Uveitis-glaucoma-hyphema syndrome associated with recurrent vitreous hemorrhage

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

doi:10.1016/j.oftale.2015.08.007

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…This is agreed by Alfaro-Juárez et al, 2015. 8 Haptic malposition was evident in 9 (31%) cases leading to recurrent microhyphema due to continuous irritation of ciliary body, what is traditionally called "HUG syndrome", this was reported by Mostafavi et al, 2013, 5 Alniemi et al, 2018. 23 Also, this malposition may lead to chronic postoperative inflammation and pushing iris anteriorly causing narrow angle, this is agreed by Lima et al, 2014.…”

Section: Discussionmentioning

confidence: 95%

“…This diagnosis is given only if there was no glaucoma prior to cataract removal. 1 Transient or permanent intraocular pressure elevation occurs in pseudophakic eyes as a result of several mechanisms including; vitreous filling the anterior chamber (AC), peripheral anterior synechia, lens particle glaucoma, corticosteroid-induced glaucoma, 2 aqueous misdirection syndrome, 3 capsular block syndrome, 4 haptic-induced post-operative pseudophakic glaucoma, 5 post-operative chronic inflammation, 6 intraocular lens (IOL) dislocation, 7 uveitis-glaucoma-hyphema (HUG) syndrome, 8 pupillary block glaucoma, 9 and pigment release glaucoma. 10 Ultrasound biomicroscopy (UBM) is based on unique 50 to 100 MHz highfrequency ultrasound transducers, incorporated into a B-mode clinical scanner.…”

Section: Introductionmentioning

confidence: 99%

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<p>Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy</p>

Ragab

Abdelkader

Kishk

et al. 2020

OPTH

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Purpose: Pseudophakic glaucoma is a secondary glaucoma in which intra-ocular pressure is elevated following cataract removal. The current study aimed to evaluate the role of ultrasound biomicroscopy (UBM) in assessing post-operative pseudophakic glaucoma. Patients and Methods: This is a case series, prospective, observational and analytical study. It included 29 eyes of 29 patients with post-operative pseudophakic glaucoma. The patients were evaluated by medical history, detailed ophthalmologic examination and UBM. Results: UBM examination has unmasked different causes of pseudophakic glaucoma. The detected causes were classified into 3 main groups, including intraocular lens (IOL)-related causes, lens remnants and intra-ocular inflammation. Haptic-related causes were present in 9 eyes, while 6 eyes had decentered or tilted IOLs. Soemmering's ring was the main cause in 3 eyes while in one eye the cause was lens particle in the anterior chamber (AC). Silicone oil in AC with seclusio pupillae was the main cause in one eye. Peripheral anterior synechiae were detected in 8 eyes while, posterior synechiae were evident in 7 eyes. Uveitis induced by anterior chamber IOL (ACIOL) was found in 3 eyes and one eye had peripheral anterior synechiae due to neovascular glaucoma. Conclusion: UBM is a helpful diagnostic tool to evaluate causes of pseudophakic glaucoma through adequate visualization of different angle structures.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

<p>Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy</p>

Ragab

Abdelkader

Kishk

et al. 2020

OPTH

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“…However, a TID formed like the haptic or optic edge should lead to the diagnosis of UGH syndrome, whereas a small solitary unspecific TID probably should not. A number of previous publications describe TID as a part of UGH syndrome (Micheli et al 2002; LeBoyer et al 2005; Rheaume et al 2009; Alfaro‐Juarez et al 2015; Sousa et al 2016; Zloto & Schwalb 2018; Jasinskas et al 2019), but largely as case reports. Our study is the first report aiming to systematically analyse the shapes of TID.…”

Section: Discussionmentioning

confidence: 99%

“…Since the low incidence of UGH syndrome makes it difficult to design a larger study, previous publications on this condition consist of single cases or small case series (John & Stark 1992; Toma et al 2007; Zhang et al 2014; Alfaro‐Juarez et al 2015; Singh et al 2015; Badakere et al, 2016; Sousa et al 2016; Jasinskas et al 2019). The development of secondary glaucoma makes UGH syndrome a potentially devastating condition that can end in blindness, which justifies a more thorough analysis of the condition.…”

Section: Introductionmentioning

confidence: 99%

Seventy‐one cases of uveitis‐glaucoma‐hyphaema syndrome

Armonaite

Behndig

2020

Acta Ophthalmologica

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Purpose To assess Uveitis‐Glaucoma‐Hyphaema syndrome (UGH syndrome) with focus on resolution, glaucoma development and risk factors. Methods This retrospective case–control study with a cross‐sectional component was performed to compare three groups with 71 patients each: UGH syndrome, dislocated intraocular lens (IOL) without UGH syndrome and ordinary pseudophakia. Main outcome measures were resolution of the UGH syndrome, best‐corrected visual acuity (BCVA) and the need of glaucoma therapy. We also assessed the IOL‐iris contact signs and the use of blood thinners. Results Uveitis‐Glaucoma‐Hyphaema (UGH) syndrome resolved in 77 % of patients who underwent various kind of IOL surgery. Intraocular pressure (IOP) decreased and BCVA improved in the operated cases (p = 0.02 and p < 0.001, respectively), but not in the cases treated conservatively. Intraocular pressure (IOP) ≥22 mmHg at the first haemorrhage predicted the need of glaucoma therapy after UGH syndrome resolution (p = 0.002, area under the curve = 0.8). Fifty‐one per cent of patients without preexisting glaucoma needed glaucoma therapy after UGH syndrome resolution. Pseudophacodonesis was seen more frequently in the UGH group than in the ordinary pseudophakia group (p = 0.001). Iris defects were not more frequent in the UGH group than in the Dislocated group but the types of defects differed (p < 0.0001). Blood thinners were not more frequent in UGH. Conclusion In UGH syndrome, the results are better with surgical intervention than with conservative treatment, but surgery does not guarantee resolution. Pseudophacodonesis is a risk factor for UGH syndrome, but blood thinners are not, and iris defects are not specific to UGH syndrome. A high IOP at the first haemorrhage increases the risk for needing subsequent IOP‐lowering therapy.

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“…7 Even though uveitis, elevated intraocular pressure, and hyphema are the classic associations, 8 another common finding is recurrent vitreous hemorrhage. 9,10 When isolated, the underlying etiology of these hemorrhages may be missed, given that UGH is not one of the common causes of blood in the vitreous cavity. Typical iris transillumination defects may not be recognized initially due to obscuration by hyphema, dulling of the red reflex by vitreous hemorrhage, or dilation of the pupil.…”

Section: Discussionmentioning

confidence: 99%

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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Uveitis-glaucoma-hyphema syndrome associated with recurrent vitreous hemorrhage

Cited by 8 publications

References 10 publications

<p>Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy</p>

<p>Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy</p>

Seventy‐one cases of uveitis‐glaucoma‐hyphaema 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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