Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage.
Publication/Presentation Date
12-1-2023
Abstract
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.
Volume
32
First Page
101935
Last Page
101935
ISSN
2451-9936
Published In/Presented At
Hekmatjah, N., Qureshi, A., Afshar, A., & Oatts, J. T. (2023). Anterior chamber fluorescein leakage in a child with intraocular pressure elevation and vitreous hemorrhage. American journal of ophthalmology case reports, 32, 101935. https://doi.org/10.1016/j.ajoc.2023.101935
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
37808082
Department(s)
Department of Pediatrics
Document Type
Article