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    This case report describes the management of a 9-year-old boy with juvenile open angle glaucoma (JOAG) and concomitant anterior uveitis. The patient presented with blurred vision and was found to have elevated intraocular pressure, iris neovascularization, anterior chamber inflammation, and optic nerve damage. He underwent trabeculectomy with anti-metabolite treatment and steroid therapy. Post-operatively, his intraocular pressure was well-controlled without signs of inflammation, demonstrating the effectiveness of trabeculectomy and steroid coverage in managing JOAG with uveitis. However, the patient was subsequently lost to follow up.

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    This case report describes the management of a 9-year-old boy with juvenile open angle glaucoma (JOAG) and concomitant anterior uveitis. The patient presented with blurred vision and was found to have elevated intraocular pressure, iris neovascularization, anterior chamber inflammation, and optic nerve damage. He underwent trabeculectomy with anti-metabolite treatment and steroid therapy. Post-operatively, his intraocular pressure was well-controlled without signs of inflammation, demonstrating the effectiveness of trabeculectomy and steroid coverage in managing JOAG with uveitis. However, the patient was subsequently lost to follow up.

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    7 views3 pages

    Parade Wspos Tipe 2

    Uploaded by

    irwan_201291
    This case report describes the management of a 9-year-old boy with juvenile open angle glaucoma (JOAG) and concomitant anterior uveitis. The patient presented with blurred vision and was found to have elevated intraocular pressure, iris neovascularization, anterior chamber inflammation, and optic nerve damage. He underwent trabeculectomy with anti-metabolite treatment and steroid therapy. Post-operatively, his intraocular pressure was well-controlled without signs of inflammation, demonstrating the effectiveness of trabeculectomy and steroid coverage in managing JOAG with uveitis. However, the patient was subsequently lost to follow up.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 3

    MANAGEMENT OF JUVENILE OPEN ANGLE GLAUCOMA

    WITH CONCOMITANT ANTERIOR UVEITIS


    Raden Irwanto Adinugroho, M. Ma’sum Effendi, Lely Retno Wulandari, Aulia Abdul Hamid
    Department of Ophthalmology, Faculty of Medicine, Universitas Brawijaya,
    Saiful Anwar General Hospital Malang, Indonesia

    PURPOSE

    To report a rare case and management of Juvenile Open Angle Glaucoma (JOAG) with concomitant anterior uveitis.

    SETTING

    Pediatric and strabismus outpatient clinic, glaucoma outpatient clinic at Dr. Saiful Anwar General Hospital Malang.

    METHODS

    A case report of patient from ophthalmology departmen Dr. Saiful Anwar General Hospital with Juvenile Open Angle
    Glaucoma with concomitant anterior uveitis who was hospitalized and underwent complete ocular examination
    including visual acuity (VA), anterior and posterior segment, intraocular pressure (IOP), visual field (VF) examination,
    optic nerve optical coherence tomography (OCT), trabeculectomy and steroid coverage before and after surgery.

    The authors of this case report have no financial disclosure


    RESULT
    History Taking
    • 9- years old boy
    • Blurred vision on both eyes since 1
    week prior to hospital
    • Left eye more blurred than right eye Figure 1. Anterior segment of RE :
    • Pain (-), narrowing of visual field (-), mid-dilatation pupil (yellow arrow)
    seeing halo (-),Nausea and vomiting (-), deep anterior chamber (blue arrow)
    diplopia(-),redness(-), tearing (-),
    discharge (-) photophobia (-)

    Clinical Presentation
    • Visual Acuity : RE Best corrected were Figure 2. Anterior segment of LE :
    6/6, LE 1/300 mid-dilatation pupil and Posterior
    • Iris neovascularization on both eyes subcapsular cataract (yellow arrow)
    • No keratic precipitate (KPs), 1+ flare, deep anterior chamber (blue arrow)
    1+ cells on RE and no KPs, 1+ flare, 3+
    cells on LE. Deep anterior chamber
    with open angle on gonioscopy
    • Intraocular pressure (IOP) was 30,4 Figure 5. Optic nerve OCT: thinning of
    mmHg in RE and 22,9 mmHg in LE retinal nerve fiber layer at superior and
    Figure 3. Figure 4.
    • Posterior subcapsular cataract on LE inferior quadrant of both eyes. Vertical
    Funduscopy Of Funduscopy Of
    • C/D ratio was 0.8 in both eyes C/D ratio was 0.8 in both eyes
    Right Eye Left Eye
    Diagnosis
    Juvenile Open Angle Glaucoma with Concomitant
    Anterior Uveitis.

    Management Figure 6. Iris coloboma Figure 7. elevated Figure 8. Deep


    • RE trabeculectomy + subconjungtival post trabeculectomy and non fibrotic anterior chamber
    injection of 5-fluorouracil intraoperatively. on right eye (blue bleb on right eye on right eye
    • Oral methylprednisolone 4mg tid and arrow) (black arrow) (yellow arrow)
    fluorometholone eye drop 6 times daily
    on both eyes since 1 week preoperatively IOP of RE was successfully
    and gradually tappered. maintained around 8 mmHg for Video 1. Video
    2 months, than patient was lost during surger
    y
    CONCLUSION to follow up.

    Trabeculectomy was effective to maintain a normal IOP in juvenile open angle glaucoma case with bad compliance and last
    eye. No postoperative inflamation flare-up was noted, due to steroid coverage before and after surgery.

    Contact : Raden Irwanto Adinugroho


    Irwan.201291@gmail.com +6281294640871
    Department of Ophthalmology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia

    All photos and video already got permission

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