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Acute angle-closure glaucoma from spontaneous massive hemorrhagic retinal detachment.

Lee YJ, Kang SM, Kang IB - Korean J Ophthalmol (2007)

Bottom Line: Her visual acuity was 0.4 in the right eye but she had no light perception in the left eye.The left anterior chamber depth was shallow and gonioscopy of the left eye showed a closed angle.In comparison, the right anterior chamber depth was normal and showed a wide, open angle.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hanyang University, School of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea. lyjot@hanyang.ac.kr

ABSTRACT

Purpose: To report a case of acute angle-closure glaucoma resulting from spontaneous hemorrhagic retinal detachment.

Methods: An 81-year-old woman visited our emergency room for severe ocular pain and vision loss in her left eye. Her intraocular pressures (IOPs) were 14 mmHg in the right eye and 58 mmHg in the left eye. Her visual acuity was 0.4 in the right eye but she had no light perception in the left eye. The left anterior chamber depth was shallow and gonioscopy of the left eye showed a closed angle. In comparison, the right anterior chamber depth was normal and showed a wide, open angle. Computed tomography and ultrasonography demonstrated retinal detachment due to subretinal hemorrhage. After systemic and topical antiglaucoma medications failed to relieve her intractable severe ocular pain, she underwent enucleation.

Results: The ocular pathology specimen showed that a large subretinal hemorrhage caused retinal detachment and pushed displaced the lens-iris diaphragm, resulting in secondary angle-closure glaucoma.

Conclusions: Prolonged anticoagulant therapy may cause hemorrhagic retinal detachment and secondary angle-closure glaucoma. If medical therapy fails to relieve pain or if there is suspicion of an intraocular tumor, enucleation should be considered as a therapeutic option.

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Related in: MedlinePlus

Orbital computed tomography with contrast enhancement showed a large hemorrhagic retinal detachment (asterisk) in the left eye.
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Figure 1: Orbital computed tomography with contrast enhancement showed a large hemorrhagic retinal detachment (asterisk) in the left eye.

Mentions: Upon visiting our emergency room, her visual acuity was 0.4 in the right eye, but she had no light perception in the left eye. Her intraocular pressures (IOPs) were 14 mmHg in the right eye and 58 mmHg in the left eye. There was moderate conjunctival injection and a fixed mid-dilated pupil in the left eye. The right anterior chamber depth was normal, but the left anterior chamber depth was shallow. Gonioscopy showed a wide-open angle in the right eye, but revealed a closed anterior chamber angle in the left eye. The left cornea was edematous with diffuse microcysts. Posterior segment examination of the right eye was not done because of patient refusal. In the left eye, a large subretinal mass abutting the posterior lens surface was suspected. B-scan ocular ultrasonography and computed tomography (Fig. 1) of the left eye showed a large, irregularly reflective mass that was thought to represent a large subretinal mass.


Acute angle-closure glaucoma from spontaneous massive hemorrhagic retinal detachment.

Lee YJ, Kang SM, Kang IB - Korean J Ophthalmol (2007)

Orbital computed tomography with contrast enhancement showed a large hemorrhagic retinal detachment (asterisk) in the left eye.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2629687&req=5

Figure 1: Orbital computed tomography with contrast enhancement showed a large hemorrhagic retinal detachment (asterisk) in the left eye.
Mentions: Upon visiting our emergency room, her visual acuity was 0.4 in the right eye, but she had no light perception in the left eye. Her intraocular pressures (IOPs) were 14 mmHg in the right eye and 58 mmHg in the left eye. There was moderate conjunctival injection and a fixed mid-dilated pupil in the left eye. The right anterior chamber depth was normal, but the left anterior chamber depth was shallow. Gonioscopy showed a wide-open angle in the right eye, but revealed a closed anterior chamber angle in the left eye. The left cornea was edematous with diffuse microcysts. Posterior segment examination of the right eye was not done because of patient refusal. In the left eye, a large subretinal mass abutting the posterior lens surface was suspected. B-scan ocular ultrasonography and computed tomography (Fig. 1) of the left eye showed a large, irregularly reflective mass that was thought to represent a large subretinal mass.

Bottom Line: Her visual acuity was 0.4 in the right eye but she had no light perception in the left eye.The left anterior chamber depth was shallow and gonioscopy of the left eye showed a closed angle.In comparison, the right anterior chamber depth was normal and showed a wide, open angle.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hanyang University, School of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea. lyjot@hanyang.ac.kr

ABSTRACT

Purpose: To report a case of acute angle-closure glaucoma resulting from spontaneous hemorrhagic retinal detachment.

Methods: An 81-year-old woman visited our emergency room for severe ocular pain and vision loss in her left eye. Her intraocular pressures (IOPs) were 14 mmHg in the right eye and 58 mmHg in the left eye. Her visual acuity was 0.4 in the right eye but she had no light perception in the left eye. The left anterior chamber depth was shallow and gonioscopy of the left eye showed a closed angle. In comparison, the right anterior chamber depth was normal and showed a wide, open angle. Computed tomography and ultrasonography demonstrated retinal detachment due to subretinal hemorrhage. After systemic and topical antiglaucoma medications failed to relieve her intractable severe ocular pain, she underwent enucleation.

Results: The ocular pathology specimen showed that a large subretinal hemorrhage caused retinal detachment and pushed displaced the lens-iris diaphragm, resulting in secondary angle-closure glaucoma.

Conclusions: Prolonged anticoagulant therapy may cause hemorrhagic retinal detachment and secondary angle-closure glaucoma. If medical therapy fails to relieve pain or if there is suspicion of an intraocular tumor, enucleation should be considered as a therapeutic option.

Show MeSH
Related in: MedlinePlus