Idiopathic elevated episcleral venous pressure (Radius - Maumenee syndrome): differential-diagnostical problems

Abstract

The lack of full knowledge of the causes and all links of glaucoma pathogenesis forces us to recognize an increased level of intraocular pressure (IOP) as one of the main risk factors for glaucoma development. That is why glaucoma treatment is based on IOP level reduction to values that hold no danger of provoking visual functions decrease. Among the reasons for ocular hypertension development, the least studied are the conditions in which pressure increases in the system of episcleral veins. In differential-diagnostic search the idiopathic elevated episcleral venous pressure syndrome (Radius-Maumenee) fills a special place. This condition is an exclusion diagnosis in the absence of other significant pathology. Currently, in foreign literature one can find single clinical cases describing this condition. In this clinical case, a patient with secondary glaucoma of the right eye resulting from a long monocular idiopathic elevated episcleral venous pressure is presented. The peculiarity of this patient’s management was the intolerance of most hypotensive drugs, which affected the treatment tactics.