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Abstract #59548 Published in IGR 16-3
Atopic Glaucoma: Clinical and Pathophysiological Analysis
Takakuwa K; Hamanaka T; Mori K; Chin S; Shinmei Y; Funaki T; Ebihara N; Ono K; Murakami A; Matsuda AJournal of Glaucoma 2015; 24: 662-668
PURPOSE: Open-angle glaucoma associated with severe atopic dermatitis (atopic glaucoma) tends to be severe and difficult to treat because of ocular surface/eye lid inflammation. To determine the validity of regarding atopic glaucoma as a clinical entity, we carried out retrospective analysis and pathologic investigations. MATERIALS AND METHODS: Forty-five cases (62 eyes) of atopic glaucoma were reviewed retrospectively. During surgical treatment, aqueous humor and trabeculectomy specimens were obtained. The aqueous humor samples were analyzed by multiplex cytokine assay. The surgical specimens were analyzed histologically. RESULTS: Atopic glaucoma was often associated with atopic cataracts (43 eyes) and retinal detachments (19 eyes). A history of glucocorticoid medications was absent in 12 cases. A total of 50 eyes required surgical interventions because of advanced visual field defects and/or high intraocular pressures. Bleb-associated postsurgical infections were observed in 7 eyes. Elevated levels of inflammatory cytokines (IL-8 and CCL2) were observed in the aqueous humor samples obtained from atopic glaucoma patients compared with those from senile cataract patients. Ultrastructural analysis of trabecular meshwork tissues obtained from atopic glaucoma patients showed abnormal accumulation of 10 to 30 nm fibers in the corneoscleral meshwork. CONCLUSIONS: We would like to propose atopic glaucoma as a new clinical entity, ranging from pure atopic glaucoma to a mixed type of atopic/steroid-induced glaucoma that should be considered as one of the clinical features of atopic ocular complications.
*Department of Ophthalmology, Juntendo University Graduate School of Medicine †Department of Ophthalmology, Japan Red Cross Society Medical Centre, Tokyo ‡Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto §Department of Ophthalmology, Hokkaido University School of Medicine, Sapporo, Japan.
Full articleClassification:
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
3.10 Immunobiology (Part of: 3 Laboratory methods)
9.4.6 Glaucomas associated with inflammation, uveitis (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
2.1 Conjunctiva (Part of: 2 Anatomical structures in glaucoma)
