Secondary acute angle-closure glaucoma associated with vitreous hemorrhage after ruptured retinal arterial macroaneurysm

Abstract

To report acute angle-closure glaucoma in a patient with dense vitreous hemorrhage due to a ruptured retinal arterial macroaneurysm. Interventional case report. A male patient presented with severe pain and decreased vision in his right eye, nausea, and vomiting. Visual acuity was hand motions, intraocular pressure was 64 mm Hg, and light reflex was not detected in the right eye. The patient underwent comprehensive ophthalmologic examination and appropriate medical and surgical management. Examination of the right eye revealed a shallow anterior chamber and closed angle; ultrasound confirmed the presence of vitreous hemorrhage. After intensive medical treatment and subsequent pars plana vitrectomy with laser treatment to the ruptured retinal macroaneurysm, pain in the right eye subsided, visual acuity improved to 20/25, and intraocular pressure decreased to 20 mm Hg. We are unaware of previous clinical reports of this finding and could find no reference to it in a computerized search utilizing MEDLINE. In our patient the pressure stabilized and the vision improved after medical and surgical management.