Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR.
J Glaucoma. 2020 Oct;29(10):992-994. doi: 10.1097/IJG.0000000000001591.
Stickler syndrome is associated with open-angle glaucoma, but no reports exist of adults presenting with acute angle closure. Here, we report the clinical associations and short-term outcomes in 2 patients with Stickler syndrome who presented with acute angle closure at a single tertiary referral center.
A 36-year-old female with Stickler syndrome presented with acute onset of red and painful left eye with cloudy vision. Initial intraocular pressure (IOP) was measured to be 54 mm Hg. Gonioscopy revealed no angle structures or peripheral anterior synechiae in the left eye. Two laser peripheral iridotomies were created 5 days apart without adequate IOP lowering. Left eye cataract extraction with intraocular lens implantation and Ahmed glaucoma drainage device implantation were performed with resolution of ocular hypertension.A 35-year-old male with Stickler syndrome presented with intermittent right eye pain and blurry vision. IOP was 42 mm Hg and gonioscopy revealed 270 degrees of angle closure in the right eye. The patient underwent laser peripheral iridotomy in the right eye with resolution of ocular hypertension by the next day.
Recognizing angle closure as a potential feature of Stickler syndrome can help providers adequately screen and manage patients with Stickler syndrome presenting with acutely elevated IOP.
节段性软骨发育不全症与开角型青光眼有关,但尚无成年人出现急性闭角型青光眼的报道。在此,我们报告了在一家三级转诊中心就诊的 2 例节段性软骨发育不全症患者出现急性闭角型青光眼的临床关联和短期结果。
一位 36 岁的女性节段性软骨发育不全症患者左眼突发眼红、疼痛伴视力模糊。最初测量的眼内压(IOP)为 54mmHg。左眼房角镜检查未见角度结构或周边前粘连。两次激光周边虹膜切开术相隔 5 天进行,但 IOP 降低不充分。左眼白内障摘除联合人工晶状体植入和 Ahmed 青光眼引流器植入后,眼内压升高得到缓解。
一位 35 岁的男性节段性软骨发育不全症患者出现间歇性右眼疼痛和视力模糊。IOP 为 42mmHg,房角镜检查显示右眼 270 度角关闭。该患者右眼行激光周边虹膜切开术,次日眼内压升高得到缓解。
认识到闭角型青光眼是节段性软骨发育不全症的一个潜在特征,可以帮助医生充分筛查和管理出现急性高眼压的节段性软骨发育不全症患者。