A 55-years-old female presented with pain in the right eye for 15 days. She had a history of complicated cataract surgery followed by pars plana vitrectomy, intraocular gas injection and sulcus fixated intraocular lens implantation. On ophthalmologic examination, pupillary capture by intraocular lens, shallow anterior chamber, corneal edema and elevated intraocular pressure despite maximum medical therapy was observed. Intraocular gas induced secondary pupillary block glaucoma diagnosis was made. She underwent intraocular lens reposition and peripheral iridectomy surgery in the same session. Intraocular pressure reduced dramatically after the procedure in addition to anterior chamber deepening. In this case report, we highlighted the very rare cause of pupillary block glaucoma and its management.
ÖzetAmaç: Yaş tip yaşa bağlı makula dejenerasyonu tedavisinde kullanılan intravitreal ranibizumab enjeksiyonunun etkinlik ve güvenilir-liğini araştırmak. Ge reç ve Yön tem: Ocak 2009-Ocak 2011 tarihleri arasında kliniğimizde yaş tip yaşa bağlı makula dejenerasyonu tanısıyla en az 12 ay takip edilen 43 hastanın 48 gözü çalışmaya dahil edildi. Ortalama takip süresi 14,2 ay; hastaların ortalama yaşı 73,65±8,93 idi. Hastalar birer ay arayla yapılan 3 enjeksiyon sonrası klinik muayene ve optik kohorens tomografi ile takip edildiler ve gerektiğinde enjeksiyon tekrarına karar verildi. Sonuçlar: 20'si erkek (%46,5) 23'ü kadın (%53,5) 43 hastanın 48 gözüne ortalama 3.7 enjeksiyon (3-7) uygulandı. 26 gözde (%54,2) klasik tip (baskın ve minimal); 22 gözde (%45,8) gizli tip koroid neovasküler membran mevcuttu. ETDRS eşeli ile ölçülen en iyi düzeltilmiş görme keskinlikleri tedavi öncesi ortalama 46,8 harf iken, 12. ayda ortalama 55,5 harf olarak alındı. Başlangıçta santral makula kalınlığı ortalama 320 mikron iken, 12. ayda ortalama 269 mikrona geriledi. Görme keskinliği ve santral makula kalınlığın-da istatistiksel olarak anlamlı iyileşme görülürken, bu düzelmenin lezyon tipi ile uyumlu olmadığı tespit edildi. Takip süresinde hiçbir hastada sistemik ya da lokal ciddi yan etki gözlenmedi. Tar t›fl ma: İntravitreal ranibizumab enjeksiyonu yaş tip yaşa bağlı makula dejenerasyonunda anatomik ve fonksiyonel iyileşmede etkili ve güvenli bir tedavi seçeneğidir. (Turk J Ophthalmol 2012; 42: 25-9) Anah tar Ke li me ler: Yaş tip yaşa bağlı makula dejenerasyonu, intravitreal ranibizumab, koroid neovaskuler membran Sum maryPur po se: To evaluate the efficacy and safety of intravitreal ranibizumab injection for exudative age-related macular degeneration. Ma te ri al and Met hod: In this study, we included forty-eight eyes of 43 age-related macular degeneration patients followed for at least twelve months. Mean age was 73.65±8.93 years and mean follow-up time was 14.2 months. All patients received three consecutive monthly intravitreal ranibizumab injections and then were followed up with clinical examination and optic coherence tomography monthly. Re-injection was executed as needed. Re sults: Twenty patients were male (46.5%) and twenty-three patients were female (53.5%). The average number of ranibizumab injection was 3.7 (3-7) per eye. Twenty-six lesions (54.2%) were classic (predominantly and minimally) and twenty-two (45.8%) were occult. Mean best-corrected visual acuity was 46.8 letters with ETDRS chart at the initial examination and 55.5 letters at twelfth month. Mean central foveal thickness decreased from 320 microns to 269 microns. There was a statistically significant improvement in visual acuity and central foveal thickness. On the other hand, this improvement was not significant between lesion types. During follow-up, there were no systemic or serious ocular complications determined. Dis cus si on: Intravitreal ranibizumab injection is safe and effective, both anatomically and functionally, for age-related macular degenerat...
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