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Secondary Open-Angle Glaucomas
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Jonathan Myers, L. Jay Katz, Anand Mantravadi
Released pigment is carried by aqueous flow into the anterior chamber. Pigment may be phagocytosed by corneal endothelial cells, creating a Krukenberg spindle (Figure 10.2). Pigment may also be deposited in circumferential iris furrows and on the posterior lens surface (Figure 10.3). Aqueous flow carries the pigment to the trabecular meshwork, which is typically heavily pigmented for 360° (Figures 10.4 and 10.5). Pigment deposition anterior to Schwalbe’s line is seen in the inferior 180° (Figure 10.6).
Bilateral Acute Iris Transillumination (BAIT): A Rare Syndrome Possibly Associated with COVID-19 and Moxifloxacin Use. A Report of 2 Cases
Published in Seminars in Ophthalmology, 2023
Kristina Lončarić, Rašeljka Tadić, Marin Radmilović, Zoran Vatavuk
On examination in UHC Sestre Milosrdnice her best corrected visual acuity (BCVA) with Snellen visual acuity charts and decimal notation was 1.0 RE and 1.0 LE. Her pupils were slightly irregularly shaped, semi-mydriatic and extremely poorly reactive (in temporal portions only) to light and accommodation. Anterior segment examination with slit-lamp biomicroscopy revealed bilateral iris depigmentation with diffuse iris transillumination defects and pigment deposits on the iris surface and corneal endothelium without the formation of a classic Krukenberg spindle. Gonioscopy examination revealed open iridocorneal angles and heavy pigment deposition in almost all quadrants OU (Figure 1). IOP was measured at 11 mmHg OU with Goldmann applanation tonometry. Dilated fundus examination revealed no glaucomatous damage OU and was unremarkable.
Transient vision loss: a neuro-ophthalmic approach to localizing the diagnosis
Published in Expert Review of Ophthalmology, 2018
Helen Chung, Jodie M. Burton, Fiona E. Costello
The anterior segment examination is also crucial to the diagnosis of pigment dispersion syndrome, which is characterized by mid-peripheral iris transillumination defects, vertically oriented pigment dusting on the corneal endothelium (Krukenberg spindle), and heavy pigmentation of the trabecular meshwork on gonioscopy [11]. A shallow anterior chamber could predispose an individual to angle closure attacks; if suspected based on Van Herick grading of the peripheral anterior chamber depth (anterior chamber <1/4 corneal thickness), formal gonioscopy should be performed to check for occludable angles [12]. Uveitis-glaucoma-hyphema (UGH) syndrome has been reported to cause TVL due to recurrent hyphemas. This is classically thought of as a late complication of cataract surgery in which the intraocular lens abrades the iris. Ocular signs that may be observed include irregular iris transillumination defects, hyphema, and anterior chamber reaction [13]. Finally, ocular ischemic syndrome can manifest in the anterior segment as arcus senilis of the contralateral eye or neovascularization of the iris or angle in the ipsilateral eye [6].
The physiologic and pathologic effects of pregnancy on the human visual system
Published in Journal of Obstetrics and Gynaecology, 2019
Dimitrios Kalogeropoulos, Velota CT Sung, Minas Paschopoulos, Marilita M. Moschos, Panagiotis Panidis, Chris Kalogeropoulos
Krukenberg’s spindle can be detected in pregnant women without the correlated outflow obstruction or elevation of intraocular pressure (IOP). This phenomenon is expected to occur in the first two trimesters of gestation. The spindle gradually decreases in size or vanish completely in the 3rd trimester and early post-partum period. During the 3rd trimester, the increase progesterone levels and the increased outflow contribute in clearing the pigment deposits from the angle and therefore prevent a rise in IOP (Hørven and Gjønnaess 1974).