scholarly journals Secondary angle closure glaucoma due to posterior scleritis in a case of empty sella syndrome

2020 ◽  
Vol 12 (2) ◽  
pp. 308-312
Author(s):  
Tarannum Mansoori
Keyword(s):  
Anterior Segment ◽  
Sella Turcica ◽  
Empty Sella ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Posterior Scleritis ◽  
Diagnostic Dilemma ◽  
Disc Edema ◽  
Shallow Anterior Chamber ◽  
The Right

Introduction: We frequently come upon cases of posterior scleritis with secondary angle closure glaucoma. However, it can pose a diagnostic dilemma in a patient with bilateral disc edema along with unilateral angle closure glaucoma due to posterior scleritis. Case: We report a case of a 25 - year old male, who presented with the complaints of pain, redness and blurring of vision in the left eye for the last 3 days. On ocular examination, unaided visual acuity of the right eye was 6/6 and the best corrected in the left eye was 6/9 with - 6.25 D sphere. Apart from conjunctival congestion and shallow anterior chamber in the left eye, rest of the anterior segment evaluation in both the eyes were normal. On fundus evaluation, there was presence of disc edema in both the eyes. Intraocular pressure was 20 and 32 mm of Hg in the right and left eye respectively. Gonioscopy revealed open angles in the right eye and no visible angle structures in the left eye. B-Scan of the left eye showed a typical “T” sign suggestive of posterior scleritis. MRI brain revealed empty sella turcica. Conclusion: Empty sella turcica has been reported to present with the bilateral disc edema which, when accompanied with other entities such as Posterior scleritis can be misleading and the diagnosis can pose to be a challenge.

scholarly journals Management of bilateral microspherophakia with secondary angle closure glaucoma

2015 ◽  
Vol 7 (1) ◽  
pp. 69-73
Author(s):  
K PS Malik ◽  
R Goel ◽  
K Jain ◽  
S Nagpal ◽  
S Singh
Keyword(s):  
Visual Acuity ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Middle Aged ◽  
Aged Patients ◽  
Posterior Chamber Intraocular Lens ◽  
Shallow Anterior Chamber ◽  
The Right

Background: Microspherophakia is characterized by lenticular myopia, late development of lens dislocation, shallow anterior chamber and angle-closure glaucoma. If it is associated with angle closure glaucoma, the management can be challenging.Objective: To report the management of a case of bilateral secondary angle closure glaucoma with isolated microspherophakia and right subluxated lens in a middle aged lady. Case: A 47-year-old female presented with bilateral secondary angle closure glaucoma with isolated microspherophakia, right subluxated lens and left operated trabeculectomy. The patient`s best corrected log mar visual acuity improved from 1.0 to 0.2 and intraocular pressure (IOP) decreased from 24.9mm of Hg to lower teens following lensectomy with scleral ¿xation of posterior chamber intraocular lens in the right eye. The left eye IOP remained in mid teens without medication in two year follow up. Conclusion: This case demonstrates that microspherophakia should be ruled out even in middle aged patients presenting as angle closure glaucoma. The possibility of thickened cornea must be kept in mind requiring an IOP correction. Lensectomy with scleral ¿xation of posterior chamber IOL provides a satisfactory recovery of visual acuity and IOP control. Though in this patient, the lens was held in position by posterior synechiae in the left eye, future stability of zonules needs to be monitored.

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

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.

scholarly journals Etiologies and clinical characteristics of young patients with angle-closure glaucoma: a 15-year single-center retrospective study

2021 ◽  
Author(s):  
Feng Gao ◽  
Jiajian Wang ◽  
Junyi Chen ◽  
Xiaolei Wang ◽  
Yuhong Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Anterior Segment ◽  
Young Patients ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Uncommon Presentation ◽  
Underlying Causes

Abstract Purpose To investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese. Methods Inpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts. Results A total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis. Conclusions We described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.

Anterior Segment OCT in Primary Angle Closure Compared to Normal Subjects with Similar Shallow Anterior Chamber

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Qinghong Xie ◽  
Ping Ma ◽  
Jutima Patlidanon ◽  
Murtaza Saifee ◽  
Sean Yonamine ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Normal Subjects ◽  
Angle Closure ◽  
Anterior Segment Oct ◽  
Primary Angle Closure ◽  
Shallow Anterior Chamber

Bilateral Isolated Spherophakia with Lens Subluxation, High Myopia and Secondary Angle Closure: A Case Report

2018 ◽  
Author(s):  
Ye Zhang ◽  
Ravi Thomas ◽  
Cong Wang ◽  
Xiangyu Shi
Keyword(s):  
Anterior Chamber ◽  
High Myopia ◽  
Rare Condition ◽  
Spherical Shape ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Pars Plana Lensectomy ◽  
Shallow Anterior Chamber ◽  
One Year ◽  
The Right

Abstract Background: Spherophakia is a rare condition and compared to its occurrence with familial and systemic disorders, isolated spherophakia is even more uncommon. This rare case of isolated spherophakia will raise the alertness of physicians when dealing with a high myopia patient with shallow anterior chamber and relatively normal fundus. Case presentation: We report a case of a 17-year-old male who experienced painless decrease of vision in both eyes (OU) for 11 years, with progression of visual impairment and occasional ocular pain for one year. Examination revealed high myopia, increased intraocular pressures (IOP, 28 mmHg in the right eye (OD) and 33 mmHg in the left (OS)), shallow central anterior chambers, lenses of a spherical shape with superior subluxation, occludable angles without peripheral anterior synechiae, and healthy optic discs OU. A diagnosis of bilateral isolated spherophakia, lens subluxation, high myopia and secondary angle closure (AC) was made. Pars plana lensectomy with anterior vitrectomy and scleral suturing of an intraocular lens was performed. On postoperative follow-up at 19 days OD and 63 days OS, the visual acuity was 6/6 and the IOP was normal without any medication OU. Conclusions: A presentation with high myopia, shallow anterior chamber with a normal retina should alert the clinician to the possibility of spherophakia, as compared to high myopia caused by elongated axial length. Surgery should be considered in cases of spherophakia with AC where the IOP cannot be controlled by noninvasive means.

scholarly journals Deep learning algorithms to isolate and quantify the structures of the anterior segment in optical coherence tomography images

2020 ◽  
pp. bjophthalmol-2019-315723
Author(s):  
Tan Hung Pham ◽  
Sripad Krishna Devalla ◽  
Aloysius Ang ◽  
Zhi-Da Soh ◽  
Alexandre H Thiery ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Objective Assessment ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Training Data ◽  
Angle Closure ◽  
Optical Coherence ◽  
Segmentation Approach ◽  
Reliable Quantification ◽  
The Given

Background/AimsAccurate isolation and quantification of intraocular dimensions in the anterior segment (AS) of the eye using optical coherence tomography (OCT) images is important in the diagnosis and treatment of many eye diseases, especially angle-closure glaucoma.MethodIn this study, we developed a deep convolutional neural network (DCNN) for the localisation of the scleral spur; moreover, we introduced an information-rich segmentation approach for this localisation problem. An ensemble of DCNNs for the segmentation of AS structures (iris, corneosclera shell adn anterior chamber) was developed. Based on the results of two previous processes, an algorithm to automatically quantify clinically important measurements were created. 200 images from 58 patients (100 eyes) were used for testing.ResultsWith limited training data, the DCNN was able to detect the scleral spur on unseen anterior segment optical coherence tomography (ASOCT) images as accurately as an experienced ophthalmologist on the given test dataset and simultaneously isolated the AS structures with a Dice coefficient of 95.7%. We then automatically extracted eight clinically relevant ASOCT measurements and proposed an automated quality check process that asserts the reliability of these measurements. When combined with an OCT machine capable of imaging multiple radial sections, the algorithms can provide a more complete objective assessment. The total segmentation and measurement time for a single scan is less than 2 s.ConclusionThis is an essential step towards providing a robust automated framework for reliable quantification of ASOCT scans, for applications in the diagnosis and management of angle-closure glaucoma.

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