Abstract：
OBJECTIVE: To describe clinical and anterior segment optical coherence tomography (AS-OCT) findings in a patient with bilateral iridoschisis and unilateral angle closure glaucoma (ACG) associated with abnormal visibility of iris vessels.
METHODS: A 67-year-old male patient with a history of red and painful left eye (LE) one year earlier, presented to our ophthalmology department for a routine examination.Ophthalmic examination of the right eye revealed narrow anterior chamber with sectorial iris atrophy associated to abnormal visibility of an iris vessel. Intraocular pressure (IOP) was 12 mmHg with normal optic disc appearance. LE anterior chamber was narrow with diffuse iris atrophy and abnormal vessels visibility. IOP was 28 mmHg with an important optic disc excavation. On gonioscopy, angle was narrow without neovessels nor synechiae. AS-OCT of both eyes revealed shallow angles, iris splitting with material release in the anterior chamber, while pigmented epithelium was preservedAnti-glaucoma eye drops were prescribed and peripheral laser iridotomy was performed in both eyes with decreased IOP at 14 mmHg in the LE.
CONCLUSIONS: Iridoschisis is a rare ocular condition characterized by a separation between the anterior and posterior layers of iris stroma with several clinical presentations, and may be associated with abnormal visibility of iris vessels in some cases. The diagnosis of iridoschisis may be challenging and AS-OCT can be a very useful tool to confirm the diagnosis in atypical presentations and to detect associated angle closure.
METHODS: A 67-year-old male patient with a history of red and painful left eye (LE) one year earlier, presented to our ophthalmology department for a routine examination.Ophthalmic examination of the right eye revealed narrow anterior chamber with sectorial iris atrophy associated to abnormal visibility of an iris vessel. Intraocular pressure (IOP) was 12 mmHg with normal optic disc appearance. LE anterior chamber was narrow with diffuse iris atrophy and abnormal vessels visibility. IOP was 28 mmHg with an important optic disc excavation. On gonioscopy, angle was narrow without neovessels nor synechiae. AS-OCT of both eyes revealed shallow angles, iris splitting with material release in the anterior chamber, while pigmented epithelium was preservedAnti-glaucoma eye drops were prescribed and peripheral laser iridotomy was performed in both eyes with decreased IOP at 14 mmHg in the LE.
CONCLUSIONS: Iridoschisis is a rare ocular condition characterized by a separation between the anterior and posterior layers of iris stroma with several clinical presentations, and may be associated with abnormal visibility of iris vessels in some cases. The diagnosis of iridoschisis may be challenging and AS-OCT can be a very useful tool to confirm the diagnosis in atypical presentations and to detect associated angle closure.
摘要：
目的：描述1例双侧虹膜劈裂和单侧闭角型青光眼（ACG）患者虹膜血管能见度异常的临床和眼前节光学相干断层扫描（AS-OCT）表现。
方法：一名67岁男性患者，一年前有左眼红肿疼痛史，送到我们的眼科进行常规检查。右眼的眼科检查显示前房狭窄，虹膜萎缩与虹膜血管的异常可见性有关。眼内压（IOP）为12mmHg，视盘外观正常。LE前房狭窄，伴有弥漫性虹膜萎缩和血管能见度异常。IOP为28mmHg，重要的视盘切除。在房角镜检查中，角度狭窄，没有新血管也没有粘连。双眼的AS-OCT显示浅角度，虹膜分裂与前房材料释放，保留色素上皮的同时，在LE中，在14mmHg的IOP降低的双眼中，规定了抗青光眼滴眼液，并进行了周围激光虹膜切开术。
结论：虹膜裂是一种罕见的眼部疾病，其特征是虹膜基质的前后层分离，有几种临床表现，并且在某些情况下可能与虹膜血管的异常可见性有关。虹膜裂隙的诊断可能具有挑战性，AS-OCT可以作为非常有用的工具来确认非典型表现的诊断并检测相关的闭角。
方法：一名67岁男性患者，一年前有左眼红肿疼痛史，送到我们的眼科进行常规检查。右眼的眼科检查显示前房狭窄，虹膜萎缩与虹膜血管的异常可见性有关。眼内压（IOP）为12mmHg，视盘外观正常。LE前房狭窄，伴有弥漫性虹膜萎缩和血管能见度异常。IOP为28mmHg，重要的视盘切除。在房角镜检查中，角度狭窄，没有新血管也没有粘连。双眼的AS-OCT显示浅角度，虹膜分裂与前房材料释放，保留色素上皮的同时，在LE中，在14mmHg的IOP降低的双眼中，规定了抗青光眼滴眼液，并进行了周围激光虹膜切开术。
结论：虹膜裂是一种罕见的眼部疾病，其特征是虹膜基质的前后层分离，有几种临床表现，并且在某些情况下可能与虹膜血管的异常可见性有关。虹膜裂隙的诊断可能具有挑战性，AS-OCT可以作为非常有用的工具来确认非典型表现的诊断并检测相关的闭角。
