The Use of Subconjunctival Erythropoietin Injection to Treat Avascular Bleb after Trabeculectomy: A Case Report
Kiana Hassanpour1 *, Maryam Yadgari10 , Iman Ansari10
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences
Abstract: To report a patient with avascular bleb after trabeculectomy who showed promising
results after subconjunctival erythropoietin injection.
Methods: A 45-year-old woman with the diagnosis of primary open-angle glaucoma and
history of trabeculectomy three years prior was admitted to our center. The corrected distance
visual acuity (CDVA) was 20/20 in both eyes.
Results: Her ocular examination revealed an avascular and
cystic bleb in the right eye. Seidel test was negative while bleb sweating was observed after
fluorescein staining of the bleb area. Intraocular pressure (IOP) was 5 mmHg in the right eye.
Erythropoietin (2000 unit in 0.1 ml) was injected subconjuctivally around the bleb area in the
temporal quadrant. Six weeks after the injection, the bleb area just superior to the conjunctiva
showed an increased fibrosis formation while the IOP remained the same as before injection.
Conclusion: Erythropoietin might play a role in preventing the progression of a cystic avascular
or hypovascular bleb to a leaking bleb.
