Acute Angle Closure Associated With Dense Vitreous Hemorrhage and Retinal Detachment in Neovascular Age-Related Macular Degeneration: A Case Report
Vitreous Hemorrhage and Angle Closure
DOI:
https://doi.org/10.62856/djcro.v12.103Keywords:
acute angle closure, age-related macular degeneration, B-scan ultrasonography, retinal detachment, vitreous hemorrhageAbstract
Acute angle closure is usually associated with primary anatomical predisposition but may result from posterior-segment etiologies. We report a case of 74-year-old patient presented with neovascular age-related macular degeneration presented with acute ocular pain, no light perception, markedly elvated intraocular pressure and diffuse shallowing of the anterior chamber. B-scan ultrasonography demonstrated a superotemporal retinal detachment and dense vitreous hemorrhage filling the entire vitreous cavity, supporting a probable posterior-pushing mechanism for the secondary angle closure. Intravenous, oral, and topical intraocular pressure-lowering agents, with systemic and topical anti-inflammatory therapy, failed to achieve adequate pressure control. Cyclophotocoagulation was subsequently performed with the palliative goals of lowering intraocular pressure and relieving pain. At discharge, ocular pain was substantially relieved. Posterior-segment causes should be considered in acute angle closure accompanied by atypical features, profound visual loss, or relevant retinal disease. B-scan ultrasonography can promptly identify posterior-segment pathology and inform management
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