Fluorescein angiography of the iris and specular microscopy of the corneal endothelium in some cases of glaucoma secondary to chronic cyclitis.
A series is presented of middle- to old-aged female patients with gray irides and mild bilateral cyclitis accompanied by severe glaucoma with advanced cupping and field loss in the late stages. The cyclitis is accompanied by edema of the corneal endothelium, with the presence of inflammatory cells on the posterior surface of the endothelium; these changes were reversible with topical corticosteroids. There also was hypoperfusion of the iris with microneovascular changes, but these changes were not reversible. The rise in intraocular pressure (IOP) was associated with changes in the endothelial cells of the posterior cornea that may be accompanied by similar changes in the endothelium of the trabecular meshwork. A large proportion of these patients had sarcoidosis, but the more florid ocular appearances of sarcoid were not present although two patients had chorioretinal scarring. The use of topical corticosteroids was important in helping to control the elevated IOP in these cases. Recognition and treatment of the condition is important, because cupping and field loss were extreme in long-standing cases.
Brooks
A M
AM
Glaucoma Investigation and Research Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Gillies
W E
WE
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D002924:Ciliary Body; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005451:Fluorescein Angiography; D005901:Glaucoma / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007498:Iris / Q000000981:diagnostic imaging*; D008853:Microscopy; D011859:Radiography; D012507:Sarcoidosis / Q000150:complications; D014605:Uveitis / Q000150:complications / Q000000981:diagnostic imaging*
D000305:Adrenal Cortex Hormones