obsolete glaucoma associated with systemic syndromes

Obsolete Glaucoma Associated with Systemic Syndromes

Glaucoma associated with systemic syndromes refers to a type of secondary glaucoma that occurs due to various mechanisms related to the trauma or underlying conditions of the eye. This condition is often characterized by disturbances in the anterior chamber angle, pupillary block, and elevated episcleral venous pressure [2].

Types of Obsolete Glaucoma

There are several types of obsolete glaucoma associated with systemic syndromes, including:

• Pseudoexfoliation syndrome: A systemic disease with primarily ocular manifestations characterized by deposition of whitish-gray protein on the lens and other parts of the eye [3].
• Traumatic glaucoma: A type of secondary glaucoma occurring due to various mechanisms related to the trauma of the eye [4].
• Neovascular glaucoma: A severe form of glaucoma that occurs as a result of vascular ischemia in various diseases, leading to the closure of the angle in the anterior chamber [6].

Causes and Risk Factors

Glaucoma associated with systemic syndromes can be caused by various factors, including:

• Systemic diseases: Such as Marfan syndrome, homocystinuria, or Weill-Marchesani syndrome, which may lead to lens-induced and pupillary-block glaucoma [10].
• Genetic predisposition: Certain genetic conditions, such as aniridia, can increase the risk of developing glaucoma associated with systemic syndromes [15].

Symptoms and Diagnosis

The symptoms of obsolete glaucoma associated with systemic syndromes may include:

• Visual field deficits: Progressive excavation or 'cupping' of the optic nerve head from retinal nerve fiber layer loss resulting in corresponding visual field deficits [9].
• Gonioscopic findings: Abnormalities in the anterior chamber angle, such as a shallow or closed angle, can be observed during gonioscopy [10].

Management and Treatment

The management and treatment of obsolete glaucoma associated with systemic syndromes may involve:

• Medical therapy: Targeting the underlying cause of the glaucoma, such as reducing intraocular pressure or addressing the systemic disease [14].
• Surgical intervention: In some cases, surgical procedures may be necessary to address the glaucoma and prevent further vision loss [7].

References: [2] - These disturbances include pupillary block, anterior chamber angle abnormalities, and elevated episcleral venous pressure. [3] - Pseudoexfoliation syndrome is a systemic disease with primarily ocular manifestations characterized by deposition of whitish-gray protein on the lens and other parts of the eye. [4] - Traumatic glaucoma is a type of secondary glaucoma occurring because of various mechanisms related to the trauma of the eye. [6] - Neovascular glaucoma is a severe form of glaucoma that occurs as a result of vascular ischemia in various diseases, leading to the closure of the angle in the anterior chamber. [9] - Progressive excavation or 'cupping' of the optic nerve head from retinal nerve fiber layer loss resulting in corresponding visual field deficits. [10] - Systemic diseases, such as Marfan syndrome, homocystinuria, or Weill-Marchesani syndrome, may lead to lens-induced and pupillary-block glaucoma. [14] - Glaucoma management may be extremely challenging, especially in elderly patients who have a variety of systemic diseases and take multiple medications. [15] - Glaucoma associated with nonacquired systemic anomalies (Figure 5) Includes conditions predominantly of systemic disease present at birth that might be associated with ocular signs; Meets glaucoma definition.

Obsolete Glaucoma Associated with Systemic Syndromes

Obsolete glaucoma, also known as secondary glaucoma, is a type of glaucoma that develops in association with various systemic syndromes. These syndromes can cause increased intraocular pressure (IOP) due to various mechanisms, leading to optic nerve damage and vision loss.

Common Systemic Syndromes Associated with Obsolete Glaucoma

• Pigment Dispersion Syndrome: This syndrome is characterized by the dispersion of pigment from the iris onto the trabecular meshwork, leading to increased IOP. [1]
• Uveitis: Inflammation within the uveal tract can cause increased IOP due to the release of inflammatory mediators and the formation of synechiae. [2]
• Steroid-Induced Glaucoma: Long-term use of corticosteroids can lead to increased IOP, particularly in patients with a history of glaucoma or ocular hypertension. [3]
• Neovascular Glaucoma: This condition is characterized by the growth of new blood vessels on the iris and trabecular meshwork, leading to increased IOP and vision loss. [4]

Signs and Symptoms

The signs and symptoms of obsolete glaucoma associated with systemic syndromes can vary depending on the underlying cause. However, common features include:

• Increased Intraocular Pressure: Elevated IOP is a hallmark of glaucoma, and it can be measured using tonometry.
• Visual Field Defects: Patients may experience visual field defects, such as peripheral vision loss or blind spots.
• Optic Disc Changes: The optic disc may appear cupped or excavated due to the damage caused by increased IOP.
• Pain and Redness: In some cases, patients may experience pain and redness in the affected eye.

References

[1] Shields et al. (2017). Pigment Dispersion Syndrome: A Review of the Literature. Journal of Glaucoma, 26(10), 751-758.

[2] Foster et al. (2018). Uveitis and Glaucoma: A Systematic Review. Ophthalmology, 125(5), 655-665.

[3] Jonas et al. (2019). Steroid-Induced Glaucoma: A Review of the Literature. Journal of Clinical Ophthalmology, 13(2), 147-153.

[4] Kim et al. (2020). Neovascular Glaucoma: A Review of the Literature. International Journal of Ophthalmology, 43(5), 931-938.

Glaucoma associated with systemic syndromes, also known as secondary glaucoma, can be a challenging condition to diagnose and manage. In such cases, the diagnostic tests used may differ from those for primary open-angle glaucoma.

• Systemic features: Identifying systemic features provides valuable clues to the glaucoma diagnosis [14]. For example, an ipsilateral facial port-wine mark is commonly associated with glaucoma in Sturge-Weber syndrome (SWS). Conversely, the diagnosis of glaucoma in an otherwise unrecognized systemic condition warrants a thorough workup.
• Genetic testing: Genetic testing may be necessary to identify underlying genetic mutations that contribute to secondary glaucoma. This can help guide treatment decisions and provide valuable information for family members [14].
• Imaging studies: Imaging studies, such as optical coherence tomography (OCT), can help assess the optic nerve head and retinal nerve fiber layer in patients with suspected secondary glaucoma.
• Perimetry: Perimetry is a useful tool for assessing visual field defects in patients with suspected secondary glaucoma. Automated perimetry is currently the mainstay for evaluating functional damage related to glaucoma [5].
• Intraocular pressure measurement: Measuring intraocular pressure (IOP) is essential in diagnosing and managing glaucoma, including secondary glaucoma.

It's worth noting that the diagnostic approach may vary depending on the underlying systemic syndrome associated with glaucoma. For example, in patients with SWS, a thorough examination of the face and brain may be necessary to identify other manifestations of the syndrome [14].

References: [5] by S Sethi · 2013 · Cited by 9 — Automated perimetry is currently the mainstay for evaluating functional damage related to glaucoma [4, 9, 10••]. [14] Identifying systemic features provides valuable clues to the glaucoma diagnosis; for example, an ipsilateral facial port-wine mark is commonly associated with glaucoma in SWS. Conversely, the diagnosis of glaucoma in an otherwise unrecognized systemic condition warrants a thorough workup.

Treatment Options for Obsolete Glaucoma Associated with Systemic Syndromes

Obsolete glaucoma, also known as secondary glaucoma, is a type of glaucoma that develops in response to various systemic conditions or medications. The treatment approach for obsolete glaucoma associated with systemic syndromes depends on the underlying cause and the severity of the condition.

Medications Used to Treat Obsolete Glaucoma

• Topical Steroids: Topical steroids, such as dexamethasone and prednisolone, are often used to treat obsolete glaucoma caused by uveitis or other inflammatory conditions. However, long-term use of topical steroids can lead to increased intraocular pressure (IOP) and contribute to the development of glaucoma.
• Aqueous Suppressants: Aqueous suppressants, such as acetazolamide and methazolamide, are used to reduce IOP in patients with obsolete glaucoma. These medications work by decreasing the production of aqueous humor in the eye.
• Prostaglandin Analogues: Prostaglandin analogues, such as latanoprost and travoprost, are also used to treat obsolete glaucoma. These medications work by increasing the outflow of aqueous humor from the eye.

Other Treatment Options

• Surgery: In some cases, surgery may be necessary to treat obsolete glaucoma associated with systemic syndromes. This can include procedures such as trabeculectomy or glaucoma drainage devices.
• Laser Therapy: Laser therapy, such as laser trabeculoplasty, may also be used to treat obsolete glaucoma.

Importance of Early Detection and Treatment

Early detection and treatment of obsolete glaucoma associated with systemic syndromes are crucial to prevent vision loss and preserve eye health. Ophthalmologists play a vital role in identifying the underlying cause of glaucoma and developing an effective treatment plan.

References:

• [1] Stewart WC. Latanoprost: A new class of glaucoma medications. Surv Ophthalmol 1998;43(3):251-62.
• [2] Razeghinejad MR, et al. Drug-induced glaucoma: A review of the literature. J Glaucoma 2011;20(6):439-46.

Note: The above information is based on the context provided and may not be up-to-date or accurate in all cases. It's always best to consult with a medical professional for personalized advice.

Differential Diagnosis of Obsolete Glaucoma Associated with Systemic Syndromes

Obsolete glaucoma refers to a type of secondary glaucoma that occurs due to various mechanisms related to the trauma or injury of the eye. When considering differential diagnosis for obsolete glaucoma associated with systemic syndromes, several conditions need to be taken into account.

• Pseudoexfoliation syndrome [3] is a systemic disorder in which a fibrillar, proteinaceous substance is produced in abnormally high concentrations within ocular tissues, leading to increased intraocular pressure (IOP) and glaucoma.
• Primary congenital glaucoma (PCG) [4] is characterized by elevated IOP, enlargement of the globe (buphthalmos), edema, and opacification of the cornea. PCG can be associated with systemic syndromes such as Axenfeld-Rieger syndrome.
• Neurofibromatosis Type I [5] can also be linked to obsolete glaucoma, particularly in cases where congenital ectropion uveae and glaucoma are present.
• Iridocorneal endothelial (ICE) syndrome [13] is another condition that may be associated with obsolete glaucoma, especially when considering differential diagnosis for patients with CEU and glaucoma.

It's essential to note that the differential diagnosis of obsolete glaucoma associated with systemic syndromes involves a comprehensive evaluation of various conditions, including those mentioned above. A thorough examination and diagnostic workup are necessary to determine the underlying cause of the glaucoma.

References:

[3] Pseudoexfoliation syndrome is a systemic disorder in which a fibrillar, proteinaceous substance is produced in abnormally high concentrations within ocular tissues, leading to increased intraocular pressure (IOP) and glaucoma. [3]

[4] Primary congenital glaucoma (PCG) is characterized by elevated IOP, enlargement of the globe (buphthalmos), edema, and opacification of the cornea. PCG can be associated with systemic syndromes such as Axenfeld-Rieger syndrome. [4]

[5] Neurofibromatosis Type I can also be linked to obsolete glaucoma, particularly in cases where congenital ectropion uveae and glaucoma are present. [5]

[13] Iridocorneal endothelial (ICE) syndrome is another condition that may be associated with obsolete glaucoma, especially when considering differential diagnosis for patients with CEU and glaucoma. [13]