Primary Angle-Closure Glaucoma Due to Cyst of the Ciliary Body. Clinical Case

Abstract

There is a clinical case of the occurrence of angle-closure glaucoma due to closure of the angle of front camera with the cyst of a ciliary body. Patient A., 42 years old, complained about a feeling of transient blurring of the right eye vision, visual impairment in the evening. At the initial ophthalmological examination, the maximum corrected visual acuity in both eyes was 1.0, intraocular pressure according to pneumotonometry: OD — 21 mm Hg, OS — 14.8 mm Hg. There were no changes in the anterior segment of the eyeball according to biomicroscopic data. Taking into account the asymmetry of IOP data, the patient underwent the following studies: static perimetry, optical coherence tomography (OCT), flowmetry with the calculation of tolerant intraocular pressure (TIOP). According to OCT and static perimetry, pathological deviations were not detected. When performing flowmetry on the left eye, the indicators were within normal values, however, a significant decrease in the volume of eye ocular blood flow and an increase in the IOP were determined in the right eye. In the left eye, the TIOP corresponded to the IOP, and in the right eye, the IOP indicators exceeded the TIOP value. The lack of correlation between morphofunctional indicators and flowmetry data, an unburdened hereditary history of glaucoma, and a discrepancy between flowmetry and age could indicate the development of the angle-closed glaucoma, so the patient was referred to ultrasound biomicroscopy. The echographic picture of the anterior part of the right eye was characterized by a decrease in the depth of the anterior chamber, a partial displacement of the peripheral part of the iris anteriorly, a slight narrowing of the angle of the anterior chamber, and an uneven posterior chamber. In the region of the process part of the ciliary body along the meridian of 3 hours, a thinwalled volumetric formation, anechogenic, with clear contours and dimensions was revealed: height 4.3 mm, length 4.8 mm. The root of the iris was determined by the average attachment to the ciliary body. In accordance with this, the diagnosis was made: OD — cyst of the ciliary body, the patient was referred for consultation about a possible laser surgical intervention.