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PURPOSE: To report a case of neovascular glaucoma after intraocular lens iris fixation, in which the neovascularization of the iris and the anterior chamber improved with only intraocular pressure (IOP) lowering agents, without treatment of the underlying cause.CASE SUMMARY: A 74-year-old woman who had undergone bilateral cataract surgery presented with left ocular pain and headache that started 3 days previously. At the initial examination, the best-corrected visual acuity was 0.9, and the IOP was 38 mmHg in the left eye. Slit-lamp examination of the left eye revealed diffuse iris neovascularization and several polypropylene suture knots fixated in the superior and inferior iris. Gonioscopic examination revealed angle neovascularization in all quadrants, with focal peripheral anterior synechia in the inferior quadrant. Fundus examination presented inferior neuroretinal rim thinning and an inferior retinal nerve fiber layer defect in the left eye. Fluorescent angiography showed no ischemic retinal lesions, with the exception of several retinal microaneurysms. Six months after topical IOP-lowering treatment in the left eye, the IOP was 10 mmHg, and neovascularization of the iris and angle had regressed completely.CONCLUSIONS: In the case of early-stage neovascular glaucoma with partial angle closure not associated with retinal ischemia, IOP-lowering treatment can be effective without other invasive procedures.
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Objective To study the effects of lucentis preventing vitreous hemorrhage after vitrectomy for diabetic retinopathy combined with iris neovascularization.Methods The clinical data of 70 patients (70 eyes) underwent vitrectomy for diabetic retinopathy combined with iris neovascularization during 2009 to 2015 in our hospital were retrospectively analyzed.The control group (30 eyes) accepted panretinal photocoagulation (PRP),re-vitrectomy,cyclocryotherapy,and the study group (40 eyes) had the 0.5mg lucentis in addition.The follow-up time was 3 months,and the visual acuity,IOP,vitreous hemorrhage,INV regression and complication were observed.Results At 1 month,2 months in the follow-up,the visual acuity of study group was better than the control group,but there was no significant difference along with the follow up.The average preoperative IOP was (26.312 ±4.566) mmHg (1 kPa =7.5 mmHg) in the study group and (24.586 ±5.783) mmHg in the control group,and at the end of the follow up,IOP was (18.576 ±4.762) mmHg in the study group and (28.587 ±7.786) mmHg in the control group,there was statistical difference between the two groups (P =0.041).The intraoperative and postoperative anterior chamber or vitreous hemorrhage occurred in 15 cases,5 cases of the control group,and 3 cases,1 case of the control group,there were significant differences (all P =0.000).At the end of the follow up,3 eyes (7.5％) developed to NVG in the study group and 10 eyes (33.3％) in the control group,there was statistical difference (P ＜ 0.05).Conclusion Lucentis can effectively eliminate the new vessels,reduce the incidence of neovascularization glaucoma and vitreous hemorrhage for patients after vitrectomy for diabetic retinopathy combined with iris neovascularization,and improve the visual acuity in a short time.
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AIM: To investigate hemodynamic alterations of retrobulbar vessels in proliferative diabetic retinopathy ( PDR) patients with anterior segment neovascularization, before and 3mo after vitrectomy combined with panretinal photocoagulation and to explore the clinical significance. ●METHODS: Color Doppler flow imaging ( CDFl ) was used for measurement of blood flow velocities and resistive indexes ( Rl ) of the ophthalmic artery ( OA ) , short posterior ciliary arteries ( sPCA ) and central retinal artery ( CRA ) in 21 eyes of 21 PDR patients with anterior segment neovascularization. CDFl parameters were obtained before and 3mo after vitrectomy combined with panretinal photocoagulation ( PRP) . ● RESULTS: Peak systolic velocity ( PSV ) and end diastolic velocity ( EVD ) of CRA were significantly increased after surgeries, Rl were decreased significantly (P0. 05). ●CONCLUSION: Vitrectomy combined with panretinal photocoagulation might increase the velocity of CRA, decrease Rl and improve ocular blood supply postoperatively. lt may delay or prevent the process of neovascular glaucoma.
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ObjectiveTo compare the effects of two treatmnent methods in the treatment of proliferative diabetic retinopathy (PDR) patients with cataract.Methods79 PDR patients with cataract,according to the different surgical methods were divided into:phacoemulsification with lensectomy of 41 cases(52 eyes) in Group A and crystal resection with lensectomy of 38 cases(48 eyes) in Group B.The changes of eye pressure,iris neovascularization (INV),fundus fluorescein angiography were observed.ResultsThe visual acuity increased in 42cases (80.0％)postoperative in group A,which was significantly higher than that of group B [ 30 cases(62.5％ ) ] (x2 =4.26,P ＜ 0.05) ;The incidence of INN was 3.8 ％ in Group A,which was significantly lower than that of Group B (12.5％ )( x2=4.02,P ＜ 0.05 ) ;The macular edema and postoperative fundus fluorescein angiography showed no significant difference in two groups ( x2 =2.02,2.58,all P ＞ 0.05 ).ConclusionThe effect of phacoemulsification with vitrectomy for the treatment of PDR with cataract was superior to the posterior lens removal of vitrectomy surgery.
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PURPOSE: To report a patient with ocular ischemic syndrome who suffered from sudden decrease in visual acuity after bevacizumab injection. CASE SUMMARY: A 70-year-old patient visited the Department of Ophthalmology due to progressively decreasing visual acuity in the right eye. Corrected visual acuity in his right eye was 0.1 on the first visit; ocular ischemic syndrome was suspected. Despite panretinal photocoagulation, severe iris neovascularization was still present in the right eye. Intravitreal bevacizumab injection was performed to regress the iris neovascularization. One day after injection, iris neovascularization regressed significantly, however, visual acuity was decreased to finger counting. CONCLUSIONS: In ocular ischemic syndrome, bevacizumab injection for reduction of iris neovascularization should be carefully considered due to possibility of acute visual loss.
Subject(s)
Aged , Humans , Antibodies, Monoclonal, Humanized , Eye , Fingers , Iris , Light Coagulation , Ophthalmology , Visual Acuity , BevacizumabABSTRACT
PURPOSE: To report a patient with ocular ischemic syndrome who suffered from sudden decrease in visual acuity after bevacizumab injection. CASE SUMMARY: A 70-year-old patient visited the Department of Ophthalmology due to progressively decreasing visual acuity in the right eye. Corrected visual acuity in his right eye was 0.1 on the first visit; ocular ischemic syndrome was suspected. Despite panretinal photocoagulation, severe iris neovascularization was still present in the right eye. Intravitreal bevacizumab injection was performed to regress the iris neovascularization. One day after injection, iris neovascularization regressed significantly, however, visual acuity was decreased to finger counting. CONCLUSIONS: In ocular ischemic syndrome, bevacizumab injection for reduction of iris neovascularization should be carefully considered due to possibility of acute visual loss.
Subject(s)
Aged , Humans , Antibodies, Monoclonal, Humanized , Eye , Fingers , Iris , Light Coagulation , Ophthalmology , Visual Acuity , BevacizumabABSTRACT
Ocular ischemic syndrome is caused by reduction of blood to the eyeball, which can prodece anterior and posterior segment ischemia. Initial symptom include sudden or gradual loss of vision and eyeball pain. Anterir segment findings are conjunctival injection, iris neovascularization(NV), angle NV,peripheralanterior synechiae, and lens opacity. Posterior segmentfindings are pale, cupped of edematous opticdisc, disc NV, retinal NV, retinal hemorrhage, cherry red spot, retinal arterioles attenuation or sclerosis, and centralretinal artery collapse with pressure on globe. We have experienced a patient who had left ophthalmic artery stenosis, right ophthalmic artery narrowing and neovascular glaucoma in both eyes. We report the case of ocular ischemic syndrome that had control of IOP, mild improvement of visual acuity and regression of neovascularization after Ahmed glaucoma valve implantation.