scholarly journals A Case Report of Preoperative, Intraoperative, and Postoperative Anterior Chamber Shallowing Resulting from Different Mechanisms

2016 ◽  
Vol 7 (1) ◽  
pp. 115-118
Author(s):  
Yujiro Mori ◽  
Yoshifumi Ikeda ◽  
Ichiya Sano ◽  
Etsuko Fujihara ◽  
Masaki Tanito
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Perioperative Period ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Appropriate Treatment ◽  
Flat Anterior Chamber ◽  
Shallow Anterior Chamber ◽  
Underlying Mechanisms

A 54-year-old woman with an epiretinal membrane in her left eye accompanied by a shallow anterior chamber due to primary angle closure glaucoma underwent vitrectomy and cataract surgery. During the cataract surgery, immediately after the ultrasonic tip had been removed from the anterior chamber, anterior chamber flattening occurred. An intraoperative fundus examination showed the development of acute intraoperative choroidal effusion. Postoperatively, the anterior chamber remained shallow even after the choroidal detachment had subsided; capsular bag distension seen by ultrasound biomicroscopy suggested the development of early postoperative capsular block syndrome. After neodymium:yttrium-aluminium-garnet laser capsulotomy, the anterior chamber deepened. Depending on the perioperative period, the mechanism of a flat anterior chamber can change, and understanding the underlying mechanisms is required for appropriate treatment.

Gonioscopy and Ultrasound Biomicroscopy in the Detection of Angle Closure in Patients with Shallow Anterior Chamber

2014 ◽  
Vol 29 (4) ◽  
pp. 204-207 ◽  
Author(s):  
Shan-shan Cui ◽  
Yan-hong Zou ◽  
Qian Li ◽  
Li-na Li ◽  
Ning Zhang ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Shallow Anterior Chamber

scholarly journals Tittle Page： The ocular biometry characteristics of young patients with primary angle-closure glaucoma

2021 ◽  
Author(s):  
Yi Xu ◽  
Qian Tan ◽  
Chunyan Li ◽  
Dan Liu
Keyword(s):  
Anterior Chamber ◽  
Young Patients ◽  
Ultrasound Biomicroscopy ◽  
Young Group ◽  
Angle Closure ◽  
Old Patients ◽  
Ciliary Process ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Malignant Glaucoma

Abstract Backgroud: Although Primary angle-closure glaucoma (PACG) mainly occurs in elderly people, diagnosis of PACG in young patients is not uncommon . However, there is no article specialized on the ocular anatomical characteristics in these patients.Methods: In this retrospective, comparative study, patients diagnosed with PACG and recieved ultrasound biomicroscopy (UBM) examination in our department were included. Patients were divided into two groups: a young group comprised of patients aged ≤45 years of age and an old group comprised of patients＞45 years of age. A-scan ultrasonography and ultrasound biomicroscopy (UBM ) were used to measure ocular biometric parameters of patients in the two groups including axial length (AL), lens thickness (LT), central anterior chamber depth (ACD), anterior chamber width (ACW), angle opening distance 500 (AOD500), anterior angle closure 500 (ACA500), iris thickness 1000 mm from the iris root (IT1000), iris thickness 500 mm from the iris root (IT500), trabecular-ciliary process angle (TCPA), trabecular-ciliary process distance (TCPD), scleral– ciliary process angle (SCPA), lens vault (LV), and pupil diameter (PD). Plateau iris (PI) and base iris insertion were determined from UBM images, and the prevalence of PI and base iris insertion were compared between the two groups. The incidence of postoperative malignant glaucoma (MG) was also determined in both groups and ocular anatomical predictors for the development of malignant glaucoma were evaluated in young PACG patients.Results: 115 patients were included into young group and 144 patients were included into old group. The eyes of patients in the young group had shorter TCPD, shorter AL, narrower TCPA and narrower SCPA compared to the eyes of patients in the old group. There were no significant differences in ACD, LT, AL, LV, AOD 500, ACA500, IT500, IT1000, PD or ACW between the two groups. The prevalence of PI was 25.0% in older patients and 66.1% in younger patients (P < 0.001). Significantly more young patients had base iris insertion compared to old patients (P < 0.001). 87 patients in young group and 79 patients in old group underwent trabeculectomy in our department. Among these patients, 21 young patients and 4 old patients developed MG after trabeculectomy (P < 0.001). Conclusions: AL was shorter, the ciliary body was positioned more anteriorly, prevalence of PI was higher, and incidence of postoperative MG was higher in younger PACG patients compared to older PACG patients. Our results suggest that shorter AL, shorter TCPD and narrower TCPA may be predictors for development of malignant glaucoma in young PACG patients after trabeculectomy.

scholarly journals Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy

2017 ◽  
Vol 11 (3) ◽  
pp. 86-91 ◽  
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Normal Subjects ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Ciliary Process ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

ABSTRACT Aim To evaluate the configuration of the anterior chamber angle quantitatively and study the morphological changes in the eye with ultrasound biomicroscopy (UBM) in primary angle closure glaucoma (PACG) patients after laser peripheral iridotomy (LPI). Materials and methods A total of 185 eyes of 185 PACG patients post-LPI and 126 eyes of 126 normal subjects were included in this prospective study. All subjects underwent complete ophthalmic evaluation, A-scan biometry, and UBM. The anterior segment and angle parameters were measured quantitatively and compared in both groups using Student's t-test. Results The PACG patients had shorter axial length, shallower central anterior chamber depth anterior chamber depth (ACD), and anteriorly located lens when compared with normal subjects. Trabecular iris angle (TIA) was significantly narrow (5.73 ± 7.76°) in patients with PACG when compared with normal subjects (23.75 ± 9.38°). The angle opening distance at 500 μm from scleral spur (AOD 500), trabecular—ciliary process distance (TCPD), iris—ciliary process distance (ICPD), and iris—zonule distance (IZD) were significantly shorter in patients with PACG than in normal subjects (p < 0.0001). The iris lens angle (ILA), scleral—iris angle (SIA), and scleral—ciliary process angle (SCPA) were significantly narrower in patients with PACG than in normal subjects (p < 0.0001). The iris—lens contact distance (ILCD) was greater in PACG group than in normal (p = 0.001). Plateau iris was seen in 57/185 (30.8%) of the eyes. Anterior positioned ciliary processes were seen in 130/185 eyes (70.3%) of eyes. Conclusion In PACG patients, persistent apposition angle closure is common even after LPI, which could be due to anterior rotation of ciliary body and plateau iris and overcrowding of anterior segment due to shorter axial length and relative anterior lens position. How to cite this article Mansoori T, Balakrishna N. Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy. J Curr Glaucoma Pract 2017;11(3):86-91.

scholarly journals Polypharmacy-associated potential contraindications of drug prescriptions in patients with primary angle closure disease in a real-world setting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Japanese Patients ◽  
Median Number ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Number Of Patients ◽  
Multiple Drugs

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.

Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

2021 ◽  
pp. 112067212110121
Author(s):  
Guido Barosco ◽  
Roberta Morbio ◽  
Francesca Chemello ◽  
Roberto Tosi ◽  
Giorgio Marchini
Keyword(s):  
Visual Impairment ◽  
Cataract Extraction ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Blurred Vision ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Increased Risk ◽  
The Right ◽  
End Stage

Purpose: This report describes a case of bilateral primary angle closure (PAC) progressing to unilateral end-stage primary angle closure glaucoma (PACG) associated with treatment for coronavirus disease-19 (COVID-19) infection. Methods: A 64-year-old man came to our attention because of blurred vision after a 2-month hospital stay for treatment of COVID-19 infection. Examination findings revealed PACG, with severe visual impairment in the right eye and PAC in the left eye due to plateau iris syndrome. The patient’s severe clinical condition and prolonged systemic therapy masked the symptoms and delayed the diagnosis. Medical chart review disclosed the multifactorial causes of the visual impairment. Ultrasound biomicroscopy (UBM) aided in diagnosis and subsequent therapy. Results: The cause behind the primary angle closure and the iridotrabecular contact was eliminated by bilateral cataract extraction, goniosynechialysis, and myotic therapy. Conclusions: COVID-19 treatment may pose an increased risk for PAC. Accurate recording of patient and family ophthalmic history is essential to prevent its onset. Recognition of early signs of PAC is key to averting its progression to PACG.

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