Southwest Hospital / Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
BMC Ophthalmol. 2023 Nov 15;23(1):458. doi: 10.1186/s12886-023-03190-y.
To report the ocular characteristics and management of three cases of retinitis pigmentosa (RP) concurrent primary angle closure glaucoma (PACG).
Three middle-aged patients presenting with diminished vision, high intraocular pressure (IOP), and typical fundus manifestations of RP were clinically evaluated. The individualized treatment was based on the ocular conditions of each case. A novel genetic alteration in ZNF408 was identified in one patient. Two patients with short-axial eyes received unilateral combined trabeculectomy, cataract surgery, and Irido-zonulo-hyaloid-vitrectomy. One of them had a subluxated lens, managed with a capsular tension ring implantation. Their contralateral eyes, respectively, underwent laser peripheral iridotomy (LPI) and transscleral cyclophotocoagulation. The third patient underwent bilaterally combined laser peripheral iridoplasty, LPI, and medication. Ultimately, all patients achieved the target IOP during a two-year follow-up.
Young patients with RP may have a risk of developing angle closure glaucoma, and conversely, patients with angle closure glaucoma at younger age should be aware of the presence of RP. Therefore, routine gonioscopy and IOP monitoring are required for RP patients, and detailed fundus examinations are warranted for young PACG patients.
报告三例伴有原发性闭角型青光眼（PACG）的色素性视网膜炎（RP）的眼部特征和治疗方法。
三名中年患者出现视力下降、高眼压和典型的 RP 眼底表现，进行了临床评估。根据每个病例的眼部情况制定了个体化治疗方案。一名患者发现了 ZNF408 的一种新的遗传改变。两名短眼球轴患者接受了单侧联合小梁切除术、白内障手术和虹膜-睫状体-脉络膜玻璃体切除术。其中一人患有晶状体半脱位，采用囊袋张力环植入术治疗。他们的对侧眼睛分别接受了激光周边虹膜切开术（LPI）和经巩膜睫状体光凝术。第三位患者接受了双侧联合激光周边虹膜成形术、LPI 和药物治疗。最终，所有患者在两年的随访中均达到了目标眼压。
年轻的 RP 患者可能有发生闭角型青光眼的风险，反之，年轻的闭角型青光眼患者应注意 RP 的存在。因此，RP 患者需要常规进行房角检查和眼压监测，而年轻的 PACG 患者需要进行详细的眼底检查。
