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.

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.

scholarly journals Recurrent Uveal Effusion after Laser Iridotomy

2017 ◽  
Vol 8 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Hiroshi Sakai ◽  
Michiko Yonahara ◽  
Miyako Sakai
Keyword(s):  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Ocular Pain ◽  
Laser Peripheral Iridotomy ◽  
Blurred Vision ◽  
Laser Iridotomy ◽  
Primary Angle Closure ◽  
Peripheral Iridotomy ◽  
Uveal Effusion

A 59-year-old woman was seen by an ophthalmologist for blurred vision, ocular pain, headache, and nausea. She was diagnosed with acute primary angle closure (APAC) and successfully treated with medications. Using ultrasound biomicroscopy (UBM), engorged episcleral vein was observed and small uveal effusion was diagnosed after laser peripheral iridotomy (LPI). The uveal effusion disappeared and was again diagnosed by UBM together with anterior segment inflammation with ocular pain. Iritis caused by LPI after APAC might be a cause of uveal effusion in this specific case.

scholarly journals Case Report: The efficacy of early phacoemulsification in the intraocular pressure control in primary angle closure glaucoma associated with cataract in a young female

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 372
Author(s):  
Carmen-Ecaterina Leferman ◽  
Madalina Cazacut ◽  
Alin Dumitru Ciubotaru
Keyword(s):  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
The Elderly ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Caucasian Woman ◽  
Blurred Vision ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Initial Symptoms

Glaucoma is a leading cause of irreversible blindness worldwide. Among different types of glaucoma, irreversible bilateral visual impairment is more common in primary angle closure glaucoma (PACG) patients. PACG and cataract often coexist and are both more prevalent among the elderly population, being rare in children and young adults. Here, we discuss the case of a 39-year-old Caucasian woman with unilateral PACG associated with cataract. The patient presented with a several-day history of left sided headache, decreased and blurred vision as well as pain and redness of the left eye (LE). She reported similar episodes in the previous year. Visual acuity (VA) of the LE was limited to counting fingers and intra-ocular pressure (IOP) of the LE was 42 mmHg. Anterior segment examination of the LE revealed: edematous cornea, a peripheral anterior chamber depth corresponding to Van Herick’s grade 0, mid-dilated pupil and lens opacities with visible glaukomflecken. Gonioscopic evaluation revealed iridotrabecular contact for 360º, no visible angle structures and a flat–mild convex iris contour. Spectral domain optical coherence tomography suggested only a thinning of neuro-retinal rim at the lower pole. Following treatment of the initial symptoms, phacoemulsification with intra-ocular lens implant was performed. IOP improved and no IOP-lowering medication was required. The patient was monitored for VA, IOP, field of vision changes, and optic disc evaluation every six months for 2 years and no glaucomatous change occurred. The patient also denied ocular symptoms during this period. This case supports the effectiveness of early phacoemulsification in the IOP control in patients with PACG.

Appositional angle closure and conversion of primary angle closure into glaucoma after laser peripheral iridotomy

2019 ◽  
Vol 104 (3) ◽  
pp. 386-391
Author(s):  
Li Qiu ◽  
Yujie Yan ◽  
Lingling Wu
Keyword(s):  
Ultrasound Biomicroscopy ◽  
Chinese Patients ◽  
Angle Closure ◽  
Glaucomatous Optic Neuropathy ◽  
Laser Peripheral Iridotomy ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Relationship ◽  
Peripheral Iridotomy

PurposeTo determine the relationship between appositional angle closure (AppAC) and the conversion of primary angle closure (PAC) into primary angle closure glaucoma (PACG) after laser peripheral iridotomy (LPI).MethodsConsecutive patients with PAC were included in this prospective cohort study. The eyes of the included patients who had undergone LPI with five or more reliable visual field (VF) tests in at least 5 years were analysed. Baseline AppAC was diagnosed when the trabecular meshwork and iris were located appositionally on the ultrasound biomicroscopy image. The criteria for PAC conversion were based on development of glaucomatous optic neuropathy and corresponding VF defects. Other factors such as age and vertical cup-to-disc ratio (VCDR) were also investigated by univariate and multivariate logistic regression analyses.Results128 patients were assessed at baseline. 80 eyes of 58 patients fulfilled the inclusion criteria. The mean follow-up period was 6.67 ± 1.33 years. PAC conversion was observed in 20 eyes. The frequency of PAC conversion was significantly higher in eyes with AppAC > 2 quadrants at baseline (58.3%, 7/12) than in those with AppAC ≤ 2 quadrants (19.1%, 13/68; p < 0.05). Compared with the non-converting group, the age and VCDR at baseline were both higher in the converting group (p < 0.05). Wider AppAC, older age and higher VCDR were significantly associated with PAC conversion.Conclusions25% of PAC eyes of Chinese patients converted into PACG eyes in more than 5 years after LPI. AppAC > 2 quadrants were related to the PAC conversion. Older baseline age and higher VCDR were also associated with PAC conversion.

Elucidation of presence of increased risk formation of primary angle-closure glaucoma among patients with hyperopia in department of refractive surgery

2021 ◽  
pp. 162-164
Author(s):  
N.V. Samokhvalov ◽  
◽  
E.L. Sorokin ◽  
A.N. Marchenko ◽  
Y.E. Pashentsev ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Refractive Surgery ◽  
Young Patients ◽  
Anterior Chamber Depth ◽  
Acute Attack ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Increased Risk

Important physiological feature of the anatomically «short» eye is the disproportionately large volume of the lens relative to the volume of the eye. A gradual and continuous increase in the volume of the lens contributes to the anterior displacement of the irido-lenticular diaphragm, causing the functional block of the anterior chamber angle. This leads to persistent disorders of the hydrodynamics of the eye, up to the development of an acute attack of angle-closure glaucoma. Purpose. To study incidence of increased risk formation of primary angle-closure glaucoma (PACG) and its acute attack in young patients with moderate and high hyperopia (Hm). Material and methods. Clinical material was presented by 58 patients (116 eyes) with indicators of axial length of the eyes less than 23 mm. The main group consisted of 33 patients (66 eyes) with moderate and high Hm. The comparison group was represented by 25 patients (50 eyes) with PACG. Results. The study made it possible to identify group of increased risk of the formation of PACG, which included 19 people (58%), from selected general population of young patients with moderate and high Hm. Conclusion. Comparative analysis of morphometric parameters of structures of the anterior segment of the anatomically «short» eyes in young patients with moderate and high Hm, on the one hand, and in patients with PACG, on the other, revealed statistically significant differences between them in the anterior chamber depth in the central zone, the thickness of the lens, the anterior chamber volume, the peripheral anterior chamber depth, of the anterior chamber angle. Key words: primary angle-closure glaucoma, acute attack of angle-closure glaucoma, hyperopia, refractive surgery.

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