■钱德勒综合征(CS)是虹膜角膜内皮综合征(ICE)之一,在前房(AC)角和虹膜上异常角膜内皮细胞增殖,导致并发症,例如,继发性闭角型青光眼(SACG)。我们报告了CS和纳米眼球之间的关联,突出诊断和治疗挑战和病理学见解。
■一名46岁女性患者表现为双侧进行性视力模糊。检查显示双侧(OU)小角膜直径,浅交流,闭合交流角,角膜内皮的青铜色外观,右眼轻度虹膜萎缩(OD)。OD和左眼(OS)的眼压为48mmHg和22mmHg,分别。眼底检查显示视神经乳头拔罐。生物测量显示短的轴向长度和微角膜OU,也就是说,纳米眼球。光学相干断层扫描和视野显示青光眼视神经病变的结构和功能证据。镜面显微镜显示角膜内皮细胞密度降低和ICE的明暗逆转特征。因此,用SACG和纳米眼诊断CS.该患者被转诊到专门的青光眼中心,建议进行透明晶状体摘除,并使用后瞳孔管放置的青光眼引流装置。
■这是关于CS和纳米眼之间关联的第一份报告。尽管存在原发性闭角型青光眼(PACG)的明显危险因素,但仍强调了SACG的可能性。此外,它提供了关于ICE病因的假设。CS和纳米眼球的同时存在表明,由于眼周间质,可能涉及共同的发育机制,角膜内皮的胚胎学前体,在视杯和茎的发育中起作用。
■即使存在明显的PACG危险因素,也应考虑SACG,例如纳米眼。此外,纳米眼球和CS的关联需要重新审视尚未确定的CS病因,可以考虑发展机制。
■AmeenIsmailA,El-RubySA.双侧钱德勒综合征,纳米眼,闭角型青光眼:一种复杂的表现,具有挑战性的诊断,病理观察-病例报告。JCurr青光眼Pract2024;18(2):68-73。
UNASSIGNED: Chandler syndrome (CS) is one of the iridocorneal endothelial syndromes (ICEs) with proliferation of abnormal corneal endothelial cells over the anterior chamber (AC) angle and iris, resulting in complications, for example, secondary angle closure glaucoma (SACG). We report an association between CS and nanophthalmos, highlighting diagnostic and therapeutic challenges and pathological insights.
UNASSIGNED: A 46-year-old female patient presented with bilateral progressive blurring of vision. Examination revealed bilateral (OU) small corneal diameter, shallow AC, closed AC angle, beaten-bronze appearance of corneal endothelium, and mild iris atrophy in the right eye (OD). Intraocular pressure was 48 mm Hg and 22 mm Hg in the OD and left eye (OS), respectively. Fundus examination revealed optic nerve head cupping. Biometry showed short axial length and microcornea OU, that is, nanophthalmos. Optical coherence tomography and visual field revealed structural and functional evidence of glaucomatous optic neuropathy. Specular microscopy demonstrated reduction of corneal endothelial cell density and the light-dark reversal characteristic of ICE. Therefore, a diagnosis of CS with SACG and nanophthalmos was made. The patient was referred to a specialized glaucoma center with recommendation of clear lens extraction and a glaucoma drainage device with retropupillary tube placement.
UNASSIGNED: This is the first report of an association between CS and nanophthalmos. It highlights the possibility of SACG despite evident risk factors for primary angle closure glaucoma (PACG). Furthermore, it provides a hypothesis about the etiology of ICE. The concurrence of CS and nanophthalmos suggests that a common developmental mechanism could be implicated since periocular mesenchyme, the embryological precursor of corneal endothelium, plays a role in the development of optic cup and stalk.
UNASSIGNED: SACG should be considered even in the presence of evident risk factors for PACG, such as nanophthalmos. Additionally, the association of nanophthalmos and CS warrants revisiting the yet inconclusive etiology of CS, where a developmental mechanism could be considered.
UNASSIGNED: Ameen Ismail A, El-Ruby SA. Bilateral Chandler Syndrome, Nanophthalmos, and Angle Closure Glaucoma: A Complex Presentation, Challenging Diagnosis, and Pathological Insight-A Case Report. J Curr Glaucoma Pract 2024;18(2):68-73.