1/159. ciliary body melanocytoma with anterior segment pigment dispersion and elevated intraocular pressure.PURPOSE: To discuss a case in which melanocytoma of the ciliary body presented with widespread pigment dispersion and elevated intraocular pressure (IOP). methods: A 64-year old woman presented with increased IOP and persistent anterior segment inflammation in her right eye. She had undergone a trabeculectomy for uncontrolled IOP before presentation. Slit-lamp examination, gonioscopy, and ultrasound biomicroscopy revealed a ciliary body mass with extension into the subconjunctiva in addition to widespread pigmentary dispersion in the anterior segment. Enucleation of the right eye was performed for histopathologic evaluation, as a diagnosis of ciliary body melanoma was made on clinical examination. RESULTS: Histopathologic findings were diagnostic of a melanocytoma of the ciliary body with necrosis and focal malignant transformation with extension of melanocytoma cells and melanophages into the subconjunctival space, trabecular meshwork, and anterior chamber angle. CONCLUSION: Melanocytoma of the ciliary body is a rare intraocular tumor that may present with pigment dispersion and secondary elevated IOP. Careful examination of the anterior segment is imperative in such cases.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/159. A false-positive Seidel test after Ahmed valve insertion.An 80-year-old monocular man with long-standing primary open angle glaucoma underwent successful filtering surgery in his sighted right eye in 1980. He subsequently developed a cataract and had an uncomplicated clear cornea phacoemulsification with posterior chamber intraocular lens in 1996. Post-operatively, the filtration bleb remained very avascular but shallowed; the intraocular pressure increased and remained uncontrolled despite maximally tolerated medical therapy. His vision improved to 6/7.5 and automated perimetry revealed a less than 5 degrees small central island of vision. His left eye was phthisical with no light perception.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
3/159. Cystoid macular edema associated with latanoprost therapy in a case series of patients with glaucoma and ocular hypertension.OBJECTIVE: To identify coexisting ocular diagnoses in a case series of eyes that developed cystoid macular edema (CME) associated with latanoprost therapy. DESIGN: Retrospective observational case series. PARTICIPANTS: Seven eyes of seven patients who developed CME possibly associated with latanoprost treatment were studied. INTERVENTION: When these patients, all of whom were treated with latanoprost in addition to other glaucoma medications, described blurred vision or eye irritation, ocular examination revealed CME, which was confirmed by fluorescein angiography. Latanoprost was discontinued, and in three cases topical corticosteroids and nonsteroidal anti-inflammatory agents were used to treat the CME. MAIN OUTCOME MEASURES: visual acuity and intraocular pressure were determined before latanoprost use began, during therapy, and after latanoprost use ceased. In these cases, resolution of CME was documented clinically after discontinuing latanoprost. RESULTS: Clinically significant CME developed after 1 to 11 months of latanoprost treatment, with an average decrease of 3 lines in Snellen visual acuity. intraocular pressure decreased an average of 27.9% during treatment. Cystoid macular edema was confirmed in all cases by fluorescein angiography. In these seven patients, the following coexisting ocular conditions may have placed these eyes at risk for prostaglandin-mediated blood-retinal barrier vascular insufficiency: history of dipivefrin-associated CME, epiretinal membrane, complicated cataract surgery, history of macular edema associated with branch retinal vein occlusion, history of anterior uveitis, and diabetes mellitus. In all cases, the macular edema resolved following discontinuation of latanoprost, in some instances with concomitant use of steroidal and nonsteroidal anti-inflammatory agents. CONCLUSIONS: In this case series of pseudophakic, aphakic, or phakic eyes, the temporal relationships between the use of latanoprost and developing CME, and the resolution of CME following cessation of the drug, suggest an association between latanoprost and CME. In all cases, coexisting ocular conditions associated with an altered blood-retinal barrier were present.- - - - - - - - - - ranking = 2.5keywords = eye (Clic here for more details about this article) |
4/159. Endocapsular hematoma: report of a case following glaucoma surgery in a pseudophakic eye.The authors describe a case of an endocapsular hematoma that occurred in a 69-year-old pseudophakic diabetic male following mitomycin C (MMC) augmented trabeculectomy for neovascular glaucoma (NVG). The clinical course of the patient is described, and the unique features of this case are presented and discussed. The endocapsular hematoma absorbed in 6 weeks with conservative management. The patient regained the preoperative visual acuity of 20/30, and his intraocular pressure was controlled without any glaucoma medication. The iris neovascularization regressed. This case is the first report of an endocapsular hematoma following glaucoma filtering surgery in a pseudophakic eye with neovascular glaucoma.- - - - - - - - - - ranking = 2.5keywords = eye (Clic here for more details about this article) |
5/159. Latanoprost and herpes simplex keratitis.PURPOSE: To report three cases in which herpes simplex keratitis developed after initiation of latanoprost therapy. methods: Case report. RESULTS: One patient with a history of herpes simplex keratitis had recurrence of herpes simplex keratitis with latanoprost treatment, resolution when latanoprost was stopped, and another recurrence when rechallenged with latanoprost. A second patient with a history of herpes simplex keratitis had bilateral recurrence with initiation of latanoprost; antiviral therapy could not eradicate herpes simplex keratitis until the latanoprost was discontinued. The third patient with latanoprost-associated herpes simplex keratitis cleared with the discontinuation of latanoprost and start of antiviral therapy; reinstitution of latanoprost with prophylactic antiviral medication kept the cornea clear, but as soon as the antiviral suppression was discontinued, herpes simplex keratitis reappeared. CONCLUSION: Latanoprost, among its diverse pharmacologic effects, may mediate inflammation in the eye. prostaglandins may be a final common pathway for stimulating recurrence of herpes simplex keratitis. Clinicians should be aware of this possible association.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
6/159. Change in optic disc topography associated with diurnal variation in intraocular pressure.PURPOSE: A case demonstrating significant changes in optic disc topography from variation in intraocular pressure (IOP) is demonstrated. methods: Within a single 24-hour period, confocal scanning laser ophthalmoscopic images were obtained in the left eye of a patient during an IOP peak (60 mmHg) and during an IOP trough (18 mmHg). RESULTS: During an IOP trough, paired t tests showed significant reduction in cup area, cup volume, mean cup depth, and maximum cup depth, and a significant increase in rim area and cup-to-disc (CD) ratio. CONCLUSION: Under certain conditions, optic disc topography may be affected by diurnal variations in IOP.- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
7/159. Unilateral capsular glaucoma after long-standing bilateral pigmentary glaucoma.In 1964 we treated a 42-year-old woman diagnosed to have classical bilateral pigment dispersion syndrome combined with an intraocular pressure (IOP) of up to 28 mmHg in both eyes. The patient now has a daughter, also with pigment dispersion syndrome. Miotic treatment brought the IOPs to normal, and 8 years later when the disease was in the inactive phase all treatment could be discontinued. At the age of 67 years, exfoliation deposits became visible in the right eye only, but the IOPs were still below 21 mmHg. Four years later, the pressure of the right eye rose to 31 mmHg. During the next few years all available IOP-lowering medications and laser trabeculoplasty failed, and finally trabeculectomy had to be performed to keep the pressure of the right eye under control and to halt visual field changes, which had already appeared. This case illustrates that development of exfoliation syndrome may take place irrespective of pigment dispersion, and that their simultaneous occurrence may lead to an IOP rise that is resistant to medical therapy and laser trabeculoplasty. It additionally provides further clues to the pathogenesis of capsular glaucoma.- - - - - - - - - - ranking = 2keywords = eye (Clic here for more details about this article) |
8/159. Loss of iridolenticular contact in eyes with exfoliation syndrome may protect against glaucoma.PURPOSE: To provide evidence for the hypothesis that dynamic iridolenticular contact predisposes to the development of glaucoma in exfoliation syndrome (XFS). methods: We present four patients with bilateral XFS and unilateral exfoliation glaucoma (XFG) whose normotensive eyes had suffered traumatic loss of dynamic iridolenticular contact. RESULTS: All 4 patients had bilateral XFS and developed XFG only in the untraumatized eyes. One patient had loss of iridolenticular contact in the traumatized eye, two had a nonreactive pupil, and one had had intracapsular cataract extraction at age 28. CONCLUSIONS: Loss of dynamic iridolenticular contact may help to protect against development of glaucoma in eyes with XFS.- - - - - - - - - - ranking = 4keywords = eye (Clic here for more details about this article) |
9/159. Posner-Schlossman syndrome: a case report.BACKGROUND: Glaucomatocyclitic Crisis (AKA Posner-Schlossman syndrome) is a syndrome that affects patients between the ages of 20 and 50 years. It is characterized by a mild recurrent anterior uveitis associated with an out-of-proportion intraocular pressure spike in the same eye. The cause is unclear, but many theories exist. Some researchers have tried to connect it with primary open-angle glaucoma. CASE REPORT: A review of the record of a 41-year-old Hispanic woman with Posner-Schlossman syndrome is discussed. She sought treatment on multiple occasions with symptoms of mild pain, photophobia, and a blurry left eye. Examination revealed mild anterior chamber reaction and an intraocular pressure (IOP) spike in the same eye. She was treated with topical anti-inflammatory and pressure-lowering agents. Each individual flare-up was treated successfully, but the patient began to show equivocal signs of primary open-angle glaucoma (PDAG). She is currently treated prophylactically for POAG with a beta-blocker. No etiologic factor was identified in this patient. The differential diagnosis is straight-forward and the treatment is general uveitic therapy--minus cycloplegics--combined with an IOP-lowering drop. CONCLUSION: This is an interesting and relatively rare uveitic condition. The list of differential diagnoses is long, as is the theorized etiologies; however, clinically the condition is relatively quickly identifiable by the presence (and absence) of signs and symptoms.- - - - - - - - - - ranking = 1.5keywords = eye (Clic here for more details about this article) |
10/159. Latanoprost-induced iris color darkening: a case report with long-term follow-up.PURPOSE: To determine the effect on iris color of discontinuing latanoprost (LP) treatment in a patient with pronounced iris color darkening, and to assess the possible role of sympathetic innervation. methods: In a patient demonstrating pronounced iris color darkening in both eyes after treatment with LP for 6 months, magnified iris color photographs were taken at 3- to 6-month intervals for 5 years after discontinuation of LP treatment. Pupillary testing for sympathetic insufficiency was performed with cocaine 10% or hydroxyamphetamine 1%. RESULTS: The iris color did not appreciably change after discontinuing LP. The cocaine-induced increase in pupillary diameter was considerably greater for the control subject than for the patient who demonstrated the LP-induced color change. CONCLUSIONS: Latanoprost-induced iris color darkening does not appreciably change for several years after discontinuing treatment. Some eyes that show LP-induced darkening may have relative ocular sympathetic insufficiency.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
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