J Korean Ophthalmol Soc > Volume 61(3); 2020 > Article
Journal of the Korean Ophthalmological Society 2020;61(3):313-318.
DOI: https://doi.org/10.3341/jkos.2020.61.3.313    Published online March 15, 2020.
Bilateral Acute Angle Closure Attack and Choroidal Detachment in Patient with Acquired Immune Deficiency Syndrome.
Keun Heung Park, Jae Jung Lee, Ji Woong Lee, Ji Eun Lee
1Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. jlee@pusan.ac.kr
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
후천면역결핍증환자에게 발생한 양안 급성폐쇄각녹내장과 삼출맥락막박리
박건형1,2⋅이재정1,2⋅이지웅1,2⋅이지은1,2
부산대학교 의과대학 안과학교실1, 부산대학교병원 의생명연구원2
Correspondence:  Ji Eun Lee,
Email: jlee@pusan.ac.kr
Received: 21 March 2019   • Revised: 22 July 2019   • Accepted: 21 February 2019
Abstract
PURPOSE
To report a case of simultaneous bilateral acute angle closure attack combined with bilateral choroidal detachment in a patient with acquired immune deficiency syndrome (AIDS). CASE SUMMARY: A 63-year-old male who had a history of several months of diarrhea, abdominal pain, and weight loss visited the emergency room with sudden bilateral blurred vision accompanied with headache, periocular pain, nausea, and vomiting. His visual acuity was finger counting in both eyes and the intraocular pressure (IOP) was 49/44 mmHg (right/left). The anterior chamber depth was three times the corneal thickness in the center and less than 1/4 of the corneal thickness in the periphery in both eyes. Maximum medical therapy had no effect and emergency cataract surgery combined with vitrectomy was performed on the right eye. During surgery, severe choroidal detachment was noted. One day after surgery, choroidal detachment was also found in the left eye and emergency cataract surgery with suprachoroidal fluid drainage was performed. Approximately 1 month after surgery, choroidal detachment of both eyes regressed without systemic therapy. The IOP was 14/7 mmHg (right/left) with a visual acuity of 0.32/0.4 (right/left). The blood test performed in the emergency room showed a positive result for AIDS and the patient started medical therapy. CONCLUSIONS: In patients with AIDS, bilateral simultaneous acute angle closure attack combined with choroidal detachment may rarely develop. Although choroidal effusion can regress spontaneously, combined suprachoroidal fluid drainage is recommended when a surgical intervention is required.
Key Words: Bilateral acute angle closure;Choroidal detachment;Human immunodeficiency virus


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