Abstract
Purpose To report cases of glaucomatocyclitic crises and discuss the possibility of occurrence in patients with narrow or closed angles. Background The prevalence of angle closure is much higher among Asians than among the Western population. Currently, there is no evidence for a direct relationship between the etiology and angle structure. Design A retrospective and observational case series. Methods We retrospectively collected data from nine adult patients (three males and six females) who were diagnosed with a glaucomatocyclitic crisis and a shallow anterior chamber over a 21-year period, from 1995 to 2016, at the Kaohsiung Medical University Hospital. A narrow angle was defined as a grade less than the Shaffer system grade II. Ophthalmic examinations, including anterior segment biomicroscopy, direct ophthalmoscopy, intraocular pressure measurements, anterior chamber reaction, visual field tests, and the grade of the anterior chamber angle according to the Shaffer system, were reviewed. Results These patients experienced at least one typical unilateral ocular hypertensive episode that fulfilled the criteria of a glaucomatocyclitic crisis without the angle feature. All patients had gonioscopically narrow or closed angles with or without peripheral anterior synechiae. Conclusions The coexistence of narrow or closed angles and a glaucomatocyclitic crisis is possible, especially in patients of Asian descent. In patients with shallow anterior chambers, a glaucomatocyclitic crisis may be a cause of acute glaucoma episodes.
Highlights
Glaucomatocyclitic crisis, known as the PosnerSchlossman syndrome (PSS), is a self-limiting, rare disease that was first described by Posner and Schlossman in 1948 [1]
Nine patients were enrolled in the study (Table 1). These patients had at least one typical unilateral ocular hypertensive episode that fulfilled the criteria of glaucomatocyclitic crisis (Table 2, Figures 1 and 2)
Six patients were first diagnosed with PSS at the time of the ocular hypertensive episodes, but narrow angles were subsequently found gonioscopically by a glaucoma specialist
Summary
Glaucomatocyclitic crisis, known as the PosnerSchlossman syndrome (PSS), is a self-limiting, rare disease that was first described by Posner and Schlossman in 1948 [1]. This relatively uncommon disease consists of unilateral recurrent attacks of increased intraocular pressure (IIOP) associated with mild anterior uveitis, a lack of visual field defects, normal optic discs, and an open angle [1,2,3]. In contrast to the common presentations of severe pain and nausea in acute angle-closure glaucoma episodes, PSS attacks involve only mild discomfort.
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