scholarly journals Causes of Iris Depigmentation in Young and Middle Age. Clinical Example

2020 ◽  
Vol 17 (3) ◽  
pp. 502-507
Author(s):  
V. N. Trubilin ◽  
E. G. Poluninа ◽  
K. V. Chinenova ◽  
D. V. Andzhelova ◽  
V. V. Kurenkov ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Anterior Segment ◽  
Pigment Dispersion ◽  
Middle Aged ◽  
Aged Patients ◽  
Adequate Treatment ◽  
Pigment Dispersion Syndrome ◽  
Anterior Eye Segment ◽  
Trabecular Network ◽  
Iris Depigmentation

The spontaneous change of eyes’ color is a quite rare complain in ophthalmological clinical practice for young and middle-aged patients. We consulted the 18-year-old patient complained that a month ago she noticed a change of the iris’ color. It was symmetrical in both eyes, which had lightened and acquired a “spotty appearance”. Before the appearance of these complaints, the patient had eyes of a rich dark brown color. After a comprehensive examination, the bilateral acute iris depigmentation (BADI) was diagnosed. BADI is bilateral symmetrical iris depigmentation followed by focal or diffuse stromal atrophy and pigment dispersion in the anterior segment. It is more common for young and middle-aged women, and is often asymptomatic. BADI has bilateral symmetrical iris depigmentation followed by focal or diffuse stromal atrophy and pigment dispersion in the anterior eye segment of the eye, which may affect the trabecular network. A feature of this disease is the absence of transillumination, changes in the shape of the pupil, and an inflammatory reaction. In some cases, repigmentation may occur spontaneously during the next few years. Therefore, from a prognostic point this disease has a favorable prognosis. However, patients with BADI syndrome should undergo regular ophthalmological examinations, including measurement of intraocular pressure to exclude the development of secondary open-angle pigmented glaucoma, and use sunglasses when the sun is bright. BADI syndrome must be differentiated with the following diseases: Fuchs heterochromic iridocyclitis, viral iridocyclitis caused by HSV and CMV, pigment dispersion syndrome and pseudo exfoliative glaucoma, as well as bilateral acute iris transillumination (BAIT) syndrome to make a correct diagnosis and apply adequate treatment tactics.

scholarly journals Use of automatic refractometer infrared images to screen pigment dispersion syndrome: a cross-sectional observational study from a preliminary hypothesis

2020 ◽  
Vol 1 (1) ◽  
pp. 25-28
Author(s):  
Paolo Brusini ◽  
Veronica Papa
Keyword(s):  
Observational Study ◽  
Pigment Epithelium ◽  
Anterior Segment ◽  
Pigment Dispersion ◽  
Pigmentary Glaucoma ◽  
Infrared Images ◽  
Cross Sectional ◽  
Pigment Dispersion Syndrome ◽  
Automatic Refractometer ◽  
Iris Pigment Epithelium

Background: This study was performed to evaluate the use of anterior segment images, obtained with an automatic refractometer, to identify early defects of the iris pigment epithelium in patients with pigment dispersion syndrome (PDS) or pigmentary glaucoma (PG) without observable alterations at the slit lamp. Methods: In this cross-sectional observational study, carried out from January 2018 to December 2019, in Policlinico Citta di Udine Health Center, Udine, Italy, we observed anterior segment infrared images of 1700 subjects who were undergoing routine ophthalmological examination using an automatic refractometer. We selected infrared images of subjects who fulfilled the inclusion and exclusion criteria and looked for a focal defect in the iris pigment epithelium. Results: Twenty patients with focal iris pigment epithelial defect were identified and none of them showed evident signs of PDS. After the necessary explanations, they agreed to have further examinations to verify the possibility of PDS. An in-depth evaluation of ocular structures, including gonioscopy, demonstrated the presence of PDS in all subjects with iris defects. Conclusions: The use of infrared images obtained by an automatic refractometer could provide early and easy identification of PDS in crowded ophthalmology clinics or mass screening programs; yet, more well-designed studies are necessary to confirm these preliminary findings and prove this proposed screening tool.

scholarly journals A Case of Bilateral Acute Depigmentation of the Iris in One of Two Identical Twins

2019 ◽  
Author(s):  
Spencer Langevin ◽  
Alexandra Gershkovich ◽  
Brian P Marr
Keyword(s):  
Chronic Migraine ◽  
Anterior Segment ◽  
Case Series ◽  
Invasive Procedure ◽  
Pigment Dispersion ◽  
Young Females ◽  
Pigment Dispersion Syndrome ◽  
The Face ◽  
History Of ◽  
Iris Pigmentation

Abstract Background: Bilateral Acute Depigmentation of the Iris (BADI) is a condition which was first described in a case series from Turkey by Tugal-Tutkin and Urgancioglu in 2006.1 The condition is characterized by bilateral acute depigmentation and discoloration of the iris stroma, pigment dispersion, and deposition of pigment in the angle. In our case we report one of two identical twin sisters who developed BADI after receiving sarapin injections for chronic migraine, while the other has normal iris architecture and pigmentation and never received any like invasive procedure. Case Presentation: Patient is a 41 year old female with history of Sarapin injections to her face for chronic migraine who later developed bilateral depigmentation of the iris. She did not have any signs of anterior segment uveitis or iridocyclitis. She has a twin sister who maintained normal iris pigmentation during the entire course. Discussions and Conclusion: Bilateral Acute depigmentation of the iris is a recently discovered condition described in the literature in Turkish patients1,2. This condition affects mainly young females and is characterized by acute bilateral stromal depigmentation without other pathologic ocular findings. These patients usually maintain normal vision and do not develop significant glaucoma from pigment collecting in the anterior chamber angle. This condition can be mistaken for Fuch’s heterochromic iridocyclitis, pigment dispersion syndrome, pseudoexfoliation syndrome, viral iridocyclitis, VZV, HSV, and CMV. This is the first reported case in North America and is important for differentiation of the above pathologies. Our patient had a history of Sarapin injections to the face but it is unsure if this is associated with our patient’s development of BADI. As awareness of this condition progresses a possible etiology may be elucidated. Keywords: Iris; depigmentation; Sarapin, iris transillumination.

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

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.

scholarly journals Anterior segment optical coherence tomography documentation of Reverse Pupillary Block -A case of Pigment Dispersion Syndrome in a 10 year Old Child

2016 ◽  
Vol 15 (1) ◽  
pp. 34-39
Author(s):  
Devendra Maheshwari ◽  
Renagappa Ramakrishnan ◽  
Neelam Pawar
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Pigment Dispersion ◽  
Optical Coherence ◽  
Laser Peripheral Iridotomy ◽  
Pupillary Block ◽  
Laser Iridotomy ◽  
Pigment Dispersion Syndrome ◽  
History Of ◽  
Peripheral Iridotomy

We report a 10-year-old boy with unusually dense, bilateral central posterior capsule pigmentation associated with the characteristic clinical features of pigment dispersion syndrome, including Krukenberg’s spindle and dense trabecular pigmentation in both eyes. There was no history of trauma , laser or intraocular surgeries . The presence of posterior or backward bowing of iris suggested a reverse pupillary block mechanism of pigment dispersion syndrome. Nd Yag laser peripheral iridotomy was performed in both eyes to relieve reverse pupillary block. Anterior segment optical coherence tomography (AS-OCT) showed reversal of iris concavity after laser iridotomy.

scholarly journals Pigment Dispersion Syndrome and Pigmentary Glaucoma in an Emmetropic Young Male

2020 ◽  
Vol 12 (1) ◽  
pp. 139-145
Author(s):  
Neha Verma ◽  
Qamar Jawaid
Keyword(s):  
Pigment Epithelium ◽  
Anterior Segment ◽  
Young Male ◽  
Retinal Nerve Fibre Layer ◽  
Pigment Dispersion ◽  
Pigmentary Glaucoma ◽  
Visual Field Examination ◽  
Pigment Dispersion Syndrome ◽  
Normal Limits ◽  
Hereditary Nature

Introduction: Pigment dispersion Syndrome (PDS) is a disorder with an onset in mid–twenties. There occurs a disruption of the iris pigment epithelium and deposition of pigment granules throughout the anterior segment. The incidence of PDS is 4-8/ 100,000. This condition is more commonly seen In Caucasians and is considered to be rare in Indians. Case: A 33-year-old male presented with the complaint of headache for three months. He had normal vision in both eyes with visual acuity of 6/6. Observation: Krukenberg’s spindle, a classic sign of pigment dispersion syndrome was evident on slit-lamp examination over the posterior corneal surface. Gonioscopy revealed a heavy and uniformly pigmented trabecular meshwork. OCT (Optical Coherence Tomography) demonstrated a characteristic iris configuration in the form of a mid-peripheral posterior bowing of the iris .Retinal nerve fibre layer analysis done on OCT revealed glaucomatous thinning in the right eye and a more advanced defect in the left eye. A visual field examination revealed the field to be outside normal limits in both the eyes pointing towards a diagnosis of pigment dispersion glaucoma. Conclusion: The purpose of presenting this case is to caution the clinicians to carefully examine young emmetropes who present with Krukenberg’s spindle as it could be associated with PDS. Patients with Krukenberg’s spindle and without elevated lOP are often treated as normal. These patients must be cautioned regarding possible future consequences of the disease and counseled regarding the hereditary nature of the syndrome.

scholarly journals PSEUDOEXFOLIATIVE SYNDROME AS A TRIGGER FOR PSEUDOEXFOLIATIVE GLAUCOMA

2021 ◽  
Vol 21 (2) ◽  
pp. 48-51
Author(s):  
Eddine Jouini Dhia ◽  
I. M. Bezkorovaуna
Keyword(s):  
Optical Coherence Tomography ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Retinal Nerve Fibre Layer ◽  
Pigment Dispersion ◽  
Optical Coherence ◽  
Drug Induced ◽  
Pseudoexfoliative Glaucoma ◽  
Diagnostic Measures ◽  
Pigment Dispersion Syndrome

Glaucoma is one of the leading causes of blindness and disability worldwide. Pseudoexfoliative glaucoma is known to be the most aggressive and difficult-to-treat form of secondary glaucoma. According to the literature, pseudoexfoliative glaucoma occurs in 25-30% of cases among all open-angle glaucoma. The recent studies have established that a quarter of patients with pseudoexfoliative glaucoma are blind in one eye, and 7% are blind in both eyes. Risk factors for glaucoma include systemic and ophthalmic factors, one of which is the development of pseudoexfoliative syndrome. In patients with pseudoexfoliative syndrome, glaucoma occurs 20 times more often than in the general population of the same age. The purpose of this research is to study the informativeness of individual phenomena of pseudoexfoliative syndrome (PES) in order to improve early diagnosis and prevention of pseudoexfoliative glaucoma. The study included 114 patients diagnosed as having PES. Exclusion criteria were as follows: age up to 45 years, surgery on the eyeball, a history of disease (iridocyclitis, uveitis, corneal pathology, and traumatic eye disease), pigment dispersion syndrome. Along with the standard set of diagnostic measures, patients underwent biomicroscopy in the conditions of maximum drug-induced mydriasis, gonioscopic examination; the proportion of patients was examined by optical coherence tomography (SD-OCT Topson 3D oct-2000FA Plus (version 7/21/003/0)). The study revealed signs of pseudoexfoliative syndrome (deposition of pseudoexfoliative material on various structures of the anterior segment of the eye) in 100% of cases. Higher values of intraocular pressure (from 29 to 34 mm Hg) were found in the patients with elements of blocking the angle of the anterior chamber (narrowing or closing the angle, increased pigmentation and the presence of draining exfoliative conglomerates). The optical coherence tomography study revealed a thinning of the retinal nerve fibres (33.60 ± 0.43 μm), a significant thinning of retinal nerve fibre layer in patients with pseudoexfoliative syndrome and even more significant thinning in 29 patients diagnosed with pseudoexfoliative glaucoma. Thus, we can conclude knowing the microsymptoms of the disease, mandatory investigating the conditions of the maximum drug-induced mydriasis can contribute to detect pseudoexfoliative syndrome even in the initial stages and thus to prevent the development of pseudoexfoliative glaucoma.

scholarly journals Pigment dispersion syndrome with possible visual field loss (in Norwegian)

2010 ◽  
Vol 3 (1) ◽  
pp. 8-14
Author(s):  
Ellen Svarverud
Keyword(s):  
Trabecular Meshwork ◽  
Visual Fields ◽  
Anterior Segment ◽  
Clinical Signs ◽  
Visual Field Loss ◽  
Diagnostic Methods ◽  
Pigment Dispersion ◽  
Pigmentary Glaucoma ◽  
Pigment Dispersion Syndrome ◽  
Pigment Deposition

Pigment dispersion syndrome (PDS) is a condition of the anterior segment of the eye characterised by pigment deposition on a number of ocular structures. The condition is usually bilateral but most commonly asymmetric. In PDS, pigment is released from the posterior surface of the iris due to friction between the zonules and the iris. In itself, the condition does not represent any problems for the patient, but pigment deposition in the trabecular meshwork may interfere with drainage of the anterior chamber fluid and cause pigmentary glaucoma (PG). This case report presents a young myopic female with many of the classic signs of PDS; Krukenberg’s spindle, transillumination of mid-peripheral iris, deep anterior chambers, concave iris profile and increased pigmentation in the trabecular meshwork. Various diagnostic methods were applied to reveal clinical signs and to establish the patient’s visual function. Optic nerve heads and intraocular pressure were normal, but visual fields were suspect. The patient was advised to make an appointment with an ophthalmologist. Risk factors for development of PG and management of patients with PDS will be discussed.

scholarly journals A case of bilateral acute depigmentation of the Iris in one of two identical twins

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Spencer Langevin ◽  
Alexandra Gershkovich ◽  
Brian P. Marr
Keyword(s):  
Chronic Migraine ◽  
Plant Extract ◽  
Anterior Segment ◽  
Case Series ◽  
Identical Twin ◽  
Pigment Dispersion ◽  
Pitcher Plant ◽  
Twin Sister ◽  
Pigment Dispersion Syndrome ◽  
History Of

Abstract Background Bilateral Acute Depigmentation of the Iris (BADI) is a condition which was first described in a case series from Turkey by Tugal-Tutkin and Urgancioglu in (Graefes Arch Clin Exp Ophthalmol 244:742-6, 2006). The condition is characterized by bilateral acute depigmentation and discoloration of the iris stroma, pigment dispersion, and deposition of pigment in the angle. In our case we report a patient who developed BADI after receiving pitcher plant extract injections for chronic migraine, while her identical twin sister has normal iris architecture and pigmentation and never received any pitcher plant injections. Case presentation Patient is a 41-year-old female with history of pitcher plant extract injections to her face for chronic migraine, who later developed bilateral depigmentation of the iris. She did not have any signs of anterior segment uveitis or iridocyclitis. She has an identical twin sister who maintained normal iris pigmentation during the entire course. Conclusions Bilateral Acute depigmentation of the is a recently discovered condition described in the literature in Turkish patients (Tugal-Tutkun and Urgancioglu, Graefes Arch Clin Exp Ophthalmol 244:742-6, 2006; Tugal-Tutkun et al., Ophthalmology 116(8):1552-7, 2009). This condition affects mainly young females and is characterized by acute bilateral stromal depigmentation, without other pathologic ocular findings. These patients usually maintain normal vision and do not develop significant glaucoma from pigment collecting in the anterior chamber angle. This condition can be mistaken for Fuchs’ heterochromic iridocyclitis, pigment dispersion syndrome, pseudoexfoliation syndrome, and viral iridocyclitis. This is the first reported case in North America and is important for differentiation from the above pathologies. Our patient had a history of pitcher plant extract injections to the face but it is unclear if this is associated with our patient’s development of BADI. As awareness of this condition progresses, a possible etiology may be elucidated.

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