Lenis Tamara Lee, Ledesma Vicioso Nahomy, Reddy Varun, Kovacs Kyle D, Van Tassel Sarah H, Orlin Anton
Department of Ophthalmology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, United States.
Front Pediatr. 2021 Dec 16;9:786327. doi: 10.3389/fped.2021.786327. eCollection 2021.
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness that occurs due to incomplete development of retinal blood vessels in preterm infants. Glaucoma is an ocular comorbidity in some patients with ROP, and it may be associated with immature anterior chamber development, ROP itself, or the treatment for ROP. There have been a few reports of narrow-angle glaucoma after laser treatment for ROP. In this case report, we describe the course of a female infant born at 24 weeks and 5 days of gestational age with treatment-requiring ROP treated with laser photocoagulation who subsequently developed very elevated intraocular pressure and shallow anterior chambers without pupillary block. The patient required bilateral trabeculotomy for elevated intraocular pressure, which normalized after the procedure. The patient has remained stable at the last follow-up at 51 weeks postmenstrual age. Differing from previous glaucoma presentations in this setting, we illustrate a case of elevated intraocular pressure and anterior chamber narrowing after laser therapy without pupillary block or synechiae. The possible multifactorial etiology of glaucoma in this patient, including incomplete angle development, ischemia, and laser treatment, highlight the need for glaucoma screening in patients with ROP, both in the short and long term.
早产儿视网膜病变（ROP）是儿童失明的主要原因，它是由于早产儿视网膜血管发育不完全所致。青光眼是一些ROP患者的眼部合并症，它可能与前房发育不成熟、ROP本身或ROP的治疗有关。已有少数关于ROP激光治疗后发生窄角型青光眼的报道。在本病例报告中，我们描述了一名孕24周零5天出生的女婴，其ROP需要激光光凝治疗，随后眼压大幅升高，前房变浅，无瞳孔阻滞。该患者因眼压升高需要进行双侧小梁切开术，术后眼压恢复正常。在月经龄51周的最后一次随访中，患者病情保持稳定。与该情况下以往的青光眼表现不同，我们展示了一例激光治疗后眼压升高和前房变窄，无瞳孔阻滞或粘连的病例。该患者青光眼可能的多因素病因，包括房角发育不完全、缺血和激光治疗，凸显了对ROP患者进行短期和长期青光眼筛查的必要性。
