J Korean Ophthalmol Soc > Volume 53(11); 2012 > Article
Journal of the Korean Ophthalmological Society 2012;53(11):1712-1717.
DOI: https://doi.org/10.3341/jkos.2012.53.11.1712    Published online November 15, 2012.
A Case of Neovascular Glaucoma Secondary to Ocular Ischemic Syndrome in a Patient with Moyamoya Disease.
Seung Min Lee, Ji Woong Lee
Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea. alertlee@hanmail.net
모야모야병 환자에서 안허혈증후군으로 인해 발생한 신생혈관 녹내장 1예
Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
To report a case of neovascular glaucoma secondary to ocular ischemic syndrome in a patient with moyamoya disease, who was successfully treated with trabeculectomy. CASE SUMMARY: A 45-year-old woman suffered from slowly decreased vision in the right eye 3 months previously. Ocular pain with conjunctival injection of the right eye and headache developed 2 months earlier. She was diagnosed with moyamoya disease and had an encephaloduroarteriosynangiosis at the neurosurgery. The patient complained of persistent conjunctival injection and decreased vision of the right eye after surgery. At the initial visit, best corrected visual acuity (BCVA) of the right eye was 0.1 and intraocular pressure (IOP) was 42 mm Hg. Slit lamp examination revealed neovascularization of the iris and gonioscopy showed a 360degrees peripheral anterior synechiae. Fluorescein angiography demonstrated prolonged arteriovenous transit time in the right eye. On the electroretinogram, the amplitude of both a and b waves decreased in the right eye more than in the left eye. On the magnetic resonance angiography, narrowing of the right internal carotid artery was observed. The patient was diagnosed with neovascular glaucoma due to ocular ischemic syndrome caused by moyamoya disease. Panretinal photocoaguration, intravitreal bevacizumab injection and trabeculectomy with mitomycin-C soaking was performed in the right eye. At 8 months after surgery, BCVA of the right eye was 0.1, IOP was 17 mm Hg without antiglaucoma medication and bleb was maintained in good condition. CONCLUSIONS: The patient's results indicate that neovascular glaucoma can occur secondary to ocular ischemic syndrome caused by moyamoya disease.
Key Words: Moyamoya disease;Neovascular glaucoma;Ocular ischemic syndrome;Trabeculectomy

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