obsolete glaucoma associated with chamber angle anomalies

Obsolete Glaucomas Associated with Chamber Angle Anomalies

Glaucomas associated with chamber angle anomalies are a group of conditions characterized by abnormal changes in the anterior chamber angle, leading to increased intraocular pressure (IOP) and potential vision loss. Here are some obsolete glaucomas associated with chamber angle anomalies:

• Angle Recession Glaucoma: This is the most common form of glaucoma associated with trauma [7]. It occurs when a blow to the eye causes a tear in the iris, leading to scarring and narrowing of the anterior chamber angle.
• Neovascular Glaucoma (NVG): NVG is characterized by intractable ocular hypertension caused by neovascularization of the iris and the anterior chamber angle [4]. It can occur after central retinal artery occlusion or other conditions that cause ischemia to the retina.
• Phacolytic Glaucoma: This type of glaucoma occurs when a mature or hypermature cataract leaks denatured protein through an intact lens capsule, leading to inflammation and increased IOP [2].
• Glaucomatous Etiology: Primary open angle glaucoma with diurnal fluctuation between normal and elevated IOP, intermittent acute angle closure glaucoma, and other forms of glaucoma can also be associated with chamber angle anomalies [6].

These conditions are considered obsolete because they have been largely replaced by more modern and effective treatments for glaucoma. However, it's essential to recognize these conditions in order to provide proper care and management for patients.

References:

[1] Nov 8, 2017 - Among the abnormalities associated with a closed angle are pupillary block, plateau iris, aqueous misdirection, and secondary pupillary ... [2] Nov 8, 2017 - Phacolytic glaucoma is seen in eyes with mature or hypermature cataracts (9‑41). [4] by AX Chan · 2020 · Cited by 1 — We report here a unique case of angle closure in a patient with major depressive disorder status post anterior chamber intraocular lens placement. [5] by R Krishnadas · 2001 · Cited by 53 — Neovascular glaucoma may occur in diabetics where abnormal new blood vessel formation has occurred causing disturbance to the outflow of aqueous at the angle of ... [6] Glaucomatous etiology · Primary open angle glaucoma with diurnal fluctuation between normal and elevated IOP · Intermittent acute angle closure glaucoma ... [7] Sep 10, 2009 — Angle recession glaucoma is the most common form of glaucoma associated with trauma. [8] Apr 9, 2019 — Topiramate-induced angle closure generally affects both eyes and presents with acute reduced vision, eye pain, eye redness, ocular fullness, ... [10] glaucoma secondary to chamber angle abnormalities in early childhood;to elevated episcleral venous pressure in late childhood and early adulthood goniotomy ...

Signs and Symptoms of Obsolete Glaucoma Associated with Chamber Angle Anomalies

Glaucoma associated with chamber angle anomalies, also known as angle-closure glaucoma, is a type of glaucoma that occurs when the drainage angle between the iris and cornea becomes blocked or narrowed. This can lead to increased pressure in the eye, which can damage the optic nerve and potentially cause blindness.

Signs:

• Decreased visual acuity, worse at distance than near [3]
• Myopic shift
• Increased intraocular pressure
• Corneal edema
• Diffusely shallow anterior chamber

Symptoms:

• Severe ocular pain and redness
• Decreased vision
• Colored halos around lights
• Headache, nausea, and vomiting [10]

In some cases, angle-closure glaucoma can progress slowly, causing no symptoms initially. This is known as chronic angle-closure glaucoma.

Differentiating Signs/Symptoms:

• Differentiating Tests:
  • Gonioscopy shows an open angle in open-angle glaucoma
  • Visual field defects are different from those of glaucoma in other optic neuropathies [11]

It's worth noting that the term "obsolete" is not typically used to describe glaucoma, as it is a progressive and potentially blinding disease. However, the signs and symptoms listed above are associated with angle-closure glaucoma, which can be considered an outdated or obsolete classification of glaucoma.

References:

[3] - Apr 9, 2019 [10] - Angle-closure glaucoma is glaucoma associated with a physically obstructed anterior chamber angle, which may be chronic or, rarely, acute. [11] - Differentiating Signs/Symptoms. Differentiating Tests. Open-angle glaucoma (primary and secondary) Clinically indistinguishable from chronic ACG. Gonioscopy shows an open angle. Other optic neuropathies (eg, compressive) Visual field defects are different from those of glaucoma. IOP is normal. Gonioscopy shows an open angle.

Diagnostic Tests for Obsolete Glaucoma Associated with Chamber Angle Anomalies

Glaucoma associated with chamber angle anomalies, also known as angle-closure glaucoma, is a type of glaucoma that can lead to irreversible blindness if left untreated. The diagnostic tests used to diagnose this condition are crucial in preventing vision loss.

Gonioscopy: A Key Diagnostic Tool Gonioscopy is a diagnostic test that allows ophthalmologists to directly visualize the anterior chamber angle and diagnose angle closure. This test is essential in evaluating causes of increased intraocular pressure (IOP) and differentiating between various conditions, such as primary open-angle glaucoma, ocular hypertension, or normal-tension glaucoma [11].

Other Diagnostic Tests In addition to gonioscopy, other diagnostic tests used to diagnose glaucoma associated with chamber angle anomalies include:

• Tonometry: This test measures eye pressure and is essential in diagnosing glaucoma.
• Ophthalmoscopy: This test examines the optic nerve head and retina for signs of damage caused by increased IOP [13].
• Ultrasound biomicroscopy (UBM): This imaging test provides detailed images of the anterior segment, including the chamber angle, and can help diagnose angle closure [4].

Serial Single-Gene Testing In some cases, serial single-gene testing may be necessary to establish a diagnosis. This involves testing for specific genetic mutations associated with glaucoma, such as CYP1B1 or LTBP2 [14].

Multigene Panel Testing A multigene panel that includes CYP1B1, LTBP2, TEK, and other genes of interest may also be used to diagnose glaucoma associated with chamber angle anomalies. This test can help identify genetic mutations that contribute to the development of this condition [14].

References:

[4] Angle-closure glaucoma is a leading cause of irreversible blindness. Diagnosis and treatment are intricately related to angle assessment techniques.

[11] When evaluating causes of increased intraocular pressure, gonioscopy is a key diagnostic tool to directly visualize and diagnose angle closure.

[13] Diagnostic Tests for Glaucoma: Tests used to diagnose glaucoma include tonometry (to measure eye pressure), ophthalmoscopy (to examine the optic nerve head and retina).

[14] Establishing the Diagnosis · Serial single-gene testing. · A multigene panel that includes CYP1B1, LTBP2, TEK, and other genes of interest (see Differential diagnosis).

Treatment Options for Glaucoma Associated with Chamber Angle Anomalies

Glaucoma associated with chamber angle anomalies, also known as primary angle-closure glaucoma (PACG), requires immediate attention to prevent vision loss. While surgical interventions are often necessary, drug treatment can be used in conjunction with or as an alternative to surgery.

Medications for PACG

The following medications may be prescribed to treat PACG:

• Acetazolamide: A carbonic anhydrase inhibitor that helps reduce intraocular pressure (IOP) by decreasing the production of aqueous humor.
• Mannitol: An osmotic diuretic that can help lower IOP by increasing the outflow of fluid from the eye.
• Topical timolol: A beta-blocker that reduces IOP by decreasing the production of aqueous humor.
• Topical pilocarpine: A muscarinic agonist that increases the outflow of fluid from the eye, thereby reducing IOP.

Laser Treatment

In addition to medication, laser treatment may be used to treat PACG. Laser peripheral iridotomy (LPI) is a procedure where a small hole is created in the iris to allow aqueous humor to flow freely and reduce IOP.

• Nd:YAG laser: A type of laser that can be used to create an LPI.
• Argon laser: Another type of laser that may be used to treat PACG.

Other Treatment Options

In some cases, other treatment options may be considered, such as:

• Lens extraction: Removing the lens from the eye to improve drainage and reduce IOP.
• Iridotomy: Creating a hole in the iris to allow aqueous humor to flow freely.

It's essential to note that each case of PACG is unique, and the most effective treatment plan will depend on individual factors. A comprehensive evaluation by an ophthalmologist or optometrist is necessary to determine the best course of action.

References:

• [6] Treatment for α-agonist-induced AACG includes acetazolamide, mannitol, topical timolol, and topical pilocarpine.
• [8] Recent Findings The concept of angle closure management is based on reversing the angle closure process while taking into account the disease's etiology, clinical presentation, and staging of the disease.

Based on the provided context, here are some potential differential diagnoses for obsolete glaucoma associated with chamber angle anomalies:

• Angle Recession Glaucoma: This type of glaucoma often presents as a unilateral or asymmetric glaucoma without symptoms unless in an advanced stage. It may be caused by trauma to the eye, which can lead to a recession of the anterior chamber angle and subsequent glaucoma [8].
• Neovascular Glaucoma: Although not directly related to chamber angle anomalies, neovascular glaucoma is often associated with other ophthalmic abnormalities, most commonly ocular ischemia. It's essential to rule out this condition in patients presenting with glaucoma symptoms [6].
• Phacomorphic Glaucoma: This type of glaucoma occurs due to the physical obstruction of the anterior chamber angle by a lens-related anomaly, such as a posteriorly dislocated lens or a lens-induced pupillary block. It's crucial to consider this diagnosis in patients with glaucoma symptoms and a history of cataract surgery [7].
• Ectopia Lentis: This condition involves the displacement of one or both lenses from their normal position, which can lead to mechanical obstruction of the anterior chamber angle and subsequent glaucoma. It's essential to consider this diagnosis in patients with glaucoma symptoms and a history of trauma or other ocular anomalies [7].
• Plateau Iris Syndrome: This condition involves an abnormally oversized ciliary body that can cause mechanical obstruction of the anterior chamber angle, leading to glaucoma. It's crucial to consider this diagnosis in patients with glaucoma symptoms and a history of previous intraocular surgery [5].

These differential diagnoses are not exhaustive, but they represent some potential causes of obsolete glaucoma associated with chamber angle anomalies. A thorough evaluation by an ophthalmologist is necessary to determine the underlying cause of glaucoma in each patient.

References: [5] Plateau iris syndrome (PIS) is one cause of acute angle closure glaucoma. [6] Neovascular glaucoma is virtually always associated with other ophthalmic abnormalities, most commonly some form of ocular ischemia. [7] Differential Diagnosis: Lens-associated angle closure glaucomas. Phacomorphic glaucoma. Ectopia lentis. [8] Angle recession glaucoma often presents as a unilateral, or asymmetric, glaucoma without symptoms unless in an advanced stage.