Acute angle-closure glaucoma from spontaneous massive hemorrhagic retinal detachment.
OBJECTIVE
To report a case of acute angle-closure glaucoma resulting from spontaneous hemorrhagic retinal detachment.


METHODS
An 81-year-old woman visited our emergency room for severe ocular pain and vision loss in her left eye. Her intraocular pressures (IOPs) were 14 mmHg in the right eye and 58 mmHg in the left eye. Her visual acuity was 0.4 in the right eye but she had no light perception in the left eye. The left anterior chamber depth was shallow and gonioscopy of the left eye showed a closed angle. In comparison, the right anterior chamber depth was normal and showed a wide, open angle. Computed tomography and ultrasonography demonstrated retinal detachment due to subretinal hemorrhage. After systemic and topical antiglaucoma medications failed to relieve her intractable severe ocular pain, she underwent enucleation.


RESULTS
The ocular pathology specimen showed that a large subretinal hemorrhage caused retinal detachment and pushed displaced the lens-iris diaphragm, resulting in secondary angle-closure glaucoma.


CONCLUSIONS
Prolonged anticoagulant therapy may cause hemorrhagic retinal detachment and secondary angle-closure glaucoma. If medical therapy fails to relieve pain or if there is suspicion of an intraocular tumor, enucleation should be considered as a therapeutic option.
Lee
Yoon Jung
YJ
Department of Ophthalmology, Hanyang University, School of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea. lyjot@hanyang.ac.kr
Kang
Sung Min
SM
Kang
Il Bong
IB
D000208:Acute Disease; D000369:Aged, 80 and over; D015353:Eye Enucleation; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000209:etiology* / Q000601:surgery; D006801:Humans; D012163:Retinal Detachment / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012166:Retinal Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed