Maculopathy due to hypotony: A diagnostic challenge

Abstract

Hypotony maculopathy is a potential complication of glaucoma filtering surgery, clinically relevant as it can cause vision loss. Classically, it produces choroidal folds, vascular tortuosity, and optic disc edema. However, in optical coherence tomography (OCT), it may also present as intraretinal cysts (IRC). We present the case of a patient who, 10 years after undergoing glaucoma surgery, developed ocular hypotony, IRC, and decreased visual acuity (VA). Given the patient's history of diabetes mellitus, it was initially diagnosed as diabetic macular edema (DME), which delayed appropriate treatment. This led to worsening corneal decompensation, ultimately requiring a corneal transplant in the form of Descemet membrane endothelial keratoplasty (DMEK).