Synchysis scintillans mimicking phacolytic glaucoma in a traumatic eye

Lo, Kang-Jung; Huang, Yu-Yun; Hsu, Chih Chien

doi:10.1002/kjm2.12050

Cited by 8 publications

(13 citation statements)

References 3 publications

(2 reference statements)

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“…Synchysis scintillans can present as a pseudohypopyon, mimicking phacolysis. 6 Although it has been reported that cholesterol deposits can originate from exudative lens material, this case was not consistent with phacolysis, and pathological tests confirmed an intact lens capsule. 7 Treatment of synchysis scintillans is limited and enucleation is often performed; this management was chosen given the low visual potential for the involved eye and poor cosmesis.…”

Section: Resultscontrasting

confidence: 53%

Pathological Findings of Synchysis Scintillans Secondary to Familial Exudative Vitreoretinopathy With Chronic Exudative Retinal Detachment

Lin

Garcia

Chen

et al. 2019

Journal of VitreoRetinal Diseases

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Purpose: We describe a unique case of synchysis scintillans in a 23-year-old woman with a history of chronic exudative retinal detachment in the setting of familial exudative vitreoretinopathy. Methods: Fundus and slit-lamp photographs were obtained at presentation, and pathological studies were performed on the enucleated specimen to confirm the diagnosis. Results: Synchysis scintillans is a degenerative condition of cholesterol deposition that affects severely damaged eyes, often as a result of chronic vitreous hemorrhage or retinal detachment. In this case, synchysis scintillans presented as crystals in the anterior chamber in the setting of a chronic retinal detachment. After enucleation, there were noted to be cholesterol slits on pathological correlation, confirming the diagnosis. Conclusions: This case demonstrates the importance of clinical pathological correlation in the diagnosis of synchysis scintillans migrating into the anterior chamber.

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Section: Resultscontrasting

confidence: 53%

Pathological Findings of Synchysis Scintillans Secondary to Familial Exudative Vitreoretinopathy With Chronic Exudative Retinal Detachment

Lin

Garcia

Chen

et al. 2019

Journal of VitreoRetinal Diseases

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“…Cholesterol crystals usually form within the vitreous cavity, but cases in which cholesterol particles are formed in the anterior chamber have occasionally been reported [6] . Cholesterol crystal deposition in the anterior chamber is very rare in the clinic, particularly in both eyes [1–5,7] . In 1828, Parfait-Landrau first reported the formation of sparkling crystals in a human ocular vitreous body.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, numerous similar cases were reported. In anterior chamber cholesterolosis, both domestic and international reports indicated a relationship with blindness, but not with patient age, sex, place of residence, or biochemical indices such as blood cholesterol content [1–5,7] …”

Section: Discussionmentioning

confidence: 99%

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Secondary glaucoma with anterior chamber cholesterolosis

Han

Tian²,

Fan³

et al. 2022

Medicine

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Rationale: The presence of cholesterol crystals in the anterior chamber is extremely rare, and secondary glaucoma with cholesterol crystals in the anterior chamber, reported in the literature, is even rarer. This paper reports 3 cases of secondary glaucoma with cholesterol crystals in the anterior chamber. Patient concerns: Three patients were admitted to the hospital because of ocular distension and blindness. Ocular examination on admission indicated high intraocular pressure, and crystalline gold substances were observed in the anterior chamber. Diagnosis: Based on clinical manifestations and an aqueous fluid smear, absolute glaucoma and anterior chamber cholesterol crystals were diagnosed. Interventions: In the first case, transscleral ciliary photocoagulation was performed; in the last 2 cases, trabeculectomy combined with extracapsular cataract extraction was performed. Outcomes: The follow-up period was 11 to 15 months. Intraocular pressure was stable in 2 patients treated with surgery, and no cholesterol crystals were observed in the anterior chamber. The intraocular pressure increased in 1 patient treated with laser, and a small amount of cholesterol crystals was still observed in the anterior chamber. Lessons: Anterior chamber cholesterol crystallization is extremely rare and cannot be treated if it does not cause other lesions. However, glaucoma occurred in all 3 cases in this study, and intraocular pressure increased in 1 case after laser treatment and remained stable in 2 cases after surgical treatment. Therefore, the treatment plan for anterior chamber cholesterol crystallization in glaucoma requires further discussion.

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“…It is characterized by many flat crystalline bodies suspended in a degenerative vitreous fluid. Synchysis scintillans can be secondary to eye trauma, long-term cataract, recurrent intraocular inflammation, hemorrhage or hyphema, secondary glaucoma, or vascular disorders, and can be found both in the anterior and posterior chamber of the eye [ 2 , 3 ]. It can be unilateral or bilateral and is usually seen in the third decade [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile and Demographic Distribution of Synchysis Scintillans: An Electronic Medical Record-Driven Big Data Analytics From an Eye Care Network in India

Das¹,

Kadam²,

Tyagi³

2022

Cureus

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Introduction: To describe the demographics and clinical profile of synchysis scintillans in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 3,082,727 new patients presenting between August 2010 and December 2021. Patients with a clinical diagnosis of synchysis scintillans in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 93 (0.003%) patients were diagnosed with synchysis scintillans. About half of the patients were male (50.54%) and had unilateral (81.72%) affliction. The most common age group at presentation was during the seventh decade of life with 38 (40.86%) patients. The overall prevalence was higher in patients from a higher socioeconomic status (0.003%) presenting from the metropolitan geography (0.005%) and in retired individuals (0.018%). A systemic history of diabetes mellitus was documented in 13 (13.98%) patients and hypertension was documented in 15 (16.13%) patients. The majority of the eyes had mild or no visual impairment (<20/70) in 74 (67.27%) eyes. The most commonly associated ocular comorbidity was cataract in 61 (55.45%) eyes followed by glaucoma in eight (7.27%) eyes. Among the surgical interventions performed for the ocular comorbidities, cataract surgery was performed in nine (8.18%) eyes, and vitreoretinal surgery and trabeculectomy were performed in two (1.82%) eyes each. Conclusion: Synchysis scintillans equally affect males and females presenting during the seventh decade of life and is predominantly unilateral. The majority of the eyes have mild or no visual impairment and over half of the eyes have an associated cataract.

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Synchysis scintillans mimicking phacolytic glaucoma in a traumatic eye

Cited by 8 publications

References 3 publications

Pathological Findings of Synchysis Scintillans Secondary to Familial Exudative Vitreoretinopathy With Chronic Exudative Retinal Detachment

Pathological Findings of Synchysis Scintillans Secondary to Familial Exudative Vitreoretinopathy With Chronic Exudative Retinal Detachment

Secondary glaucoma with anterior chamber cholesterolosis

Clinical Profile and Demographic Distribution of Synchysis Scintillans: An Electronic Medical Record-Driven Big Data Analytics From an Eye Care Network in India

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