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1 General aspects (0)   1.1 Epidemiology (9)   1.2 Population genetics (2)   1.3 Pathogenesis (3)   1.4 Quality of life (5)   1.5 Glaucomas as cause of blindness (6)   1.6 Prevention and screening (7) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (8)   2.2 Cornea (15)   2.3 Sclera (4)   2.4 Anterior chamber angle (8)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (7)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (1)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (3)   2.7 Episcleral veins and venous pressure (1)   2.8 Iris (2)   2.9 Ciliary body (1)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (5)   2.13 Retina and retinal nerve fibre layer (18)   2.14 Optic disc (19)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (3)   2.17 Stem cells (2)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (1)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (5)     3.4.2 Gene studies (21)   3.5 Molecular biology incl. 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associated with intraocular tumors (5)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (3)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (6)       9.4.11.2 Glaucomas in aphakia and pseudophakia (6)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (8)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (7)     9.4.15 Glaucoma in relation to systemic disease (18)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (4) 11 Medical treatment (0)   11.1 General management, indication (4)   11.2 Cholinergic drugs (0)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (1)     11.3.4 Betablocker (6)     11.3.5 Other (0)   11.4 Prostaglandins 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    12.8.1 Without tube implant (5)     12.8.2 With tube implant or other drainage devices (13)     12.8.3 Non-perforating (5)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (12)     12.8.11 Complications, endophthalmitis (8)   12.9 Trabeculotomy, goniotomy (1)   12.10 Cyclodestruction (5)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (3)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (1)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (1)   12.20 Other (1) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (2)   13.2 Outcome (0)     13.2.1 IOP (2)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (1) 14 Costing studies; pharmacoeconomics (7) 15 Miscellaneous (13)

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Abstract #52013 Published in IGR 14-4

Is pre-operative ciliary body and iris anatomical configuration a predictor of malignant glaucoma development?

Prata TS; Dorairaj S; De Moraes CG; Mehta S; Sbeity Z; Tello C; Liebmann J; Ritch R
Clinical and Experimental Ophthalmology 2013; 41: 541-545

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BACKGROUND: To investigate anatomic configuration of ciliary body and iris, using ultrasound biomicroscopy (UBM), as a predictive factor for development of malignant glaucoma (MG). DESIGN: Retrospective study in a tertiary care hospital. PARTICIPANTS: Cohort of 31 consecutive patients diagnosed with postsurgical MG. METHODS: Anterior chamber angle, iris and ciliary body configuration of involved eyes that had UBM evaluation prior to the onset of MG were evaluated. Patients with no pre-surgical UBM of the involved eye, we analyzed UBM information from the fellow eye, imaged within 6 months. MAIN OUTCOME MEASURES: Qualitative UBM parameters. RESULTS: Thirty-one eyes of 31 patients (mean age 69.7±13.9 years) had confirmed MG between 1996 and 2008. Most patients were women (65%), of European ancestry (52%) and had an anatomic narrow angle or angle-closure glaucoma (77%). Mean IOP at diagnosis was 30.4±13.5 mmHg. The most common previous surgeries noted were trabeculectomy with mitomycin C [45%, 17/31 eyes; combined (10%, 3/17 eyes) or not (45%, 14/17 eyes) with cataract extraction and intraocular lens implantation] and cataract extraction with intraocular lens implantation (26%, 8/31 eyes). Among the 31 cases, we were able to evaluate the UBM of 13 patients (13 eyes) including involved eyes imaged prior to the MG onset or eligible fellow eyes. A narrow angle with or without irido-trabecular contact was found in all eyes. A large and/or anteriorly positioned ciliary body associated with an iris root angulating forward and centrally, revealing a plateau iris configuration, was noticed in 85% (11/13) of these eyes. Based on gonioscopic data, (8/11 eyes) had a low or incomplete plateau. CONCLUSION: Plateau iris configuration could be a risk factor for development of MG. Identification of this using UBM should be considered as a predictor of possible post-operative MG development.

Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY, USA; Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.

Full article

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Classification:

9.4.11.1 Ciliary block (malignant) glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
2.8 Iris (Part of: 2 Anatomical structures in glaucoma)
2.9 Ciliary body (Part of: 2 Anatomical structures in glaucoma)

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