Hypoperfusion retinopathy and elevated intraocular pressure in a 17-year-old

We describe a case of bilateral hypoperfusion retinopathy (HR) in a 17-year-old man with intraocular pressure (IOP) of >40 mm Hg. After 6 months of antiglaucoma drug therapy, the patient's bilateral IOP remained over 35 mm Hg, and features of HR were found bilaterally in the absence of carotid artery obstruction. On restoration of IOP to normal by means of trabeculectomy, the bilateral signs of HR regressed. We speculate that the elevated IOP contributed to HR in this patient.