Ciliary Body Melanocytoma with Anterior Segment Pigment Dispersion and Elevated Intraocular Pressure

Glaucoma is a blinding disease largely caused by increased resistance to drainage of fluid from the eye's anterior chamber, resulting in elevated intraocular pressure (IOP). A major site of fluid outflow regulation and pathology is the trabecular meshwork (TM), an extracellular matrix (ECM)-rich tissue at the entrance of the eye's drainage system. We aimed to characterize the structural and functional properties of a newly developed tissue-engineered (TE) anterior segment eye culture model. We hypothesized that repopulation of decellularized TM ECM with non-native TM cells could restore intraocular pressure (IOP) homeostatic ability. Decellularized porcine anterior segment scaffolds demonstrated complete removal of cells, significant reduction of DNA content, and well-preserved ECM ultrastructure. Seeded cells localized to the TM region (p < 0.001) and progressively infiltrated meshwork ECM. Cells reached a distribution comparable to control TM after four days of perfusion culture. After perfusion rate increase challenge, TE cultures maintained healthy IOPs through regulation of outflow resistance (reseeded = 16.53 ± 0.89, decellularized = 35.23 ± 2.20 mmHg, p < 0.0001). In conclusion, we describe a readily available, storable, and biocompatible scaffold for anterior segment perfusion culture of non-native cells. TE organs demonstrated physiological similarities to native tissues and may reduce the need for scarce donor globes in outflow research.

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Diode laser transscleral cyclophotocoagulation causes intraocular collamer lens displacement in pseudophakic eye: a case report

BMC Ophthalmology ◽

10.1186/s12886-021-02026-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Wei ◽

Xueqing Yu ◽

Lu Yang ◽

Chan Xiong ◽

Xu Zhang

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Anterior Chamber ◽

Intraocular Lens ◽

Angle Closure ◽

Pigment Dispersion ◽

Intraocular Lens Implantation ◽

Lens Implantation ◽

Elevated Intraocular Pressure ◽

Transscleral Cyclophotocoagulation

Abstract Background With the rapid development of intraocular collamer lens (ICL) operation, it is foreseeable that we will encounter a large number of glaucoma patients with ICL implantation history. However, our current understanding of the treatment of glaucoma patients with ICL is limited. Hence we report a rare case of refractory glaucoma after intraocular collamer lens and intraocular lens implantation in a patient who underwent unsuccessful transscleral cyclophotocoagulation, which led to intraocular collamer lens displacement, angle closure and uncontrolled intraocular pressure. Case presentation A 39-year-old woman presented with intractably elevated intraocular pressure in the right eye. Since her intraocular collamer lens implantation surgery in 2017, her intraocular pressure had remained over 40 mmHg while using 3 types of anti-glaucoma medications. The patient had a history of phacoemulsification and posterior chamber phakic intraocular lens implantation for complicated cataracts secondary to uveitis in 2006. On gonioscope examination, there were signs of pigment dispersion, and the anterior chamber angle was open. Ultrasound biomicroscopy examination showed contact and rubbing between the intraocular collamer lens and posterior surface of the iris. And typical advanced glaucomatous optic neuropathy and visual field defects were observed. Transscleral cyclophotocoagulation was performed to control the intraocular pressure and prevent further visual field loss. However, the intraocular collamer lens was displaced after transscleral cyclophotocoagulation, which resulted in formation of a shallow anterior chamber 1 week later, angle closure and loss of intraocular pressure control 1 month later, even though the maximum dose of anti-glaucoma medication was used. Finally, an Ahmed glaucoma valve was successfully implanted in her anterior chamber, and the glaucoma was controlled, as observed at the 10-month follow-up. Conclusions Pigment dispersion is a common phenomenon after intraocular collamer lens implantation and may accelerate the progression of glaucoma. Transscleral cyclophotocoagulation should be carefully considered in glaucoma patients with elevated intraocular pressure after intraocular collamer lens implantation, given that transscleral cyclophotocoagulation may cause intraocular collamer lens displacement.

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Implantation of a trifocal toric intraocular lens to a patient with pigment dispersion syndrome

Kazan medical journal ◽

10.17816/kmj2019-495 ◽

2019 ◽

Vol 100 (3) ◽

pp. 495-499

Author(s):

R F Akhmetshin ◽

M R Gilyazev ◽

A T Galeeva ◽

S N Bulgar

Keyword(s):

Intraocular Pressure ◽

Intraocular Lens ◽

Anterior Segment ◽

Ultrasound Biomicroscopy ◽

Pigment Dispersion ◽

Toric Intraocular Lens ◽

Lens Extraction ◽

Pigment Dispersion Syndrome ◽

Myopic Astigmatism ◽

Peripheral Iridotomy

Aim. To present a clinical case of treatment of pigment dispersion syndrome by clear lens extraction and implantation of a toric intraocular lens in a patient with myopic astigmatism. Methods. A 33-year-old patient with a diagnosis of moderate myopia, complex mild myopic astigmatism, pigment dispersion syndrome of both eyes. Results. The first stage was laser peripheral iridotomy of both eyes. On follow-up pathological irido-zonular contact and increases intraocular pressure by 2 mm persisted. The second stage included clear lens extraction and implantation of a toric multifocal intraocular lens to both eyes. In 2 months, distance and near visual acuity was 1.0, intraocular pressure was normal, no pathological irido-zonular contact was observed according to the ultrasound biomicroscopy. Conclusion. Implantation of an intraocular lens in patients with myopia and pigment dispersion syndrome is both a method of preventing pigment glaucoma and myopia correction; patients with pigment dispersion syndrome after peripheral iridotomy should monitor the state of the anterior segment of the eye and the effectiveness of the treatment by ultrasound biomicroscopy.

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Tissue-Engineered Anterior Segment Eye Cultures Maintain Intraocular Pressure within a Normal Range

10.20944/preprints201907.0142.v3 ◽

2020 ◽

Author(s):

Susannah Waxman ◽

Alicja Strzalkowska ◽

Chao Wang ◽

Ralitsa Loewen ◽

Yalong Dang ◽

...

Keyword(s):

Intraocular Pressure ◽

Rate Increase ◽

Anterior Segment ◽

Drainage System ◽

Perfusion Culture ◽

Normal Range ◽

Perfusion Rate ◽

Structural And Functional Properties ◽

Culture Model ◽

Elevated Intraocular Pressure

Glaucoma is a blinding disease largely caused by increased resistance to drainage of fluid from the eye’s anterior chamber, resulting in elevated intraocular pressure (IOP). A major site of fluid outflow regulation and pathology is the trabecular meshwork (TM) at the entrance of the eye’s drainage system. We aimed to characterize the structural and functional properties of a newly developed tissue-engineered anterior segment eye culture model. We hypothesized that repopulation of a decellularized TM with non-native TM cells could restore aspects of normal TM. The decellularization protocol removed all cells and debris while preserving the ECM. Seeded cells localized to the TM region and progressively infiltrated the meshwork ECM. Cells reached a distribution comparable to control TM after four days of perfusion culture. After a perfusion rate increase challenge, tissue-engineered cultures reestablished normal IOPs (reseeded = 13.7±0.4 mmHg, decellularized = 35.2±2.2 mmHg, p < 0.0001). eGFP expressing CrFK control cells caused a high and unstable IOP (27.0±6.2 mmHg). In conclusion, we describe a readily available, storable, and biocompatible scaffold for anterior segment perfusion culture of non-native cells. Tissue-engineered organs demonstrated similarities to native tissues and may reduce the need for scarce donor globes in outflow research.

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Sutureless, Glueless, Scleral Fixation of Single-Piece and Toric Intraocular Lens: A Novel Technique

Case Reports in Ophthalmology ◽

10.1159/000437349 ◽

2015 ◽

Vol 6 (2) ◽

pp. 239-245 ◽

Cited By ~ 3

Author(s):

Aditya Kelkar ◽

Rachana Shah ◽

Jai Kelkar ◽

Shreekant Kelkar ◽

Ekta Arora

Keyword(s):

Intraocular Pressure ◽

Intraocular Lens ◽

Pigment Dispersion ◽

Toric Intraocular Lens ◽

Scleral Fixation ◽

Novel Technique ◽

Single Piece ◽

Intraocular Hemorrhage ◽

Elevated Intraocular Pressure ◽

Capsular Support

Sutureless, glueless, scleral fixation of an intraocular lens is a known technique of fixing a lens in the scleral pockets. However, this technique is applied to single-piece and toric lenses instead of 3-piece lenses, allowing the advantage of the use of premium lenses in patients with poor capsular support. Favourable results without complications of pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage and cystoid macular edema with a well-centered, stable intraocular lens have been observed in the 3-month postoperative period in both cases.

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Elevated intraocular pressure, pigment dispersion and dark hypopyon in endogenous endophthalmitis from Listeria monocytogenes

Survey of Ophthalmology ◽

10.1016/0039-6257(92)90074-4 ◽

1992 ◽

Vol 37 (2) ◽

pp. 117-124 ◽

Cited By ~ 21

Author(s):

Dean Eliott ◽

Terrence P. O'Brien ◽

W.Richard Green ◽

Henry D. Jampel ◽

Morton F. Goldberg

Keyword(s):

Intraocular Pressure ◽

Listeria Monocytogenes ◽

Endogenous Endophthalmitis ◽

Pigment Dispersion ◽

Elevated Intraocular Pressure

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Tissue-Engineered Anterior Segment Eye Cultures Maintain Intraocular Pressure

10.20944/preprints201907.0142.v2 ◽

2020 ◽

Author(s):

Susannah Waxman ◽

Chao Wang ◽

Yalong Dang ◽

Ralitsa Loewen ◽

Nils A. Loewen

Keyword(s):

Intraocular Pressure ◽

Rate Increase ◽

Anterior Segment ◽

Drainage System ◽

Perfusion Culture ◽

Perfusion Rate ◽

Major Site ◽

Structural And Functional Properties ◽

Culture Model ◽

Elevated Intraocular Pressure

Glaucoma is a blinding disease largely caused by increased resistance to drainage of fluid from the eye’s anterior chamber, resulting in elevated intraocular pressure (IOP). A major site of fluid outflow regulation and pathology is the trabecular meshwork (TM) at the entrance of the eye’s drainage system. We aimed to characterize the structural and functional properties of a newly developed tissue-engineered anterior segment eye culture model. We hypothesized that repopulation of a decellularized TM with non-native TM cells could restore aspects of normal TM. The decellularization protocol removed all cells and debris while preserving the ECM. Seeded cells localized to the TM region and progressively infiltrated the meshwork ECM. Cells reached a distribution comparable to control TM after four days of perfusion culture. After a perfusion rate increase challenge, tissue-engineered cultures reestablished normal IOPs (reseeded = 13.7±0.4 mmHg, decellularized = 35.2±2.2 mmHg, p < 0.0001). eGFP expressing CrFK control cells caused a high and unstable IOP (27.0±6.2 mmHg). In conclusion, we describe a readily available, storable, and biocompatible scaffold for anterior segment perfusion culture of non-native cells. Tissue-engineered organs demonstrated similarities to native tissues and may reduce the need for scarce donor globes in outflow research.

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Concurrent lacrimal gland melanocytoma and ocular melanocytosis in a dog

Journal of Veterinary Diagnostic Investigation ◽

10.1177/10406387211045027 ◽

2021 ◽

pp. 104063872110450

Author(s):

Ikki Mitsui ◽

Seigi Nishimura

Keyword(s):

Intraocular Pressure ◽

Lacrimal Gland ◽

Ciliary Body ◽

Mammalian Species ◽

Final Diagnosis ◽

Mixed Breed ◽

Elevated Intraocular Pressure ◽

Mitotic Figures ◽

Rostral Portion ◽

Ocular Melanocytosis

A 9-y-5-mo-old, spayed female, mixed-breed dog with buphthalmia and elevated intraocular pressure in the left eye, consistent with glaucoma, was evaluated. Black-pigmented, slightly elevated tissue with irregular margins was noted on the dorsolateral aspect of the left globe. Ultrasonography detected a mass, later identified as lacrimal gland, adjacent to the globe and the thickened uvea. The surgically removed lacrimal gland was effaced by dense sheets of melanin-laden cells. Within the enucleated globe, numerous melanin-laden cells infiltrated and expanded the rostral two-thirds thickness of the cornea, the entire anterior uvea (iris and ciliary body), and a rostral portion of the choroid. Melanin-laden cells in the left lacrimal gland and globe showed no nuclear atypia or mitotic figures, and reacted to anti-S100 and anti–melan A antibodies by immunohistochemistry. Our final diagnosis was concurrent lacrimal gland melanocytoma and ocular melanocytosis. The trabecular meshwork of the eye was obliterated by melanin-laden cells, which was the likely cause of glaucoma in this patient. To our knowledge, melanocytoma affecting the lacrimal gland has not been reported previously in a non-human mammalian species. Veterinary clinicians are encouraged to include melanocytoma in the differential list when examining an enlarged lacrimal gland.

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Primary Angle-Closure Glaucoma Due to Cyst of the Ciliary Body. Clinical Case

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-3-508-512 ◽

2020 ◽

Vol 17 (3) ◽

pp. 508-512

Author(s):

D. V. Angelova ◽

E. E. Kazaryan ◽

N. Yu. Shkolyarenko

Keyword(s):

Intraocular Pressure ◽

Anterior Chamber ◽

Ciliary Body ◽

Clinical Case ◽

Anterior Segment ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Ophthalmological Examination ◽

Static Perimetry ◽

The Right

There is a clinical case of the occurrence of angle-closure glaucoma due to closure of the angle of front camera with the cyst of a ciliary body. Patient A., 42 years old, complained about a feeling of transient blurring of the right eye vision, visual impairment in the evening. At the initial ophthalmological examination, the maximum corrected visual acuity in both eyes was 1.0, intraocular pressure according to pneumotonometry: OD — 21 mm Hg, OS — 14.8 mm Hg. There were no changes in the anterior segment of the eyeball according to biomicroscopic data. Taking into account the asymmetry of IOP data, the patient underwent the following studies: static perimetry, optical coherence tomography (OCT), flowmetry with the calculation of tolerant intraocular pressure (TIOP). According to OCT and static perimetry, pathological deviations were not detected. When performing flowmetry on the left eye, the indicators were within normal values, however, a significant decrease in the volume of eye ocular blood flow and an increase in the IOP were determined in the right eye. In the left eye, the TIOP corresponded to the IOP, and in the right eye, the IOP indicators exceeded the TIOP value. The lack of correlation between morphofunctional indicators and flowmetry data, an unburdened hereditary history of glaucoma, and a discrepancy between flowmetry and age could indicate the development of the angle-closed glaucoma, so the patient was referred to ultrasound biomicroscopy. The echographic picture of the anterior part of the right eye was characterized by a decrease in the depth of the anterior chamber, a partial displacement of the peripheral part of the iris anteriorly, a slight narrowing of the angle of the anterior chamber, and an uneven posterior chamber. In the region of the process part of the ciliary body along the meridian of 3 hours, a thinwalled volumetric formation, anechogenic, with clear contours and dimensions was revealed: height 4.3 mm, length 4.8 mm. The root of the iris was determined by the average attachment to the ciliary body. In accordance with this, the diagnosis was made: OD — cyst of the ciliary body, the patient was referred for consultation about a possible laser surgical intervention.

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