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Conjunctival Microangiopathy in a Patient with Neovascular Glaucoma.

Abdul-Rahman AM, Molteno A - Case Rep Ophthalmol (2015)

Bottom Line: Capillaries were tortuous, with sparse microaneurysm formation, and arterioles were attenuated.We are unaware of previous reports in the literature on conjunctival microangiopathy secondary to diabetes presenting as a red eye.We hypothesized that the clinical features in our case may have been modified by a combination of postoperative wound healing and degenerative vascular remodeling, in addition to microvascular alterations secondary to both diabetes and consequent ocular ischemia, which may have played a role.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Counties Manukau DHB, Auckland, New Zealand.

ABSTRACT

Purpose: To report a case of conjunctival microangiopathy secondary to diabetes presenting as a red eye 5 years after glaucoma implant surgery for neovascular glaucoma.

Materials and methods: A 52-year-old Tongan male with a past history of neovascular glaucoma secondary to proliferative diabetic retinopathy underwent slitlamp examination and color photography of the anterior and posterior segment, in addition to anterior segment fluorescein angiography.

Results: The conjunctival venules perilimbally demonstrated tortuosity and dilation (saccular, fusiform and tricornuate). Capillaries were tortuous, with sparse microaneurysm formation, and arterioles were attenuated. Anterior segment fluorescein angiography showed generalized iris ischemia, extensive perilimbal microvascular degenerative changes and leakage of fluorescein into the anterior chamber. We are unaware of previous reports in the literature on conjunctival microangiopathy secondary to diabetes presenting as a red eye.

Conclusions: We hypothesized that the clinical features in our case may have been modified by a combination of postoperative wound healing and degenerative vascular remodeling, in addition to microvascular alterations secondary to both diabetes and consequent ocular ischemia, which may have played a role.

No MeSH data available.


Related in: MedlinePlus

a–f Anterior segment fluorescein angiography. Time after injection (min:s) is shown in the upper right hand corner. Of note, there is an absence of fluorescein flow in the iris except at the pupillary margin, extensive microaneurysm formation, early arborescent inferonasal corneal neovascularization and a lack of filling in a large saccular dilation at 5 o'clock. e, f Late leakage of the fluorescein dye in the anterior chamber is shown.
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Figure 3: a–f Anterior segment fluorescein angiography. Time after injection (min:s) is shown in the upper right hand corner. Of note, there is an absence of fluorescein flow in the iris except at the pupillary margin, extensive microaneurysm formation, early arborescent inferonasal corneal neovascularization and a lack of filling in a large saccular dilation at 5 o'clock. e, f Late leakage of the fluorescein dye in the anterior chamber is shown.

Mentions: The inferior nasal cornea demonstrated early neovascularization. Leakage of fluorescein into the anterior chamber was noted after 1 min of fluorescein injection (fig. 3).


Conjunctival Microangiopathy in a Patient with Neovascular Glaucoma.

Abdul-Rahman AM, Molteno A - Case Rep Ophthalmol (2015)

a–f Anterior segment fluorescein angiography. Time after injection (min:s) is shown in the upper right hand corner. Of note, there is an absence of fluorescein flow in the iris except at the pupillary margin, extensive microaneurysm formation, early arborescent inferonasal corneal neovascularization and a lack of filling in a large saccular dilation at 5 o'clock. e, f Late leakage of the fluorescein dye in the anterior chamber is shown.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608607&req=5

Figure 3: a–f Anterior segment fluorescein angiography. Time after injection (min:s) is shown in the upper right hand corner. Of note, there is an absence of fluorescein flow in the iris except at the pupillary margin, extensive microaneurysm formation, early arborescent inferonasal corneal neovascularization and a lack of filling in a large saccular dilation at 5 o'clock. e, f Late leakage of the fluorescein dye in the anterior chamber is shown.
Mentions: The inferior nasal cornea demonstrated early neovascularization. Leakage of fluorescein into the anterior chamber was noted after 1 min of fluorescein injection (fig. 3).

Bottom Line: Capillaries were tortuous, with sparse microaneurysm formation, and arterioles were attenuated.We are unaware of previous reports in the literature on conjunctival microangiopathy secondary to diabetes presenting as a red eye.We hypothesized that the clinical features in our case may have been modified by a combination of postoperative wound healing and degenerative vascular remodeling, in addition to microvascular alterations secondary to both diabetes and consequent ocular ischemia, which may have played a role.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Counties Manukau DHB, Auckland, New Zealand.

ABSTRACT

Purpose: To report a case of conjunctival microangiopathy secondary to diabetes presenting as a red eye 5 years after glaucoma implant surgery for neovascular glaucoma.

Materials and methods: A 52-year-old Tongan male with a past history of neovascular glaucoma secondary to proliferative diabetic retinopathy underwent slitlamp examination and color photography of the anterior and posterior segment, in addition to anterior segment fluorescein angiography.

Results: The conjunctival venules perilimbally demonstrated tortuosity and dilation (saccular, fusiform and tricornuate). Capillaries were tortuous, with sparse microaneurysm formation, and arterioles were attenuated. Anterior segment fluorescein angiography showed generalized iris ischemia, extensive perilimbal microvascular degenerative changes and leakage of fluorescein into the anterior chamber. We are unaware of previous reports in the literature on conjunctival microangiopathy secondary to diabetes presenting as a red eye.

Conclusions: We hypothesized that the clinical features in our case may have been modified by a combination of postoperative wound healing and degenerative vascular remodeling, in addition to microvascular alterations secondary to both diabetes and consequent ocular ischemia, which may have played a role.

No MeSH data available.


Related in: MedlinePlus