Department of Ophthalmology and Otorhinolaryngology, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Hospital de Olhos Francisco Vilar, Teresina, Piauí, Brazil.
Eur J Ophthalmol. 2024 Jan;34(1):NP22-NP26. doi: 10.1177/11206721231174489. Epub 2023 May 9.
Bilateral acute iris transillumination (BAIT) is a relatively new syndrome whose etiopathogenesis is still not fully understood. It is characterized by acute bilateral onset of intense pigment dispersion in the anterior chamber, iris depigmentation with severe transillumination defects, accentuated pigment deposition in the angle, and elevated intraocular pressure (IOP). In literature, the first case was of bilateral acute iris depigmentation (BADI) reported in 2004 in a 77-year-old woman. In 2019, Perone et al. published a review about BAIT syndrome. They reported a total of 79 cases have been published up that date, mainly in Europe and especially in Turkey and Belgium. The majority of reported cases were of bilateral acute iris depigmentation (BADI). BAIT syndrome might be mainly confused with acute iridocyclitis, acute primary angle-closure (APAC) and pigment dispersion syndrome (PDS). In relation to BAIT, controversies still exist regarding the etiology being the differential diagnosis of paramount importance for adequate treatment.
To report a case of BAIT syndrome associated to refractory glaucoma and to discuss the differential diagnosis based on clinical, OCT and UBM findings.
We present a case of BAIT syndrome in which clinical, OCT and UBM findings have pointed out the similarities and, mainly the diagnosis differences with other ocular diseases.
BAIT syndrome with accentuated IOP rise must be differentiated of other ocular diseases. It requires urgent clinical therapy and/or surgical management as occurred in the present case for avoiding structural damage in OCT and visual field loss. OCT and UBM are critical for early recognition, differential diagnosis and management.
双侧急性虹膜光透射（BAIT）是一种相对较新的综合征，其发病机制尚不完全清楚。它的特征是前房内急性双侧强烈的色素播散，虹膜脱色素伴有严重的光透射缺陷，角部色素沉着加重，眼内压（IOP）升高。在文献中，首例双侧急性虹膜色素减退（BADI）于 2004 年在一名 77 岁女性中报告。2019 年，Perone 等人发表了一篇关于 BAIT 综合征的综述。他们报告说，截至当时，共发表了 79 例病例，主要在欧洲，特别是在土耳其和比利时。报告的大多数病例为双侧急性虹膜色素减退（BADI）。BAIT 综合征可能主要与急性虹膜炎、急性原发性房角关闭（APAC）和色素播散综合征（PDS）混淆。关于 BAIT，病因学仍然存在争议，这对明确诊断和适当治疗至关重要。
报告一例与难治性青光眼相关的 BAIT 综合征，并根据临床、OCT 和 UBM 结果讨论鉴别诊断。
我们报告了一例 BAIT 综合征病例，其临床、OCT 和 UBM 结果指出了与其他眼病的相似之处，主要是诊断差异。
必须将伴有明显眼压升高的 BAIT 综合征与其他眼病相区别。它需要紧急的临床治疗和/或手术管理，就像本病例中发生的那样，以避免 OCT 和视野丧失的结构损伤。OCT 和 UBM 对于早期识别、鉴别诊断和管理至关重要。
