21):1971– 1979. doi: 10.1056/NEJMoa1213507.

6. Almobarak FA, Alobaidan AS, Alobrah MA. Outcomes of Deep Sclerectomy for Glaucoma Secondary to Sturge-Weber Syndrome. J Clin Med. 2023;12(2):516. doi: 10.3390/jcm12020516.

7. Starostina AV, Sidorova AV, Klepinina OB, Khabazova MR, Arisov AA, Stefankova KA. Features of the postoperative period after glaucoma surgery in a patient with Sturge-Weber syndrome (clinical case). Natsional’nyi zhurnal glaukoma. 2022;21(3):32–40 (In Russ.). doi: 10.53432/2078-4104-2022-21-3-32-40.

8. Barbosa GCS, Susanna BN, Okuno RK, Junior RS. Serous Retinal Detachment Resolution following Trabeculectomy in a Patient with Sturge-Weber Syndrome. J Curr Ophthalmol. 2021;33(2):209–211. doi: 10.4103/joco.joco_176_20.

9. Shilov AI, Pravosudova MM, Shefer KK. A clinical case of choroidal detachment as choroidal effusion in a child with Sturge-Weber-Crabbe syndrome. Russian Pediatric Ophthalmology. 2022;17(3):31–37 (In Russ.). doi: 10.17816/rpoj108984.

10. Hassanpour K, Nourinia R, Gerami E, Mahmoudi G, Esfandiari H. Ocular Manifestations of the Sturge-Weber Syndrome. J Ophthalmic Vis Res. 2021;16(3):415–431. doi: 10.18502/jovr.v16i3.9438.

11. Sullivan TJ, Clarke MP, Morin JD. The ocular manifestations of the SturgeWeber syndrome. J Pediatr Ophthalmol Strabismus. 1992;29(6):349–356. doi: 10.3928/0191-3913-19921101-05.

12. Cibis GW, Tripathi RC, Tripathi BJ. Glaucoma in Sturge-Weber syndrome. Ophthalmology. 1984;91(9):1061–1071. doi: 10.1016/s0161-6420(84)34194-x.

13. Basler L, Sowka J. Sturge-Weber syndrome and glaucoma. Optometry. 2011;82(5):306– 309. doi: 10.1016/j.optm.2010.11.015.

14. Iwach AG, Hoskins HD Jr., Hetherington J Jr., Shaffer RN. Analysis of surgical and medical management of glaucoma in Sturge-Weber syndrome. Ophthalmology. 1990;97(7):904–909. doi: 10.1016/s0161-6420(90)32483-1.

15. Ali MA, Fahmy IA, Spaeth GL. Trabeculectomy for glaucoma associated with Sturge-Weber syndrome. Ophthalmic Surg. 1990;21(5):352–325.