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Romanian Journal of Ophthalmology 2023A 65-year-old male was planned for Deep anterior lamellar keratoplasty (DALK) to improve his visual quality from the underlying spheroidal degeneration along the visual...
A 65-year-old male was planned for Deep anterior lamellar keratoplasty (DALK) to improve his visual quality from the underlying spheroidal degeneration along the visual axis. An attempt for a big bubble was futile, hence converted to a manual DALK. On postoperative day 1, he developed secondary angle closure glaucoma due to reverse pupillary block by the host DM. Decompression of the big bubble was done and angle closure was resolved with a good visual outcome at 1-month post-op. We present the first case of secondary angle closure glaucoma due to reverse pupillary block by a big bubble in a rigid cornea. DALK = Deep anterior lamellar keratoplasty, OD = oculus dexter, OS = oculus sinister, DS = Diopters Sphere, DC = Diopters cylinder, AS-OCT = anterior segment optical coherence tomography, DM = Descemet's membrane, IOP - Intraocular pressure, GHJ = Graft-host junction, BSS = Balanced salt solution.
Topics: Male; Humans; Aged; Corneal Transplantation; Keratoconus; Glaucoma, Angle-Closure; Visual Acuity; Treatment Outcome; Iatrogenic Disease; Retrospective Studies
PubMed: 37876517
DOI: 10.22336/rjo.2023.50 -
Drug and Therapeutics Bulletin Aug 2022
Topics: Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Migraine Disorders; Sumatriptan
PubMed: 35393301
DOI: 10.1136/dtb.2022.235880rep -
Indian Journal of Ophthalmology Jan 2011Primary angle closure glaucoma (PACG) is equally prevalent in Indian in Asian population as the primary open angle glaucoma. Eighty-six percent of people with PACG are... (Comparative Study)
Comparative Study
Primary angle closure glaucoma (PACG) is equally prevalent in Indian in Asian population as the primary open angle glaucoma. Eighty-six percent of people with PACG are in Asia, with approximately 48.0% in China, 23.9% in India and 14.1% in southeast Asia. To understand PACG, it is mandatory to understand its classification and type of presentation with the underlying pathophysiology. The treatment options are medical, laser and/or surgical. The present article provides an overview of PACG.
Topics: Acute Disease; Antihypertensive Agents; Asia; China; Chronic Disease; Glaucoma, Angle-Closure; Humans; Iris; Laser Therapy; Ophthalmologic Surgical Procedures; Prevalence
PubMed: 21150039
DOI: 10.4103/0301-4738.73690 -
Indian Journal of Ophthalmology Jul 2021The aim of this study was to investigate the optic disc morphology in primary angle-closure glaucoma (PACG) versus primary open-angle glaucoma (POAG) in South Indians. (Observational Study)
Observational Study
PURPOSE
The aim of this study was to investigate the optic disc morphology in primary angle-closure glaucoma (PACG) versus primary open-angle glaucoma (POAG) in South Indians.
METHODS
A total of 60 patients (60 eyes) with PACG and 52 patients (52 eyes) with POAG were included in a cross-sectional observational study. The glaucoma diagnosis was based on a glaucomatous appearance of the optic disc correlating with visual field defects. The glaucoma was graded as early, moderate, or severe, depending upon perimetric loss. All patients underwent an ophthalmic evaluation, including visual field examination and planimetric analysis of 30° stereoscopic color optic disc photographs.
RESULTS
The POAG and PACG groups did not differ significantly in a disc or rim area, rim width, and frequencies of disc hemorrhages or rim notches. However, early POAG group (n = 15) had a significantly deeper cup depth (P = 0.01), larger beta zone (P = 0.01), and a higher frequency of localized retinal nerve fiber layer (RNFL) defects (P = 0.02) than early PACG (n = 20).
CONCLUSION
In the early stage of the disease, POAG compared to PACG may be characterized by deeper disc cupping, a larger beta zone of peripapillary atrophy, and a higher frequency of localized RNFL defects. Such differences in early glaucoma may suggest differences in pathophysiology in POAG and PACG.
Topics: Cross-Sectional Studies; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; India; Intraocular Pressure; Optic Disk
PubMed: 34146039
DOI: 10.4103/ijo.IJO_2442_20 -
Medicine Jul 2022Angle closure glaucoma (ACG) is one of the most emergent types of glaucoma in clinical practice. Laser peripheral iridotomy (LPI) could minimize pupillary block and... (Review)
Review
RATIONALE
Angle closure glaucoma (ACG) is one of the most emergent types of glaucoma in clinical practice. Laser peripheral iridotomy (LPI) could minimize pupillary block and prevent ACG from an acute attack. However, recurrent increase in intraocular pressure (IOP) may still occur despite successful LPI. The aim of this study is to highlight the importance of postLPI pilocarpine use and larger LPI size as well as to share some experiences of cataract surgery in patients with ACG.
PATIENT CONCERNS
A 63-year-old female was referred to our hospital for headache, and poor control of IOP in the right eye for 3 hours.
DIAGNOSES
The patient was diagnosed ACG in the right eye. Recurrence of ACG in the right eye and new-onset and recurrent ACG in the left eye were noted during follow-up, despite successful LPI. The diagnosis was confirmed through slit lamp and gonioscope examination.
INTERVENTIONS
The LPI size was enlarged and pilocarpine use was maintained at 2% (1 drop 4 times a day) in both the eyes. Finally, cataract surgery was performed in both the eyes.
OUTCOMES
No recurrence of ACG was noted during postLPI pilocarpine use in both the eyes. The postoperative IOP was stable for >6 months after cataract surgery without any surgical intervention or antiglaucoma medication use. No discomfort or major complication was observed.
CONCLUSION
This report highlights the importance of postLPI pilocarpine use and larger LPI size in patients with refractory ACG.
Topics: Acute Disease; Cataract; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iris; Laser Therapy; Lasers; Middle Aged; Pilocarpine
PubMed: 35801778
DOI: 10.1097/MD.0000000000029245 -
Clinical & Experimental Ophthalmology 2008
Topics: Adaptation, Physiological; Arctic Regions; Asia; Biological Evolution; Body Temperature Regulation; Emigration and Immigration; Glaucoma, Angle-Closure; Health Care Costs; Humans; Inuit; Mass Screening
PubMed: 18290946
DOI: 10.1111/j.1442-9071.2008.01675.x -
Medicine Jun 2017Drug-induced bilateral angle-closure glaucoma is a rare event and should be treated correctly and promptly to prevent visual loss.
RATIONALE
Drug-induced bilateral angle-closure glaucoma is a rare event and should be treated correctly and promptly to prevent visual loss.
PATIENT CONCERNS
We report a rare case of sumatriptan-induced bilateral angle-closure glaucoma in a young woman with migraine, and explore the possible mechanism.
DIAGNOSES
We describe the clinical outcome of a patient with sumatriptan-induced bilateral angle-closure glaucoma. The patient presented with bilateral acute elevation of intraocular pressure (IOP) and myopic shift.
INTERVENTIONS
The clinical symptoms and signs resolved rapidly after treatment with a topical cycloplegic agent, topical steroid, and aqueous suppressant.
OUTCOMES
Based on the suspicious of malignant glaucoma, we prescribed topical phenylephrine, whose application immediately lowered the IOP. All symptoms resolved after treatment with a long-acting cycloplegic agent, topical steroid, and aqueous suppressant for 3 days.
LESSONS
We presume that the mechanism underlying sumatriptan-induced bilateral angle-closure glaucoma may be correlated to the malignant glaucoma. Timely diagnosis and appropriate treatment are essential for resolving this ophthalmic emergency.
Topics: Adult; Diagnosis, Differential; Female; Glaucoma, Angle-Closure; Humans; Migraine Disorders; Sumatriptan; Vasoconstrictor Agents
PubMed: 28562545
DOI: 10.1097/MD.0000000000006953 -
Der Ophthalmologe : Zeitschrift Der... Aug 2021A 72-year-old female patient developed bilateral secondary iridocorneal angle-closure glaucoma with uveal effusion syndrome after uncomplicated cataract surgery. The...
A 72-year-old female patient developed bilateral secondary iridocorneal angle-closure glaucoma with uveal effusion syndrome after uncomplicated cataract surgery. The postoperative intake of acetazolamide was identified as causative for the development of the effusion syndrome. Taking a sulfonamide-free systemic and local intraocular pressure lowering and anti-inflammatory treatment into account, a rapid improvement of the ocular manifestation was achieved. The case illustrates a rare but clinically severe adverse effect of acetazolamide and outlines efficient treatment options.
Topics: Aged; Cataract; Cataract Extraction; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Phacoemulsification; Tonometry, Ocular
PubMed: 32803274
DOI: 10.1007/s00347-020-01202-6 -
The Journal of International Medical... Sep 2020Systemic lupus erythematosus (SLE) is a chronic idiopathic autoimmune disease. SLE can involve almost any part of the eyes. However, bilateral angle-closure glaucoma due...
Systemic lupus erythematosus (SLE) is a chronic idiopathic autoimmune disease. SLE can involve almost any part of the eyes. However, bilateral angle-closure glaucoma due to lupus choroidopathy that is accompanied by polyserositis and nephropathy is rare. We report a 21-year-old woman whose clinical manifestations were diagnosed as bilateral angle-closure glaucoma caused by ciliochoroidal effusion. Subsequently, SLE and lupus nephritis were diagnosed on the basis of malar rash, photosensitivity, proteinuria, positive anti-Smith and anti-DNA antibodies, and a renal histopathological biopsy. After 1 month of treatment with steroids and immunosuppressive drugs, the patient's intraocular pressure returned to normal, visual acuity improved, and lupus nephritis was effectively controlled. Bilateral secondary acute angle closure caused by SLE choroidal disease can be an ocular manifestation of SLE, and is usually accompanied by polyserositis and nephropathy. High-dose steroids and immunosuppressive therapy should be immediately and actively provided for this condition.
Topics: Adult; Female; Glaucoma, Angle-Closure; Humans; Immunosuppressive Agents; Intraocular Pressure; Lupus Erythematosus, Systemic; Lupus Nephritis; Young Adult
PubMed: 32996806
DOI: 10.1177/0300060520959492 -
Ophthalmology. Glaucoma 2022To assess the proportion of newly diagnosed cases of primary angle-closure glaucoma (PACG) with and without prior diagnosis of anatomical narrow angle (ANA) and to...
PURPOSE
To assess the proportion of newly diagnosed cases of primary angle-closure glaucoma (PACG) with and without prior diagnosis of anatomical narrow angle (ANA) and to identify sociodemographic risk factors for late detection (PACG without prior ANA diagnosis).
DESIGN
Retrospective cohort study.
METHODS
One hundred two thousand six hundred seventeen patients with PACG were identified from the Optum Clinformatics Data Mart Database (2007-2019). Patients with newly diagnosed PACG met the following criteria: (1) diagnosis made by an ophthalmologist, (2) disease observable for at least 12 months before diagnosis, and (3) no history of treatment before diagnosis unless preceded by a diagnosis of ANA. Multivariate logistic regression modeling was performed to identify sociodemographic risk factors for late detection.
MAIN OUTCOME MEASURES
Proportion of patients with newly diagnosed PACG without prior ANA diagnosis and sociodemographic factors associated with late detection.
RESULTS
Thirty-one thousand forty-four patients were eligible. More than 70% of PACG cases were detected without prior ANA diagnosis, regardless of patient age, sex, or race. The odds of late detection were significantly higher (P < 0.001) among men (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.25-1.40), Black patients (OR, 1.25; 95% CI, 1.15-1.37), and patients 80 years of age or older (OR, 1.28; 95% CI, 1.11-1.47) or living in Southern (OR, 1.30; 95% CI, 1.22-1.40) or Pacific (OR, 1.27; 95% CI, 1.16-1.36) regions. Findings were similar for patients with PACG with a record of gonioscopy and treatment or with a 24-month lookback period.
CONCLUSIONS
Most patients who receive a new diagnosis of PACG in the United States do not have a prior diagnosis of ANA. The elderly, men, and Black patients are at higher risk of late detection. A need exists for increased disease awareness among providers and more accessible tools to detect patients at risk of developing PACG.
Topics: Aged; Cross-Sectional Studies; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Male; Prevalence; Retrospective Studies; United States
PubMed: 35085828
DOI: 10.1016/j.ogla.2022.01.001