Síndrome uveítis-glaucoma-hipema asociado a hemorragia vítrea de repetición

Alfaro-Juárez, A.; Vital-Berral, C.; Sánchez-Vicente, J.L.; Muñoz-Morales, A.

doi:10.1016/j.oftal.2014.11.007

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…The loss of anterior hyaloids integrity (spontaneous, degenerative or after surgery) enables communication between the aqueous humor and the vitreous, allowing the passage of blood and giving rise to the possibility of simultaneous bleeding in both chambers. The coexistence of VH should not delay the diagnose [ 13 ].…”

Section: Presentationmentioning

confidence: 99%

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Uveitis–Glaucoma–Hyphaema Syndrome. General review

Zemba¹,

Camburu²

2017

rjo

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Uveitis-Glaucoma-Hyphaema Syndrome (UGH syndrome, or "Ellingson" Syndrome) is a rare condition caused by the mechanical trauma of an intraocular lens malpositioned over adjacent structures (iris, ciliary body, iridocorneal angle), leading to a spectrum of iris transillumination defects, microhyphaemas and pigmentary dispersion, concomitant with elevated intraocular pressure (IOP). UGH Syndrome can also be characterized by chronic inflammation, secondary iris neovascularization, cystoid macular edema (CME). The fundamental step in the pathogenesis of UGH syndrome appears to arise from repetitive mechanical iris trauma by a malpositioned or subluxed IOL. These patients have uncomplicated cataract implants and return for episodes of blurry vision weeks to months after surgery. This may be accompanied by pain, photophobia, erythropsia, anterior uveitis, hyphaema along with raised intraocular pressure. A careful history and examination, as well as appropriate investigations can confirm the diagnostic. Treatment options are IOL Explantation exchange, topical and systemic medication, and cyclophotocoagulation, the placement of a Capsular Tension Ring to redistribute zonular tension and Anti-vascular endothelial growth factor (anti-VEGF) Therapy.

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Section: Presentationmentioning

confidence: 99%

“…Ultrasound biomicroscopy (UBM) is often used in the diagnosis of UGH syndrome to visualize the malpositioned IOLs, to confirm the haptics position and their contact with the uveal tissue. In addition, ocular coherence tomography (OCT) can aid in the guidance of diagnosing CME [ 13 ].…”

Section: Investigationsmentioning

confidence: 99%

Uveitis–Glaucoma–Hyphaema Syndrome. General review

Zemba¹,

Camburu²

2017

rjo

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“…On the contrary, the syndrome might be complicated by vitreous hemorrhage (UGH Plus), pseudophakic bullous keratopathy, glaucomatous nerve damage, chronic inflammation, macular edema or neovascularization of the iris. 2,3 Ultrasound biomicroscopy (UBM) is the most frequently used imaging technique to confirm the diagnosis. 4 In fact, it allows the visualization of the IOL plate and haptics position.…”

Section: Introductionmentioning

confidence: 99%

The role of anterior segment optical coherence tomography in uveitis-glaucoma-hyphema syndrome

Lippera

Nicolosi

Vannozzi

et al. 2021

European Journal of Ophthalmology

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Purpose To describe features of uveitis-glaucoma-hyphema (UGH) syndrome, using Anterior Segment-Optical Coherence Tomography (AS-OCT) and Ultrasound Biomicroscopy (UBM) and to evaluate the diagnostic role of AS-OCT as an imaging technique alternative to UBM. Design Retrospective case series. Methods Four eyes of 4 patients with UGH syndrome were analyzed. All patients reported previous uncomplicated cataract surgery with in-the-bag implantation of single-piece-intraocular lens (IOL). They underwent at presentation complete ophthalmological examination and imaging with slit-lamp anterior segment photographs, UBM and AS-OCT. Results Although AS-OCT did not allow to visualize the structures behind the iris, it displayed a contact between IOL (plate and/or haptics) and iris and IOL tilting in 3 out of 4 eyes. AS-OCT directly detected the cause of UGH syndrome in one eye, 2 eyes required some expedients to display the iris chafing, like scans in mydriasis and/or patient's gaze direction change. AS-OCT did not allow to appreciate the IOL-iris contact (showed by UBM technique) only in one eye, probably due to the change of patient position from supine to sitting, and consequent anteriorization of iris diaphragm. Furthermore AS-OCT showed fine details, as capsular bag collapse and indirect signs of haptic malposition in 3 out of 4 eyes. Conclusion AS-OCT is a non-invasive technique that allows to determine IOL position and IOL-uveal contact in selected cases of UGH syndrome. Considering AS-OCT and UBM advantages and limitations, AS-OCT should be used as first imaging modality when clinical diagnosis is uncertain. When UGH diagnosis cannot be verified using AS-OCT, UBM should be performed.

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Recurrent Vitreous Hemorrhage Secondary to Sulcus Positioning of a One-Piece Acrylic Intraocular Lens Haptic: Report of 3 Cases and Management With Retrocapsular Haptic Repositioning

Mantopoulos

Prenner

Wheatley

2017

Journal of VitreoRetinal Diseases

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Three pseudophakic patients presented with recurrent, unilateral vitreous hemorrhage, one of which also had uveitis, glaucoma, and hyphema, consistent with "uveitis-glaucoma-hyphema (UGH)-Plus" syndrome. Arcuate transillumination defects secondary to inadvertent placement of 1 intraocular lens (IOL) haptic in the sulcus were identified in each case. The second haptic and optic were located in the capsular bag. The IOLs were all single-piece foldable acrylic lenses with square-edge haptic design. Surgical repositioning of the malpositioned haptic from the sulcus to the retrocapsular space resulted in the resolution of the recurrent vitreous hemorrhage. This series highlights the fact that recurrent vitreous hemorrhage secondary to iris chafing, with or without UGH, may occur in cases where a square-edge IOL haptic is placed in the sulcus. Vitrectomy with repositioning of the malpositioned IOL is a simple alternative to IOL exchange in these cases.

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Síndrome uveítis-glaucoma-hipema asociado a hemorragia vítrea de repetición

Cited by 5 publications

References 10 publications

Uveitis–Glaucoma–Hyphaema Syndrome. General review

Uveitis–Glaucoma–Hyphaema Syndrome. General review

The role of anterior segment optical coherence tomography in uveitis-glaucoma-hyphema syndrome

Recurrent Vitreous Hemorrhage Secondary to Sulcus Positioning of a One-Piece Acrylic Intraocular Lens Haptic: Report of 3 Cases and Management With Retrocapsular Haptic Repositioning

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