Glaucoma Services.
Vitreo-Retina and Uvea Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
J Glaucoma. 2018 Jan;27(1):e1-e6. doi: 10.1097/IJG.0000000000000810.
We report two cases of bilateral severe familial exudative vitreoretinopathy (FEVR) presenting with bilateral angle closure glaucoma, with evidence of neovascularization in one eye of each case. Both cases displayed bilateral disc dragging with evidence of avascular retinae on fundus fluorescein angiography. Retinal laser photocoagulation and antivascular endothelial growth factor injections provided satisfactory regression of the neovascularization. Medical management of glaucoma was administered to both patients. Lens aspiration with posterior chamber intraocular lens implantation was performed for one eye of each patient. It helped in clearing media as well as in increasing anterior chamber depth, helping in indirect control of intraocular pressure. Although the primary pathology of FEVR lies in the retina, a comprehensive glaucoma screening is essential. We conclude that neovascular glaucoma albeit uncommon in FEVR, may be the presenting feature in advanced unlasered cases, and should be specifically looked for.
我们报告了两例双侧严重家族性渗出性玻璃体视网膜病变(FEVR)合并双侧闭角型青光眼的病例,每只眼均有新生血管形成的证据。这两例病例均表现为双侧视盘牵拉,眼底荧光血管造影显示视网膜无血管。视网膜激光光凝和抗血管内皮生长因子注射治疗使新生血管得到了满意的消退。对两名患者均进行了青光眼的药物治疗。对每只眼行晶状体抽吸联合后房型人工晶状体植入术。这有助于清除眼部介质并增加前房深度,有助于间接控制眼压。尽管 FEVR 的主要病变位于视网膜,但全面的青光眼筛查是必不可少的。我们的结论是,尽管新生血管性青光眼在 FEVR 中并不常见,但在未经激光治疗的晚期病例中可能是首发特征,应特别注意。