Department of ophthalmology B, Institut Hédi Raies d'ophtalmologie de Tunis, Tunisia.
Faculté de médecine de Tunis, Université Tunis - El Manar, Tunis, Tunisia.
Eur J Ophthalmol. 2024 Mar;34(2):NP38-NP42. doi: 10.1177/11206721231206792. Epub 2023 Oct 6.
To describe clinical and anterior segment optical coherence tomography (AS-OCT) findings in a patient with bilateral iridoschisis and unilateral angle closure glaucoma (ACG) associated with abnormal visibility of iris vessels.
A 67-year-old male patient with a history of red and painful left eye (LE) one year earlier, presented to our ophthalmology department for a routine examination.Ophthalmic examination of the right eye revealed narrow anterior chamber with sectorial iris atrophy associated to abnormal visibility of an iris vessel. Intraocular pressure (IOP) was 12 mmHg with normal optic disc appearance. LE anterior chamber was narrow with diffuse iris atrophy and abnormal vessels visibility. IOP was 28 mmHg with an important optic disc excavation. On gonioscopy, angle was narrow without neovessels nor synechiae. AS-OCT of both eyes revealed shallow angles, iris splitting with material release in the anterior chamber, while pigmented epithelium was preservedAnti-glaucoma eye drops were prescribed and peripheral laser iridotomy was performed in both eyes with decreased IOP at 14 mmHg in the LE.
Iridoschisis is a rare ocular condition characterized by a separation between the anterior and posterior layers of iris stroma with several clinical presentations, and may be associated with abnormal visibility of iris vessels in some cases. The diagnosis of iridoschisis may be challenging and AS-OCT can be a very useful tool to confirm the diagnosis in atypical presentations and to detect associated angle closure.
描述一位双眼虹膜劈裂和单侧闭角型青光眼（ACG）患者的临床和眼前节光学相干断层扫描（AS-OCT）表现，该患者伴有虹膜血管可见度异常。
一位 67 岁男性患者，一年前左眼出现红痛，来我院眼科就诊行常规检查。右眼眼科检查发现前房狭窄，扇形虹膜萎缩，伴有虹膜血管可见度异常。眼压（IOP）为 12mmHg，视盘外观正常。左眼前房狭窄，弥漫性虹膜萎缩和异常血管可见度。IOP 为 28mmHg，视盘明显凹陷。房角镜检查显示角度狭窄，无新生血管或粘连。双眼 AS-OCT 显示浅房角，虹膜分层，房水中有物质释放，色素上皮保留。
给予抗青光眼滴眼剂，并对双眼行周边激光虹膜切开术，左眼眼压降至 14mmHg。
虹膜劈裂是一种罕见的眼部疾病，特征为虹膜基质的前层和后层分离，有多种临床表现，在某些情况下可能与虹膜血管可见度异常有关。虹膜劈裂的诊断具有挑战性，AS-OCT 可以作为一种非常有用的工具，用于在不典型表现中确认诊断，并检测相关的闭角。
