Clinical Features and Risk Factors of Glaucomatous Change in Posner-Schlossman Syndrome

PURPOSE: To analyze the clinical features and determine the factors that affect glaucomatous change of patients with Posner-Schlossman syndrome (PSS). METHODS: A retrospective analysis of 51 eyes of 51 patients diagnosed with PSS was performed. We analyzed the factors including age of first attack, highest intraocular pressure (IOP), duration of the disease, number of the attacks and interval between attacks among the patients who developed glaucoma and those who did not and compared the 2 groups. RESULTS: The age of first attack was 34.73 +/- 10.77 years, and highest IOP was 47.75 +/- 9.43 mm Hg. Duration of the disease was 62.06 +/- 69.84 months, number of the attacks was 6.20 +/- 7.73 times, and interval between attacks was 12.65 +/- 8.95 months. Of 51 eyes of 51 patients, 12 eyes (23.5%) of 12 patients showed significant glaucomatous change. In the glaucoma group, highest IOP was 52.81 +/- 7.87 mm Hg, number of attacks was 11.91 +/- 10.63 times, and interval between attacks was 8.07 +/- 3.97 months. In the non-glaucomatous group highest IOP was 46.19 +/- 9.14 mm Hg, number of attacks was 4.59 +/- 5.94 times, and interval between attacks was 14.59 +/- 9.79 months, respectively. Highest IOP was significantly greater, number of attacks was higher, and interval was shorter with statistical significance in the glaucoma group (p = 0.025, p = 0.001, p = 0.028). CONCLUSIONS: A significant number of patients with PSS tend to show glaucomatous change over time. Patients with high IOP during attacks and those having frequent attacks with short intervals should be closely monitored and evaluation for glaucomatous damage is recommended.

Cinical Manifestations and Prognosis of Cytomegalovirus Retinitis

PURPOSE: Cytomegalovirus (CMV) retinitis is common in patients with immunodeficient conditions caused by acquired immunodeficiency syndrome (AIDS), cytotoxic chemotherapy and immunosuppresive treatment. The purpose of this study was to assess the clinical manifestations and prognosis of CMV retinitis cases. METHODS: Thirty-one eyes of 21 patients who were diagnosed with CMV retinitis were retrospectively reviewed. The clinical manifestations and prognosis of all patients were analyzed. RESULTS: The average age of patients was 24.4+/-19.8 years. Eight patients were female and 13 patients were male. The predisposing conditions of patients were leukemia (nine patients), immunosuppressed conditions due to organ transplantation (three patients), AIDS (two patients) and other (seven patients). Eleven patients exhibited bilateral disease. The mean follow-up period was 31.3 months, and there were no differences between mean initial visual acuity (0.70+/-0.31) and mean visual acuity (0.77+/-0.20) at final visit. The major causes of visual loss were retinitis and atrophic changes involving the macula. Although retinitis was successfully treated with anti-viral agents in all cases, cataract (10 eyes, 31.3%), cystoid macular edema (four eyes, 12.5%), retinal detachment (two eyes, 6.3%), epiretinal membrane (two eyes, 6.3%) and immune recovery uveitis (two eyes, 6.3%) developed after the initial treatment. CONCLUSIONS: Although the visual prognosis of CMV retinitis was relatively good after administration of appropriate antiviral therapy, clinicians should remain alert for the development of late complications, including retinal detachment, cystoid macular edema and immune recovery uveitis.

Two Cases of Mucocele After Orbital Fracture Repair

PURPOSE: We report two cases of mucocele formation after medial orbital wall fracture repair with an alloplastic implant. CASE SUMMARY: A 61-year-old man with a history of a medial orbital wall fracture repaired with an alloplastic implant five years earlier presented with a several-month history of left proptosis without diplopia, pain, or lid edema. A 55-year-old man with a history of a medial orbital wall fracture repaired with an alloplastic implant seven years prior, presented with a five.year history of left proptosis with diplopia. Computed tomography (CT) scans revealed a large cyst on the orbital medial wall, which surrounded the alloplastic implant and had no definite enhancement. The patients underwent orbital surgery to remove both the cyst and implant. Histologic examination of the cyst revealed a capsule lined with ciliated pseudostratified columnar epithelium. Both patients had an uncomplicated postoperative course with resolution of the proptosis. CONCLUSIONS: For cases that present with late proptosis after orbital fracture repair, mucocele formation should be included in the differential diagnosis.