Hypotony maculopathy in a case of diabetes insipidus

A 79-year-old female presented with blurring in her right eye of two week's duration. She had received cataract surgery with intraocular lens implantation in the same eye 8 months before. She had also been diagnosed as insulinoma followed by splenectomy and partial pancreatectomy 6 years before. Diabetes insipidus had been present since one year before. The visual acuity in her right eye was 0.2. The intraocular pressure (IOP) was 0 mmHg. Funduscopy showed choroidal folds and macular edema, leading to the diagnosis of hypotony maculopathy. The left eye was normal except for ocular hypony with IOP of 8 mmHg. After start of systemic vasopressin, the urine volume decreased to normal level. The IOP was 12 mmHg and the visual acuity in her right eye was 0.5 at day 18 of treatment. It appeared that the ocular hypotension was initiated by low serum osmolarity due to diabetes insipidus and was triggered by cataract surgery.