Popovic Marko, Schlenker Matthew B
Undergraduate Medical Education Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
J Curr Glaucoma Pract. 2018 Sep-Dec;12(3):142-144. doi: 10.5005/jp-journals-10028-1259.
Herein, we report a case of a 55-year-old male who presented with intermittent acute-on-chronic angle-closure glaucoma triggered by sexual excitation.
Sexual excitation is an uncommon cause of pupillary block and angle closure attack.
A 55-year-old male with a history of myopic laser in situ keratomileusis (LASIK) presented with a volatile intraocular pressure (IOP) and blurred vision over the last seven years. He was particularly symptomatic following sexual excitation. Examination revealed an IOP of 36 mm Hg and best-corrected vision of 20/80 OD, with bilateral closed angles and a double hump sign on gonioscopy. There were advanced glaucomatous changes OD and mild-to-moderate changes OS on optical coherence tomography. Following an exploration of potential options, it was chosen to proceed with OD lens-based surgery, goniosynechialysis and endocyclophotoplasty. During OD recovery, the patient reported an episode of visual blurring OS secondary to sexual excitation, which was consistent with pupillary block and angle closure attack on examination. Initially managed with acetazolamide and laser peripheral iridotomy, he eventually underwent the same surgical procedure OS as for OD. Over 1-year of follow-up, he has achieved a stable IOP and excellent visual acuity bilaterally.
This case highlights the importance of a thorough history, with the understanding that sexual excitation can precipitate angle-closure glaucoma. Gonioscopy must be performed even in the setting of myopia and a deep anterior chamber, and the double hump sign must be assessed. Appropriate education surrounding the risks of sexual activity in angle closure suspects is advised.
Popovic M, Schlenker MB. Angle-closure Glaucoma in a Myopic Patient Precipitated by Sexual Excitation: A Case Report. J Curr Glaucoma Pract 2018;12(3):142-144.
在此，我们报告一例55岁男性，其因性兴奋引发间歇性慢性闭角型青光眼急性发作。
性兴奋是瞳孔阻滞和房角关闭发作的罕见原因。
一名有准分子激光原位角膜磨镶术（LASIK）病史的55岁男性，在过去七年中出现眼压波动和视力模糊。他在性兴奋后症状尤为明显。检查发现眼压为36毫米汞柱，右眼最佳矫正视力为20/80，双眼房角关闭，前房角镜检查可见双峰征。光学相干断层扫描显示右眼有晚期青光眼性改变，左眼有轻度至中度改变。在探讨了潜在的治疗方案后，选择对右眼进行基于晶状体的手术、房角粘连分离术和睫状体光凝术。在右眼恢复过程中，患者报告因性兴奋继发左眼视力模糊，检查结果与瞳孔阻滞和房角关闭发作一致。最初用乙酰唑胺和激光周边虹膜切开术治疗，他最终对左眼进行了与右眼相同的手术。经过1年的随访，他双眼眼压稳定，视力良好。
该病例强调了全面病史的重要性，即要认识到性兴奋可诱发闭角型青光眼。即使在近视和前房深的情况下也必须进行前房角镜检查，并评估双峰征。建议对闭角型青光眼疑似患者进行有关性活动风险的适当教育。
波波维奇M，施伦克MB。性兴奋诱发近视患者闭角型青光眼：一例报告。《当代青光眼实践杂志》2018年；12(3):142 - 144。
