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Management of angle-closure glaucoma with X-linked retinoschisis: a case report
BACKGROUND: X-linked retinoschisis (XLRS), due to mutations in the RS1 gene, is a common genetically determined form of macular degeneration. This report describes an unusual case of angle-closure glaucoma (ACG) with XLRS and discusses the treatment. CASE PRESENTATION: A 39-year-old Chinese man with...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10111739/ https://www.ncbi.nlm.nih.gov/pubmed/37069516 http://dx.doi.org/10.1186/s12886-023-02903-7 |
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author | Li, Yanxia Li, Jia Pan, Xingzhu Zhang, Zhaoying Zheng, Yajuan |
author_facet | Li, Yanxia Li, Jia Pan, Xingzhu Zhang, Zhaoying Zheng, Yajuan |
author_sort | Li, Yanxia |
collection | PubMed |
description | BACKGROUND: X-linked retinoschisis (XLRS), due to mutations in the RS1 gene, is a common genetically determined form of macular degeneration. This report describes an unusual case of angle-closure glaucoma (ACG) with XLRS and discusses the treatment. CASE PRESENTATION: A 39-year-old Chinese man with an X chromosome-recessive inherited c.489G > A variant in the RS1 gene was diagnosed as XLRS and ACG, presenting with cystic macular lesions, shallow anterior chamber depth (ACD), and angle-closure with uncontrolled intraocular pressure (IOP). Malignant glaucoma occurred following trabeculectomy combining phacoemulsification with intraocular lens (IOL) implantation and goniosynechialysis. Subsequent anterior vitrectomy and irido-zonulo-hyaloid-vitrectomy (IZHV) effectively lowered IOP and deepened ACD, but the cystic cavity became larger. CONCLUSIONS: There is a potential risk of malignant glaucoma in ACG patients with XLRS after filtering surgery. Although anterior vitrectomy can effectively resolve aqueous misdirection, the macular retinoschisis may get worse. Awareness of this risk may aid in surgical planning and postoperative management in these patients. |
format | Online Article Text |
id | pubmed-10111739 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101117392023-04-19 Management of angle-closure glaucoma with X-linked retinoschisis: a case report Li, Yanxia Li, Jia Pan, Xingzhu Zhang, Zhaoying Zheng, Yajuan BMC Ophthalmol Case Report BACKGROUND: X-linked retinoschisis (XLRS), due to mutations in the RS1 gene, is a common genetically determined form of macular degeneration. This report describes an unusual case of angle-closure glaucoma (ACG) with XLRS and discusses the treatment. CASE PRESENTATION: A 39-year-old Chinese man with an X chromosome-recessive inherited c.489G > A variant in the RS1 gene was diagnosed as XLRS and ACG, presenting with cystic macular lesions, shallow anterior chamber depth (ACD), and angle-closure with uncontrolled intraocular pressure (IOP). Malignant glaucoma occurred following trabeculectomy combining phacoemulsification with intraocular lens (IOL) implantation and goniosynechialysis. Subsequent anterior vitrectomy and irido-zonulo-hyaloid-vitrectomy (IZHV) effectively lowered IOP and deepened ACD, but the cystic cavity became larger. CONCLUSIONS: There is a potential risk of malignant glaucoma in ACG patients with XLRS after filtering surgery. Although anterior vitrectomy can effectively resolve aqueous misdirection, the macular retinoschisis may get worse. Awareness of this risk may aid in surgical planning and postoperative management in these patients. BioMed Central 2023-04-17 /pmc/articles/PMC10111739/ /pubmed/37069516 http://dx.doi.org/10.1186/s12886-023-02903-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Li, Yanxia Li, Jia Pan, Xingzhu Zhang, Zhaoying Zheng, Yajuan Management of angle-closure glaucoma with X-linked retinoschisis: a case report |
title | Management of angle-closure glaucoma with X-linked retinoschisis: a case report |
title_full | Management of angle-closure glaucoma with X-linked retinoschisis: a case report |
title_fullStr | Management of angle-closure glaucoma with X-linked retinoschisis: a case report |
title_full_unstemmed | Management of angle-closure glaucoma with X-linked retinoschisis: a case report |
title_short | Management of angle-closure glaucoma with X-linked retinoschisis: a case report |
title_sort | management of angle-closure glaucoma with x-linked retinoschisis: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10111739/ https://www.ncbi.nlm.nih.gov/pubmed/37069516 http://dx.doi.org/10.1186/s12886-023-02903-7 |
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