scholarly journals Case Report: Glaucoma in an Infant With Retinopathy of Prematurity

2021 ◽  
Vol 9 ◽  
Author(s):  
Tamara Lee Lenis ◽  
Nahomy Ledesma Vicioso ◽  
Varun Reddy ◽  
Kyle D Kovacs ◽  
Sarah H Van Tassel ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Anterior Chamber ◽  
Laser Treatment ◽  
Retinopathy Of Prematurity ◽  
Pupillary Block ◽  
Narrow Angle ◽  
Retinal Blood Vessels ◽  
Elevated Intraocular Pressure ◽  
Postmenstrual Age

Retinopathy of prematurity (ROP) is a leading cause of childhood blindness that occurs due to incomplete development of retinal blood vessels in preterm infants. Glaucoma is an ocular comorbidity in some patients with ROP, and it may be associated with immature anterior chamber development, ROP itself, or the treatment for ROP. There have been a few reports of narrow-angle glaucoma after laser treatment for ROP. In this case report, we describe the course of a female infant born at 24 weeks and 5 days of gestational age with treatment-requiring ROP treated with laser photocoagulation who subsequently developed very elevated intraocular pressure and shallow anterior chambers without pupillary block. The patient required bilateral ab externo trabeculotomy for elevated intraocular pressure, which normalized after the procedure. The patient has remained stable at the last follow-up at 51 weeks postmenstrual age. Differing from previous glaucoma presentations in this setting, we illustrate a case of elevated intraocular pressure and anterior chamber narrowing after laser therapy without pupillary block or synechiae. The possible multifactorial etiology of glaucoma in this patient, including incomplete angle development, ischemia, and laser treatment, highlight the need for glaucoma screening in patients with ROP, both in the short and long term.

scholarly journals Bilateral spontaneous crystalline lens dislocation to the anterior chamber: A case report

2013 ◽  
Vol 141 (11-12) ◽  
pp. 800-802 ◽  
Author(s):  
Milos Jovanovic
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Anterior Chamber ◽  
Crystalline Lens ◽  
Time Intervals ◽  
Lens Dislocation ◽  
Elevated Intraocular Pressure ◽  
History Of ◽  
Sudden Decrease ◽  
The Right

Introduction. There are various reasons for the lens dislocation. Spontaneous dislocation of a clear lens is extremely rare, especially its dislocation to the anterior chamber. Case Outline. The author presents a case of spontaneous clear lens dislocation to the anterior chamber in both eyes in a patient without the history of any trauma. Dislocation occurred spontaneously, first in the left eye, along with a sudden decrease of vision. The ophthalmologist found a clear lens in the anterior chamber, without any sign of an elevated intraocular pressure, as should have been expected. The dislocated lens was removed surgically (intracapsular extraction) with the preventive basal iridectomy. Two years later, the same happened in the right eye: clear lens moved spontaneously to the anterior chamber, with a decrease of vision, but again without any rise of intraocular pressure and/or any pain. Intracapsular extraction of the lens with basal iridectomy was done again. Conclusion. The presented case demonstrates that spontaneous dislocation of the transparent lens to the eye anterior chamber can occur in both eyes at different time intervals. We suggest the removal of dislocated lens in the anterior chamber by the intracapsular extraction.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

scholarly journals A Case of Repeating Transient Increase in Intraocular Pressure by Instability of an Intraocular Lens Implanted in the Capsular Bag

2020 ◽  
Vol 11 (1) ◽  
pp. 60-67
Author(s):  
Yukihisa  Takada ◽  
Takayoshi Sumioka ◽  
Nobuyuki Ishikawa ◽  
Shingo Yasuda ◽  
Ryoko Komori ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
University Hospital ◽  
Angle Closure ◽  
Light Reaction ◽  
Narrow Angle ◽  
Medical University

We observed repeated episodes of rapid increases in intraocular pressure (IOP) considered to be caused by an in-the-bag intraocular lens (IOL) instability in a patient with an implanted IOL. As acute glaucoma attack-like increase in IOP was noted in the left eye on November 8, she was admitted to Wakayama Medical University Hospital. The findings at the first examination included an IOP of 62 mm Hg, instability of a PMMA one-piece IOL, shallow anterior chamber, narrow angle, moderate mydriasis, and loss of pupillary light reaction in the left avitreous eye. On November 15, a 6-mm Hg increase in IOP was observed during 60-min dark room prone provocative testing. After the first examination, the patient perceived pain and reduced visual acuity of the left eye and emergently consulted our hospital twice. Despite miosis, normalization of the anterior chamber depth and IOP with widening of the angle were achieved by resting in the supine position. These episodes were thought to be caused by instability and anterior shift of the IOL. On January 17, 2018, suture fixation of the in-the-bag IOL was performed. The IOL was fixed by transscleral suturing of the bilateral supporting parts to the sclera. Recurrence of sudden ophthalmalgia, instability of the in-the-bag IOL, and an increase in IOP have not been observed for 1 year after surgical treatment. Instability of an in-the-bag IOL caused repeated acute angle-closure glaucoma-like attacks. The situation was well treated by suturing and fixing the haptics of IOL to the sclera.

scholarly journals GLIS1 regulates trabecular meshwork function and intraocular pressure and is associated with glaucoma in humans

2021 ◽  
Author(s):  
Saidas Nair ◽  
Chitrangda Srivastava ◽  
Robert V Brown ◽  
Swanand Koli ◽  
Helene Choquet ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Trabecular Meshwork ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Transcriptional Factor ◽  
Histopathological Analysis ◽  
Resonance Imaging ◽  
Progressive Degeneration ◽  
Elevated Intraocular Pressure

Chronically elevated intraocular pressure (IOP) is the major risk factor of primary open-angle glaucoma, a leading cause of blindness. Dysfunction of the trabecular meshwork (TM), which controls the outflow of aqueous humor (AqH) from the anterior chamber, is the major cause of elevated IOP. Here, we demonstrate that mice deficient in the Kruppel-like zinc finger transcriptional factor GLI-similar-1 (GLIS1) develop chronically elevated IOP. Magnetic resonance imaging and histopathological analysis reveal that deficiency in GLIS1 expression induces progressive degeneration of the TM, leading to inefficient AqH drainage from the anterior chamber and elevated IOP. Transcriptome and cistrome analyses identified several glaucoma- and extracellular matrix-associated genes as direct transcriptional targets of GLIS1. We also identified a significant association between GLIS1 variant rs941125 and glaucoma in humans (P=4.73x10-6), further supporting a role for GLIS1 into glaucoma etiology. Our study identifies GLIS1 as a critical regulator of TM function and maintenance, AqH dynamics, and IOP.

scholarly journals Diode laser transscleral cyclophotocoagulation causes intraocular collamer lens displacement in pseudophakic eye: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Wei ◽  
Xueqing Yu ◽  
Lu Yang ◽  
Chan Xiong ◽  
Xu Zhang
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Angle Closure ◽  
Pigment Dispersion ◽  
Intraocular Lens Implantation ◽  
Lens Implantation ◽  
Elevated Intraocular Pressure ◽  
Transscleral Cyclophotocoagulation

Abstract Background With the rapid development of intraocular collamer lens (ICL) operation, it is foreseeable that we will encounter a large number of glaucoma patients with ICL implantation history. However, our current understanding of the treatment of glaucoma patients with ICL is limited. Hence we report a rare case of refractory glaucoma after intraocular collamer lens and intraocular lens implantation in a patient who underwent unsuccessful transscleral cyclophotocoagulation, which led to intraocular collamer lens displacement, angle closure and uncontrolled intraocular pressure. Case presentation A 39-year-old woman presented with intractably elevated intraocular pressure in the right eye. Since her intraocular collamer lens implantation surgery in 2017, her intraocular pressure had remained over 40 mmHg while using 3 types of anti-glaucoma medications. The patient had a history of phacoemulsification and posterior chamber phakic intraocular lens implantation for complicated cataracts secondary to uveitis in 2006. On gonioscope examination, there were signs of pigment dispersion, and the anterior chamber angle was open. Ultrasound biomicroscopy examination showed contact and rubbing between the intraocular collamer lens and posterior surface of the iris. And typical advanced glaucomatous optic neuropathy and visual field defects were observed. Transscleral cyclophotocoagulation was performed to control the intraocular pressure and prevent further visual field loss. However, the intraocular collamer lens was displaced after transscleral cyclophotocoagulation, which resulted in formation of a shallow anterior chamber 1 week later, angle closure and loss of intraocular pressure control 1 month later, even though the maximum dose of anti-glaucoma medication was used. Finally, an Ahmed glaucoma valve was successfully implanted in her anterior chamber, and the glaucoma was controlled, as observed at the 10-month follow-up. Conclusions Pigment dispersion is a common phenomenon after intraocular collamer lens implantation and may accelerate the progression of glaucoma. Transscleral cyclophotocoagulation should be carefully considered in glaucoma patients with elevated intraocular pressure after intraocular collamer lens implantation, given that transscleral cyclophotocoagulation may cause intraocular collamer lens displacement.

Volumetric parameters-based differentiation of narrow angle from open angle and classification of angle configurations: an SS-OCT study

2019 ◽  
Vol 104 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Fei Li ◽  
Rouxi Zhou ◽  
Kai Gao ◽  
Ling Jin ◽  
Xiulan Zhang
Keyword(s):  
Anterior Chamber ◽  
Sensitivity And Specificity ◽  
Angle Closure ◽  
Open Angle ◽  
Training Set ◽  
Pupillary Block ◽  
Narrow Angle ◽  
Validation Set

BackgroundTo evaluate the diagnostic ability of volumetric parameters to differentiate narrow angle from open angle and distinguish different configurations of narrow angle.MethodsThe current study was composed of two parts. In the first part, with gonioscopy as reference standard, we tested power of each parameter to differentiate narrow angle from open angle. In the second part, we evaluated the efficacy of different parameters to distinguish angle configurations which were subclassified into type 1 (pupillary block) and type 2 (non-pupillary block and multiple mechanisms) based on ultrasound biomicroscopy (UBM) images.ResultsIn part 1, the training set was composed of 117 narrow-angle eyes and 60 open-angle eyes, and the validation set included 38 narrow-angle eyes and 37 open-angle eyes. Anterior chamber volume (ACV) outperformed all the other parameters with an area under the curve (AUC) of 0.988. The sensitivity and specificity of the cut-off value 98.1 mm3 in the validation set were 90.0% and 97.1%, respectively. In part 2, training set was composed of 96 eyes of 88 patients with primary angle-closure disease, with 49 diagnosed as type 1 and 47 as type 2 configuration. 32 eyes were used for validation. A model comprised of iris volume (IV), iris thickness (IT) 2000 µm from the scleral spur and angle open distance (AOD) 750 µm from the scleral spur was found to have an AUC of 0.793 (95% CI, 0.695 to 0.870). Sensitivity and specificity of the model were 82.6% and 77.8% respectively in the validation set.ConclusionsWith ACV, we can detect patients with narrow angle from open angle faster and more easily than AOD and anterior chamber depth. Then, for patients with narrow angle, the combination of IV, IT and AOD750 measured by swept-source optical coherence tomography could further classify configurations of angle closure compared with UBM.

scholarly journals Trabeculectomy in Staphyloma Eye with High Intraocular Pressure Following Ocular Trauma – A Case Report

2021 ◽  
Vol 9 (T3) ◽  
pp. 23-25
Author(s):  
Masitha Dewi Sari
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Anterior Chamber ◽  
Ocular Trauma ◽  
Anterior Segment ◽  
Rectus Muscle ◽  
Tissue Destruction ◽  
Corneal Scar ◽  
History Of ◽  
Blurry Vision

BACKGROUND: Ocular trauma may alter the anterior segment condition that may lead to secondary glaucomas such as inflammation, hyphema, angle recession, and lens subluxation. One of the most common procedures to decrease intraocular pressure (IOP) is trabeculectomy by creating pathways that allow aqueous humor to flow out of the anterior chamber. Scleral tissue destruction can cause damage in thin areas (such as posterior to the rectus muscle insertions) as in case of scleritis. CASE REPORT: An 11-year-old boy presented to the Ophthalmology Department of Universitas Sumatera Utara Hospital with a bigger white grayish mass and blurry vision. There was a history of the left ocular trauma 6 years ago, followed by redness of the eye, but not treated properly. On the general examination, the patient’s left eyes looked cloudy. On ocular examination, the left eye visual acuity was 1/300 and IOP was 28 mmHg. Segment anterior examination showed staphyloma from 9 to 12 o’clock, conjunctival injection, corneal scar, shallow anterior chamber, and cloudy lens. We could not asses the posterior segment due to cloudy media. We gave anti-glaucoma medication for 1 month, but the IOP did not decrease. We performed a trabeculectomy to control IOP and to prevent staphyloma from getting bigger. CONCLUSION: Trabeculectomy was an effective procedure to control IOP in a staphyloma eye following ocular trauma.

scholarly journals Assessment of anterior chamber angle changes after phacoemulsification with swept-source OCT

2021 ◽  
Vol 14 (10) ◽  
pp. 1527-1532
Author(s):  
Qian Zheng ◽  
◽  
Zhang-Liang Li ◽  
Ping-Jun Chang ◽  
Yun-E Zhao ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Anterior Chamber Angle ◽  
Swept Source ◽  
Narrow Angle ◽  
Significant Difference ◽  
Shallow Anterior Chamber ◽  
Chamber Angle

AIM: To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens (IOL) implantation, based on anterior segment swept-source optical coherence tomography (AS-SS-OCT) measurements. METHODS: This was a prospective case control study; sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure (IOP). Based on anterior chamber depth (ACD) and gonioscopy findings, the eyes were divided into two groups: group of shallow anterior chamber and narrow angle (SAC group, 30 eyes); and group of normal anterior chamber group with wide angle (NAC group, 30 eyes). Measurements of ACD, anterior chamber volume (ACV), iris volume (IV), lens vault (LV), angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), and trabecular iris angle (TIA) were conducted in each group before and 3mo after surgery. RESULTS: There was no significant difference in age, axial length (AL), corneal curvature, corneal diameter, intraocular pressure, and IV between two groups before surgery, except for the LV (P=0.000). ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation (3.69±0.38 vs 3.85±0.39 mm, P=0.025; 161.37±19.47 vs 178.26±20.30 mm3, P=0.002). AOD750, ARA750 in nasal and inferior quadrants, TISA750 in all quadrants except temporal, and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation (all P<0.05). CONCLUSION: Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects, but the angle related parameters including AOD750, ARA750, TISA750, TIA, TISA750, and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.

scholarly journals Spontaneous dislocation of a transparent lens to the anterior chamber: A case report

2010 ◽  
Vol 138 (7-8) ◽  
pp. 486-488 ◽  
Author(s):  
Milos Jovanovic ◽  
Ivan Stefanovic
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Anterior Chamber ◽  
General Anaesthesia ◽  
Vision Impairment ◽  
Hereditary Diseases ◽  
Eye Injuries ◽  
Lens Dislocation ◽  
Acute Glaucoma ◽  
History Of

Introduction. The causes leading to dislocation of the natural lenses are different involving injuries, hereditary diseases and spontaneous dislocation. Spontaneous dislocation of a transparent natural lens is extremely rare, especially dislocation of the anterior eye chamber. We report a case of spontaneous dislocation of the transparent natural lens to the anterior eye chamber in a patient who had no history of eye injuries. Case Outline. The patient was a 17-year old boy. Lens dislocation was spontaneous, and the patient presented for ophthalmological consultation due to a sudden vision impairment of the left eye. Biomicroscopic examination verified that the transparent lens was in the anterior chamber, and it was spherophakia of lesser diameter; there were no signs of increased intraocular pressure, as typically expected in lens dislocation to the anterior chamber. The patient was operated on in general anaesthesia. Surgery involved intracapsular extraction of the dislocated lens through a corneoscleral incision. Conclusion. This case report shows that a spontaneous dislocation of the natural lens may occur in younger people. The dislocated spherophakic lens to the anterior eye chamber did not contribute to the rise of the intraocular pressure and development of acute glaucoma. The acute glaucoma resulted from the pilocarpine narrowing of the pupil due to pupillary block. The intracapsular instrumental extraction of the dislocated transparent lens from the anterior chamber was successfully completed through a corneoscleral incision.

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