Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage
Purpose: To report a case of a child with neovascular and ghost cell glaucoma in the setting of previously treated vitreous hemorrhage with unique fluorescein leakage from abnormal iris vessels ultimately preventing successful fluorescein angiography. Observations: A 3-year-9-month-old female with a...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993623001433 |
| _version_ | 1797399054669316096 |
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| author | Natan Hekmatjah Azam Qureshi Armin Afshar Julius T. Oatts |
| author_facet | Natan Hekmatjah Azam Qureshi Armin Afshar Julius T. Oatts |
| author_sort | Natan Hekmatjah |
| collection | DOAJ |
| description | Purpose: To report a case of a child with neovascular and ghost cell glaucoma in the setting of previously treated vitreous hemorrhage with unique fluorescein leakage from abnormal iris vessels ultimately preventing successful fluorescein angiography. Observations: A 3-year-9-month-old female with a medical history of very high-risk B-cell acute lymphoblastic leukemia presented with eye pain and was noted to have a complete vitreous hemorrhage and intraocular pressure elevation in the right eye which was refractory to maximum medical therapy and vitrectomy. Following vitreous hemorrhage resolution, an examination under anesthesia with fluorescein angiography was found to have diffuse leakage of fluorescein into the anterior chamber, presumably due to the active iris neovascularization. This anterior chamber fluorescein signal prevented visualization of the retinal vasculature. The patient was diagnosed with mixed mechanism glaucoma (neovascular and ghost cell) due to a resolved vitreous hemorrhage in the setting of a presumed prior ischemic event. Conclusions and Importance: We report a case of an unsuccessful fluorescein angiogram in the setting of anterior chamber fluorescein leakage due to active iris neovascularization, and review considerations for the differential diagnosis and useful diagnostic tests in this clinical scenario. |
| first_indexed | 2024-03-09T01:33:54Z |
| format | Article |
| id | doaj.art-1787c36b937e41b780e644b53dea5796 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-03-09T01:33:54Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-1787c36b937e41b780e644b53dea57962023-12-09T06:07:18ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362023-12-0132101935Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhageNatan Hekmatjah0Azam Qureshi1Armin Afshar2Julius T. Oatts3University of California San Francisco School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USAUniversity of California San Francisco, Department of Ophthalmology, 490 Illinois Street, San Francisco, CA, 94158, USAUniversity of California San Francisco, Department of Ophthalmology, 490 Illinois Street, San Francisco, CA, 94158, USAUniversity of California San Francisco, Department of Ophthalmology, 490 Illinois Street, San Francisco, CA, 94158, USA; Corresponding author. University of California San Francisco, Department of Ophthalmology, 490 Illinois Street, San Francisco, CA, 94158, USA.Purpose: To report a case of a child with neovascular and ghost cell glaucoma in the setting of previously treated vitreous hemorrhage with unique fluorescein leakage from abnormal iris vessels ultimately preventing successful fluorescein angiography. Observations: A 3-year-9-month-old female with a medical history of very high-risk B-cell acute lymphoblastic leukemia presented with eye pain and was noted to have a complete vitreous hemorrhage and intraocular pressure elevation in the right eye which was refractory to maximum medical therapy and vitrectomy. Following vitreous hemorrhage resolution, an examination under anesthesia with fluorescein angiography was found to have diffuse leakage of fluorescein into the anterior chamber, presumably due to the active iris neovascularization. This anterior chamber fluorescein signal prevented visualization of the retinal vasculature. The patient was diagnosed with mixed mechanism glaucoma (neovascular and ghost cell) due to a resolved vitreous hemorrhage in the setting of a presumed prior ischemic event. Conclusions and Importance: We report a case of an unsuccessful fluorescein angiogram in the setting of anterior chamber fluorescein leakage due to active iris neovascularization, and review considerations for the differential diagnosis and useful diagnostic tests in this clinical scenario.http://www.sciencedirect.com/science/article/pii/S2451993623001433Vitreous hemorrhageNeovascular glaucomaGhost cell glaucomaFluorescein angiographyCentral retinal vein occlusion |
| spellingShingle | Natan Hekmatjah Azam Qureshi Armin Afshar Julius T. Oatts Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage American Journal of Ophthalmology Case Reports Vitreous hemorrhage Neovascular glaucoma Ghost cell glaucoma Fluorescein angiography Central retinal vein occlusion |
| title | Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage |
| title_full | Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage |
| title_fullStr | Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage |
| title_full_unstemmed | Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage |
| title_short | Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage |
| title_sort | anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage |
| topic | Vitreous hemorrhage Neovascular glaucoma Ghost cell glaucoma Fluorescein angiography Central retinal vein occlusion |
| url | http://www.sciencedirect.com/science/article/pii/S2451993623001433 |
| work_keys_str_mv | AT natanhekmatjah anteriorchamberfluoresceinleakageinachildwithintraocularpressureelevationandvitreoushemorrhage AT azamqureshi anteriorchamberfluoresceinleakageinachildwithintraocularpressureelevationandvitreoushemorrhage AT arminafshar anteriorchamberfluoresceinleakageinachildwithintraocularpressureelevationandvitreoushemorrhage AT juliustoatts anteriorchamberfluoresceinleakageinachildwithintraocularpressureelevationandvitreoushemorrhage |