First experience using micropulse cyclophotocoagulation in complex treatment acute angle closure glaucoma

Purpose. To study effectiveness of micropulse cyclophotocoagulation (MP-CPC) in complex treatment acute angle closure glaucoma (ACG). Material and methods. Dynamic observation of 4 patients with acute ACG was carried out. There was stagnant injection of the conjunctiva, corneal edema, shallow anterior chamber, iris bombe, mydriasis up to 4–6 mm, closed anterior chamber angle in all quadrants. In three cases, the initial lens opacities were determined, in one eye the lens was transparent. Against the background of drug therapy and laser iridectomy, the intraocular pressure (IOP) level reached values from 26 to 33 mm Hg. On days 2–3 after admission to the hospital, all patients underwent MP-CPC using the Cyclo G6 Glaucoma Laser System the MicroPulse P3 glaucoma device (Iridex, USA). Results. The operation and postoperative period were uneventful. All patients had pain relief, inflammatory response was absent. Corneal edema was stopped 1–2 days after surgery. In all eyes, on the first day after the operation, there was significant decrease in IOP level to 14–23 mm Hg. One month after the complex treatment, the IOP level remained stably normal and ranged from 16 to 21 mm Hg in all patients. Increase in visual acuity was noted in all cases. Conclusion. MP-CPC is effective, safe and low-traumatic operation and can be used in complex treatment of patients with an acute ACG. Key words: micropulse cyclophotocoagulation, acute angle closure glaucoma, intraocular pressure.

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Combined Acute Haemolytic and Secondary Angle Closure Glaucoma following Spontaneous Intraocular Haemorrhages in a Patient on Warfarin

Case Reports in Ophthalmology ◽

10.1159/000452440 ◽

2016 ◽

Vol 7 (3) ◽

pp. 511-516 ◽

Cited By ~ 2

Author(s):

Walter Andreatta ◽

Stavroula Boukouvala ◽

Atul Bansal

Keyword(s):

Intraocular Pressure ◽

Anterior Chamber ◽

Acute Angle ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

First Case ◽

Oral Warfarin ◽

Acute Angle Closure ◽

Excessive Anticoagulation ◽

Acute Angle Closure Glaucoma

Background: To report the first described case of combined haemolytic and acute angle closure glaucoma secondary to spontaneous intraocular haemorrhages in a patient on excessive anticoagulation. To the best of our knowledge, this is the first case reported in the literature presenting with raised intraocular pressure due to both mechanisms. Case Description: A 90-year-old woman presented with acute pain and reduction in vision in the left eye. Her intraocular pressure (IOP) was 55 mm Hg. There were red tinted blood cells in the anterior chamber giving it a reddish hue. The patient was known to have advanced wet macular degeneration. She was taking oral warfarin for atrial fibrillation. Her international normalised ratio (INR) was 7.7. B-scan ultrasound of posterior segment showed vitreous and suprachoroidal haemorrhages. An ultrabiomicroscopic examination confirmed open angles. A diagnosis of haemolytic glaucoma secondary to intraocular haemorrhages was made. The IOP was controlled medically. Warfarin was withdrawn and oral vitamin K therapy was initiated leading to a rapid INR reduction. Three days later, her anterior chamber became progressively shallower causing a secondary acute angle closure which was managed medically. After 2 months, the left IOP was well-controlled without any medications and the eye was not inflamed. Her vision in that eye remained perception of light. Conclusion: Patients with suprachoroidal haemorrhages should be closely monitored as they might subsequently develop acute angle closure despite an initially open angle and well-controlled INR and IOP. Excessive anticoagulation needs to be prevented to minimise the risk of sight-threatening complications.

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Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation

Case Reports in Ophthalmological Medicine ◽

10.1155/2015/687829 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Osman Okan Olcaysu ◽

Kenan Cadirci ◽

Ahmet Altun ◽

Afak Durur Karakaya ◽

Huseyin Bayramlar

Keyword(s):

Intraocular Pressure ◽

Optic Nerve ◽

Optic Neuropathy ◽

Acute Angle ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Hand Motion ◽

Snake Envenomation ◽

Acute Angle Closure ◽

Acute Angle Closure Glaucoma

Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation.Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE). The patient’s best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared.Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

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Acute angle closure glaucoma precipitated by intranasal application of cocaine

The Journal of Laryngology & Otology ◽

10.1017/s0022215100143695 ◽

1999 ◽

Vol 113 (3) ◽

pp. 250-251 ◽

Cited By ~ 13

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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Factors Affecting Intraocular Pressure after Laser Iridotomy in Fellow Eye with Acute Angle Closure Glaucoma

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2020.61.12.1493 ◽

2020 ◽

Vol 61 (12) ◽

pp. 1493-1499

Author(s):

Yu Min Kim ◽

Dai Woo Kim

Keyword(s):

Intraocular Pressure ◽

Acute Angle ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Factors Affecting ◽

Fellow Eye ◽

Laser Iridotomy ◽

Acute Angle Closure ◽

Acute Angle Closure Glaucoma

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Simultaneous Bilateral Acute Angle-Closure Glaucoma in Miller Fisher Syndrome

Czech and Slovak Ophthalmology ◽

10.31348/2019/4/5 ◽

2019 ◽

Vol 75 (4) ◽

pp. 210-218

Author(s):

Jana Štěpánková ◽

Lenka Kinštová ◽

Ivana Gažová ◽

Martina Kodetová ◽

Jiří Cendelín ◽

...

Keyword(s):

Intraocular Pressure ◽

Rehabilitation Program ◽

Acute Angle ◽

Angle Closure Glaucoma ◽

Miller Fisher Syndrome ◽

Angle Closure ◽

Fisher Syndrome ◽

Normal Limits ◽

Acute Angle Closure ◽

Acute Angle Closure Glaucoma

Purpose: To report a case of patient with Miller Fisher syndrome, complicated by simultaneous bilateral acute angle-closure glaucoma in her slightly (+1.5) hyperopic eyes. Methods: We present a case report of a 71-year-old female patient presenting with total ophthalmoplegia, areflexia, ataxia and bilateral acute angle-closure glaucoma. Results: The initial ocular examination revealed hand motion in the both eyes and oedematic corneas. Initial intraocular pressure was immeasurable high (measurment by Tonopen Avia). Measurement was possible after intravenous Mannitol 20 % infusion on both eyes as 54 and 56 mm Hg, respectively. Local medical therapy of pilocarpine, timolol, dorsolamide and dexamethasone improve intraocular pressure into normal limits within several hours. Prophylactic peripheral Nd-YAG laser iridotomy was performed on a both eyes two days later. Systemic treatment involved plasma exchange and rehabilitation program. Subsequent cataract surgery on both eyes with posterior capsule lens implantation improve the best corrected visual acuity on right eye from 0.5 to 1.0 and the left eye from 0.5 to 0.8, respectively. Intraocular pressure is within normal limits without any glaucoma therapy. Follow up period is three years. Conclusions: This is the second reported case of patient with Miller Fisher syndrome and simultaneous bilateral acute angle-closure glaucoma and the fifth reported case of Miller Fisher syndrome and acute angle-closure glaucoma. Treatment for both conditions made a very good recovery.

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