Gonioscopy and Ultrasound Biomicroscopy in the Detection of Angle Closure in Patients with Shallow Anterior Chamber

2014 ◽  
Vol 29 (4) ◽  
pp. 204-207 ◽  
Author(s):  
Shan-shan Cui ◽  
Yan-hong Zou ◽  
Qian Li ◽  
Li-na Li ◽  
Ning Zhang ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Shallow Anterior Chamber

scholarly journals A Case Report of Preoperative, Intraoperative, and Postoperative Anterior Chamber Shallowing Resulting from Different Mechanisms

2016 ◽  
Vol 7 (1) ◽  
pp. 115-118
Author(s):  
Yujiro Mori ◽  
Yoshifumi Ikeda ◽  
Ichiya Sano ◽  
Etsuko Fujihara ◽  
Masaki Tanito
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Perioperative Period ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Appropriate Treatment ◽  
Flat Anterior Chamber ◽  
Shallow Anterior Chamber ◽  
Underlying Mechanisms

A 54-year-old woman with an epiretinal membrane in her left eye accompanied by a shallow anterior chamber due to primary angle closure glaucoma underwent vitrectomy and cataract surgery. During the cataract surgery, immediately after the ultrasonic tip had been removed from the anterior chamber, anterior chamber flattening occurred. An intraoperative fundus examination showed the development of acute intraoperative choroidal effusion. Postoperatively, the anterior chamber remained shallow even after the choroidal detachment had subsided; capsular bag distension seen by ultrasound biomicroscopy suggested the development of early postoperative capsular block syndrome. After neodymium:yttrium-aluminium-garnet laser capsulotomy, the anterior chamber deepened. Depending on the perioperative period, the mechanism of a flat anterior chamber can change, and understanding the underlying mechanisms is required for appropriate treatment.

Anterior Segment OCT in Primary Angle Closure Compared to Normal Subjects with Similar Shallow Anterior Chamber

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Qinghong Xie ◽  
Ping Ma ◽  
Jutima Patlidanon ◽  
Murtaza Saifee ◽  
Sean Yonamine ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Normal Subjects ◽  
Angle Closure ◽  
Anterior Segment Oct ◽  
Primary Angle Closure ◽  
Shallow Anterior Chamber

Bilateral Isolated Spherophakia with Lens Subluxation, High Myopia and Secondary Angle Closure: A Case Report

2018 ◽  
Author(s):  
Ye Zhang ◽  
Ravi Thomas ◽  
Cong Wang ◽  
Xiangyu Shi
Keyword(s):  
Anterior Chamber ◽  
High Myopia ◽  
Rare Condition ◽  
Spherical Shape ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Pars Plana Lensectomy ◽  
Shallow Anterior Chamber ◽  
One Year ◽  
The Right

Abstract Background: Spherophakia is a rare condition and compared to its occurrence with familial and systemic disorders, isolated spherophakia is even more uncommon. This rare case of isolated spherophakia will raise the alertness of physicians when dealing with a high myopia patient with shallow anterior chamber and relatively normal fundus. Case presentation: We report a case of a 17-year-old male who experienced painless decrease of vision in both eyes (OU) for 11 years, with progression of visual impairment and occasional ocular pain for one year. Examination revealed high myopia, increased intraocular pressures (IOP, 28 mmHg in the right eye (OD) and 33 mmHg in the left (OS)), shallow central anterior chambers, lenses of a spherical shape with superior subluxation, occludable angles without peripheral anterior synechiae, and healthy optic discs OU. A diagnosis of bilateral isolated spherophakia, lens subluxation, high myopia and secondary angle closure (AC) was made. Pars plana lensectomy with anterior vitrectomy and scleral suturing of an intraocular lens was performed. On postoperative follow-up at 19 days OD and 63 days OS, the visual acuity was 6/6 and the IOP was normal without any medication OU. Conclusions: A presentation with high myopia, shallow anterior chamber with a normal retina should alert the clinician to the possibility of spherophakia, as compared to high myopia caused by elongated axial length. Surgery should be considered in cases of spherophakia with AC where the IOP cannot be controlled by noninvasive means.

scholarly journals Angiographic features of drug-induced bilateral angle closure and transient myopia with Ciliochoroidal effusion

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yong Koo Kang ◽  
Byeong Jae Son ◽  
Dong Ho Park ◽  
Jae Pil Shin
Keyword(s):  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Drug Induced ◽  
Idiosyncratic Reaction ◽  
Transient Myopia ◽  
Extravascular Fluid ◽  
Ciliochoroidal Effusion ◽  
Myopic Shift ◽  
Shallow Anterior Chamber

Abstract Background To report five cases of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion and to analyze angiographic findings of these cases. Methods This study is an observational case series. Five patients with acute drug-induced angle closure and transient myopia with ciliochoroidal effusion were examined by fluorescein angiography, indocyanine green angiography (ICGA) and ultrasound biomicroscopy (UBM). Results Five patients presented with bilateral visual loss and ocular pain after intake of topiramate, methazolamide, phendimetrazine tartrate or mefenamic acid. All patients showed elevated intraocular pressure (IOP) with shallow anterior chamber and myopic shift from − 0.5 to − 17.0 diopters (D). UBM showed ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid normalization of IOP and decrease of myopic shift occurred in all patients after discontinuing the suspected drugs. We classified the ICGA findings into 2 major signs (hypofluorescent dark spots, hyperfluorescent pinpoints) and 3 minor signs (diffuse choroidal hyperfluorescence, early hyperfluorescence of choroidal stromal vessel, and leakage and dilated retinal vessels). Conclusions The pathogenesis of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion may be idiosyncratic reaction of uveal tissue to systemic drugs. Accumulation of extravascular fluid in the ciliochoroidal layer had a major role in the pathogenesis. ICGA could be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer.

scholarly journals Anterior Segment Imaging – Anterior Chamber Angle Assessment

2010 ◽  
Vol 04 (01) ◽  
pp. 60
Author(s):  
Lisandro Sakata ◽  
Kenji Sakata ◽  
◽  
Keyword(s):  
Anterior Chamber ◽  
Clinical Decision Making ◽  
Anterior Segment ◽  
Clinical Decision ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Decision Making Process ◽  
Anterior Chamber Angle ◽  
Anterior Segment Imaging

Angle closure is a visually destructive form of glaucoma that accounts for approximately half of the worldwide blindness caused by this disease. Angle-closure glaucoma tends to occur in anatomically pre-disposed eyes, and the evaluation of the anterior segment morphology may help identify eyes at risk of angle closure. Ultrasound biomicroscopy is one of the devices developed for anterior-segment imaging, and it helped to provide better understanding of the mechanisms of angle closure. Recently, optical coherence tomography (OCT) technology became available for evaluating the anterior segment of the eye, enabling rapid non-contact imaging of the anterior chamber. Interestingly, anterior segment OCT (AS-OCT) technology appears to detect more eyes with angle closure compared with gonioscopy, and further studies should address how anterior segment imaging findings should be incorporated into the clinical decision-making process. In summary, this article reviews most of the previously published papers on the use of anterior segment imaging in angle-closure glaucoma and tackles some relevant points for the interpretation of imaging exams in daily clinical practice.

scholarly journals Vitreous Decompression Combined with Phacoemulsification for Medically Unresponsive Acute Angle Closure

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Xiaoli Xiang ◽  
Yuan Chen ◽  
Jinyu Wang ◽  
Zhengru Huang ◽  
Zheng Gu
Keyword(s):  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Needle Aspiration ◽  
Acute Angle ◽  
Angle Closure ◽  
Final Examination ◽  
Aspiration Technique ◽  
Acute Angle Closure ◽  
Shallow Anterior Chamber ◽  
Medical University

The management of acute angle closure combined with an extremely shallow anterior chamber and cataract remains complex. This study evaluated a technique of vitreous needle aspiration combined with phacoemulsification for the treatment of acute angle closure with continuous high intraocular pressure (IOP). We retrospectively reviewed the results of vitreous needle aspiration combined with phacoemulsification in 17 eyes (17 patients) with acute angle closure with continuous high IOP and coexisting visually significant cataracts between September 2018 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University. The main outcomes were the best corrected visual acuity (BCVA), IOP, anterior chamber depth (ACD), angle open distance 500 (AOD500), number of antiglaucoma medications, and surgery-associated complications. There were no complications during phacoemulsification and a foldable acrylic intraocular lens was implanted in the capsular bag in all 17 patients. For all patients, vitreous needle aspiration was successful at the first attempt. The BCVA improved from 2.02 ± 0.54 logMAR preoperatively to 0.73 ± 0.57 logMAR postoperatively at the final examination ( p < 0.001 ). The mean IOP was 54.47 ± 5.33 mmHg preoperatively and 15.59 ± 2.35 mmHg at the final examination ( p < 0.001 ) without any medication. The ACD was 1.70 ± 0.16 mm preoperatively and 3.35 ± 1.51 mm at the final examination ( p < 0.001 ). The AOD500 was 0.07 ± 0.02 mm preoperatively and 0.51 ± 0.04 mm at the final examination ( p < 0.001 ). Our vitreous needle aspiration technique can be performed safely in phacoemulsification for the management of acute angle closure with continuous high IOP.

Acute angle closure glaucoma precipitated by intranasal application of cocaine

1999 ◽  
Vol 113 (3) ◽  
pp. 250-251 ◽  
Author(s):  
C. K. Hari ◽  
D. G. Roblin ◽  
M. I. Clayton ◽  
R. G. Nair
Keyword(s):  
Anterior Chamber ◽  
Acute Angle ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Potential Complication ◽  
Intranasal Cocaine ◽  
Acute Glaucoma ◽  
Acute Angle Closure ◽  
Shallow Anterior Chamber ◽  
Acute Angle Closure Glaucoma

AbstractWe describe a patient who developed acute angle-closure glaucoma following the application of topical intranasal cocaine. A 46-year-old woman underwent an elective antral washout under general anaesthesia and with local application of 25 per cent cocaine paste to the nasal mucosa. Twenty-four hours post-operatively the patient developed sudden painful blindness which was found to be due to acute glaucoma. Cocaine with its indirect sympathomimetic activity causes mydriasis, that can precipitate acute angle-closure glaucoma in predisposed individuals with a shallow anterior chamber. Although the incidence is rare, otolaryngologists need to be aware of this potential complication.

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