Bilateral Chandler's syndrome: Uncommon entity diagnosed by ultrasound biomicroscopy and confocal microscopy

A 22?year?old female presented with bilateral, progressive diminution of vision. Slit?lamp examination revealed bilateral sectoral corneal edema. Gonioscopy showed broad?based peripheral anterior synechiae and a membrane obscuring angle structure in both the eyes. On ultrasound biomicroscopy (UBM), a membrane extending from corneal endothelium to anterior iris surface causing traction was seen. Confocal microscopy showed an "epithelium?like" transformation of the corneal endothelium. This case demonstrates a bilateral Chandler variant of the iridocorneal endothelial (ICE) syndrome where the diagnosis of Chandler's disease was confirmed by confocal microscopy, after the mechanism of secondary angle closure was demonstrated by the UBM.

Progress of iridocorneal endothelial syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

@#Iridocorneal endothelial syndrome(ICES)is a rare ocular disease characterized by abnormal structure and proliferation of the corneal endothelium, the anterior chamber angle, and the iris. Common clinical features include corneal edema, secondary glaucoma and iris atrophy. ICES often occurs in young women, and most of them are monocular. Its pathogenesis is still unclear, the symptoms are various, and the blindness rate is high. The disease is difficult to diagnose, and there is no ideal treatment. The purpose of this article is to review the literature on the characteristics, diagnosis and treatment of ICES in order to help the diagnosis and treatment of the disease.

Iridocorneal Endothelial Syndrome with Features of Posterior Polymorphous Corneal Dystrophy

PURPOSE: To report a case of iridocorneal endothelial syndrome, which overlapped with some of the features of posterior polymorphous corneal dystrophy. CASE SUMMARY: A 61-year-old female presented with tearing pain and blurred vision in her left eye, which was aggravated in the morning. The symptom started approximately 1 year prior to her visit. At the initial visit, the visual acuities were 1.0 in both eyes and the intraocular pressures were normal. On slit-lamp examination, a single pair of horizontal parallel lines was observed at the central corneal endothelial layer in the right eye. In contrast, multiple pairs of oblique parallel lines were observed in the left eye. The lines of the lesions were more prominent and wavier in the left eye than those of the right eye. The overlying cornea was clear, and the corneal thicknesses were in the normal range in both eyes. Using a gonioscopic examination, localized peripheral anterior synechiae were observed only in the left eye. The pupil and iris were normal in both eyes. On specular microscopic examination, the corneal endothelial cell size in the right eye increased and the corneal endothelial density decreased to 668 cells/mm². In the left eye, multiple abnormal endothelial cells with dark-light reversal were observed. In conclusion, the patient was subsequently diagnosed with iridocorneal syndrome, rather than posterior polymorphous corneal dystrophy. CONCLUSIONS: Posterior polymorphous corneal dystrophy and iridocorneal endothelial syndrome may present with many similarities. Therefore, in cases of uncertain diagnosis, an understanding of the clinical features is important for proper diagnosis.

A Case of Chandler's Syndrome Associated with Anterior Uveitis

PURPOSE: To report a case of Chandler's syndrome associated with anterior uveitis. METHODS: We encountered a 39-year-old woman who complained of decreased visual acuity in the left eye with anterior uveitis and increased intraocular pressure. On examination, we found corectopia, endothelial pleomorphism and peripheral anterior synechiae, leading to the diagnosis of Chandler's syndrome with anterior uveitis. RESULTS: The anterior uveitis and increased intraocular pressure in Chandler's syndrome were well controlled with the use of Beta-blocker, Latanoprost and topical corticosteroids. We report this case with a review of the literatures.

A Case of Chandler's Syndrome Associated with Anterior Uveitis

PURPOSE: To report a case of Chandler's syndrome associated with anterior uveitis. METHODS: We encountered a 39-year-old woman who complained of decreased visual acuity in the left eye with anterior uveitis and increased intraocular pressure. On examination, we found corectopia, endothelial pleomorphism and peripheral anterior synechiae, leading to the diagnosis of Chandler's syndrome with anterior uveitis. RESULTS: The anterior uveitis and increased intraocular pressure in Chandler's syndrome were well controlled with the use of Beta-blocker, Latanoprost and topical corticosteroids. We report this case with a review of the literatures.

A Case of Cogan-Reese Syndrome

Cogan-Reese syndrome is a disease characterized by glaucoma in an eye with peripheral anterior synechia, multiple pigmented iris nodules, and ectopic Descemet's membranes. Cogan-Reese syndrome is a variant of iridocorneal endothelial syndrome and shares common properties whcih are corneal endothelial degeneration, iris atrophy and secondary glaucoma, with progressive iris atrophy and Chandler's syndrome. We have experienced a 43-year-old female patient complaining of visual dimness in the left eye. On examination, we found characteristics of Cogan-Reese syndrome which were corneal endothelial pleomorphism and cell loss, corneal edema, iris atrophy and multiple pigmented nodules on the surface of the iris, peripheral anterior synechia, and increased intraocular pressure in the left eye. We report a case of Cogan-Reese syndrome which has not been reported in Korea.