Purpose: To determine the risk factors for hypotony maculopathy.
Design: Retrospective case control study.
Participants: Two hundred twenty-eight eyes of 228 patients with hypotony from one medical center.
Methods: Chart review of patients with hypotony from January 1988 to April 2001. Hypotony was defined as intraocular pressure of 5 mmHg or less. Cases of hypotony maculopathy had retinal or choroidal folds or both within the arcades. Controls had hypotony alone. Risk factors were evaluated using multiple logistic regression analysis.
Main outcome measures: Risk factors for hypotony maculopathy, including age, gender, race, refractive error, systemic illness, intraocular pressure, primary filtering surgery, use of antifibrotic agents, and presence of choroidal effusion.
Results: Eighty-one case eyes with hypotony maculopathy and 147 control eyes with hypotony alone were identified. The mean age of patients with hypotony maculopathy was 50.5 years +/- 18.7 compared with 70.6 years +/- 12.7 for the control patients (P < 0.001). More patients with hypotony maculopathy were male, 54.3% (44 of 81), than controls, 33.6% (49 of 147) (P = 0.004). The refractive error was -3.02 +/- 3.67 diopters (D) for phakic eyes with hypotony maculopathy (n = 31), whereas the phakic control eyes' (n = 30) refractive error was -0.61 D +/- 2.00 (P = 0.003). Choroidal effusion was found in 21% (17 of 81) of the case eyes at diagnosis and 52.4% (77 of 147) of the control eyes (P < 0.001). Race distribution and use of antifibrotics was similar for both groups. In multivariate analyses, young age, male gender, no history of diabetes, and absence of choroidal effusion predicted the development of hypotony maculopathy; in phakic eyes myopia was also a risk factor for hypotony maculopathy.
Conclusions: Young age, male gender, and myopia are significant risk factors for hypotony maculopathy. A history of diabetes and the presence of choroidal effusion are associated with a decreased risk for hypotony maculopathy.