Erosion of conjunctiva over the suture knot with a leak in an eye with a non-flow restrictive aqueous drainage device

2021 ◽  
Vol 14 (9) ◽  
pp. e244073
Author(s):  
Dangeti Divya ◽  
Manan Jariwala ◽  
Sirisha Senthil
Keyword(s):  
Surgical Repair ◽  
Angle Closure ◽  
Ahmed Glaucoma Valve ◽  
Drainage Device ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Vicryl Suture ◽  
Patch Graft ◽  
The Right ◽  
Conjunctival Defect

We report a case of conjunctival erosion due to ligature suture knot exposure following Aurolab aqueous drainage device (AADI) implantation. A 48-year-old man, a known case of primary angle-closure glaucoma, had failed trabeculectomy with mitomycin-C and Ahmed glaucoma valve (AGV) in the right eye. The right eye had a large posterior AGV bleb with hypertropia and limitation of extraocular movement on downward gaze and uncontrolled intraocular pressure (IOP). An inferonasal AADI was performed uneventfully. At the 1-month postoperative visit, a small conjunctival erosion was noted over the ligature (6-0 vicryl) suture knot. However, there was no leak. Two weeks later, there was hypotony and a leak was noted at the site of the absorbed ligature. Immediate surgical repair was performed by re-ligature of the AADI tube with 8-0 vicryl and the ligature knot was placed under the scleral patch graft and the conjunctival defect was sutured. Early intervention helped in successfully healing the conjunctival erosion, reversal of the hypotony and well-controlled IOP. Adequate covering of the entire subconjunctival tube including its ligated part by a patch graft may prevent this complication.

Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

2021 ◽  
pp. 112067212110121
Author(s):  
Guido Barosco ◽  
Roberta Morbio ◽  
Francesca Chemello ◽  
Roberto Tosi ◽  
Giorgio Marchini
Keyword(s):  
Visual Impairment ◽  
Cataract Extraction ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Blurred Vision ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Increased Risk ◽  
The Right ◽  
End Stage

Purpose: This report describes a case of bilateral primary angle closure (PAC) progressing to unilateral end-stage primary angle closure glaucoma (PACG) associated with treatment for coronavirus disease-19 (COVID-19) infection. Methods: A 64-year-old man came to our attention because of blurred vision after a 2-month hospital stay for treatment of COVID-19 infection. Examination findings revealed PACG, with severe visual impairment in the right eye and PAC in the left eye due to plateau iris syndrome. The patient’s severe clinical condition and prolonged systemic therapy masked the symptoms and delayed the diagnosis. Medical chart review disclosed the multifactorial causes of the visual impairment. Ultrasound biomicroscopy (UBM) aided in diagnosis and subsequent therapy. Results: The cause behind the primary angle closure and the iridotrabecular contact was eliminated by bilateral cataract extraction, goniosynechialysis, and myotic therapy. Conclusions: COVID-19 treatment may pose an increased risk for PAC. Accurate recording of patient and family ophthalmic history is essential to prevent its onset. Recognition of early signs of PAC is key to averting its progression to PACG.

Frequency-specific oscillations synchronization in primary angle-closure glaucoma

2019 ◽  
Vol 61 (4) ◽  
pp. 537-548
Author(s):  
Fei Jiang ◽  
Yin-Quan Ye ◽  
Jin-Min Zuo ◽  
Xin Huang ◽  
Chen Yu ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Regional Homogeneity ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Frequency Bands ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Full Band ◽  
The Right ◽  
Glaucoma Group

Background Previous neuroimaging studies demonstrated that patients with primary angle-closure glaucoma were accompanied by abnormal neuronal activity. Purpose To investigate frequency-dependent local oscillations synchronization in primary angle-closure glaucoma using the regional homogeneity method. Material and Methods In total, 37 individuals with primary angle-closure glaucoma (20 men, 17 women) and 37 normal-sighted controls (20 men, 17 women) closely matched in age, sex, and education underwent resting-state MRI scans. We compared the different regional homogeneity values in full band (0.01–0.08 Hz) and two different frequency bands (slow-4: 0.027–0.073 Hz and slow-5: 0.010–0.027 Hz) between two groups. Results Compared to the normal-sighted group, the primary angle-closure glaucoma group showed decreased regional homogeneity values in the left calcarine and left postcentral in full band. The primary angle-closure glaucoma group showed increased regional homogeneity values in the bilateral superior medial frontal lobe in the slow-4 band. The primary angle-closure glaucoma group exhibited decreased regional homogeneity values in the right calcarine in the slow-5 band. Specifically, we found that the regional homogeneity values in the right superior frontal lobe were greater in the slow-4 than in the slow-5 band, whereas regional homogeneity in the left calcarine, right pallidum, left inferior occipital gyrus, left superior occipital gyrus, left postcentral/angular gyrus, left paracentral lobule, left superior parietal gyrus, and right precuneus gyrus were greater in the slow-5 than in the slow-4 band. Conclusion Primary angle-closure glaucoma groups showed abnormal regional homogeneity in visual network (calcarine) and default mode network (superior medial frontal lobe) at two frequency bands. Moreover, the regional homogeneity signals in slow-5 band showed closely related to the severity of individuals with primary angle-closure glaucoma.

Complex visualization of the anterior segment of the eye in the diagnosis, monitoring and treatment of angle closed disease

2021 ◽  
pp. 79-83
Author(s):  
G.А. Sharova ◽  
◽  
N.I. Kurysheva ◽  
◽  
◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Optical Coherence ◽  
Advantages And Disadvantages ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Right

The aim of this work is to review the literature on the role of anterior segment imaging in the diagnosis, monitoring, and treatment of primary angle closed disease. An analysis of the use of modern technical devices – optical coherence tomography of the anterior segment (ASOST), ultrasonic biomicroscopy, Scheimpflug camera – is presented, the advantages and disadvantages in comparison with gonioscopy are assessed. Visualization of the structures of the anterior segment of the eye is an important part of the strategy aimed at solving the problem of identifying risk factors, diagnosing, monitoring and evaluating the effectiveness of treatment of diseases of primary angle closure. Qualitative and quantitative analysis of data based on optical coherence tomography, ultrasound biomicroscopy, and Scheimflug camera data confirms high comparability with gonioscopy, but each of the methods complements each other. Conclusion. Visualization of the anterior segment of the eye is the standard in modern diagnostics and evaluation of the effectiveness of treatment of primary angle closure disease. Multimodal imaging improves the ability to accurately diagnose and choose the right treatment strategy. Key words: primary angle closure, primary angle-closure glaucoma, optical coherence tomography, ultrasound biomicroscopy, Scheimflug camera, gonioscopy.

Altered effective connectivity of primary visual cortex in primary angle closure glaucoma using Granger causality analysis

2019 ◽  
Vol 61 (4) ◽  
pp. 508-519
Author(s):  
Fei Jiang ◽  
Jian-Wen Fang ◽  
Yin-Quan Ye ◽  
Yan-Jin Tian ◽  
Xian-Jun Zeng ◽  
...  
Keyword(s):  
Effective Connectivity ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Precentral Gyrus ◽  
Healthy Controls ◽  
Causality Analysis ◽  
Granger Causality Analysis ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Right

Background Previous neuroimaging studies demonstrated that primary angle closure glaucoma patients were associated with abnormal intrinsic brain activity in primary visual cortex (V1). Purpose The purpose of this study was to investigate the effective connectivity patterns of V1 in patients with primary angle closure glaucoma. Material and Methods Thirty-seven patients with primary angle closure glaucoma (20 men, 17 women) and 36 healthy controls (20 men, 16 women) closely matched for age, sex, and education, underwent resting-state MRI scans. A voxel-wise Granger causality analysis method was performed to explore different effective connectivity pattern of V1 between the two groups. Results Compared with healthy controls, patients with primary angle closure glaucoma showed decreased effective connectivity from the left V1 to left cuneus and increased effective connectivity from the left V1 to left precentral gyrus and right supplementary motor area. Meanwhile, patients with primary angle closure glaucoma showed decreased effective connectivity from left precentral gyrus to left V1 and right frontal middle gyrus to left V1. In addition, patients with primary angle closure glaucoma showed a decreased effective connectivity from the right V1 to left cuneus/calcarine and increased effective connectivity from the right V1 to left inferior frontal gyrus and right caudate. Meanwhile, patients with primary angle closure glaucoma showed decreased effective connectivity from right middle frontal gyrus/precentral gyrus to right V1 and left precentral gyrus to right V1. Conclusion Our results highlighted that patients with primary angle closure glaucoma had abnormal effective connectivity between V1 and higher visual area, motor cortices, somatosensory cortices, and frontal lobe, which indicated that they might present with abnormal top-down modulations, visual imagery, vision-motor function, and vision-related higher cognition function.

scholarly journals Polypharmacy-associated potential contraindications of drug prescriptions in patients with primary angle closure disease in a real-world setting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Japanese Patients ◽  
Median Number ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Number Of Patients ◽  
Multiple Drugs

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.

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