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PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 45-47

Assessment of anterior segment changes using multimodal imaging in a case of post-traumatic transient myopia


Department of Vitreoretina, Sankara Eye Hospital, Guntur, Andhra Pradesh, India

Date of Submission21-Apr-2020
Date of Acceptance01-Aug-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Simakurthy Sriram
Department of Vitreoretina, Sankara Eye Hospital, Guntur - 522 509, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1088_20

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  Abstract 


Keywords: Multimodal imaging, transient myopia, trauma


How to cite this article:
Kanakamedla A, Sriram S, Kumar M, Shandil A, Gudimetla J. Assessment of anterior segment changes using multimodal imaging in a case of post-traumatic transient myopia. Indian J Ophthalmol Case Rep 2021;1:45-7

How to cite this URL:
Kanakamedla A, Sriram S, Kumar M, Shandil A, Gudimetla J. Assessment of anterior segment changes using multimodal imaging in a case of post-traumatic transient myopia. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Feb 26];1:45-7. Available from: https://www.ijoreports.in/text.asp?2021/1/1/45/305474



A 17-year-old male presented with sudden onset painless diminution of vision in the right eye post blunt trauma to eye with tennis ball 2 days ago. Visual acuity (VA) was 2/60 in the right eye, improving to 6/9 with a refraction of –6.50/–0.50 × 30°, and 6/9 in left eye improving to 6/6 with a refraction of –1DS. Addition of cycloplegic agent did not alter the refractive status. Slit-lamp examination showed shallow anterior chamber with crystalline lens and commotion retinae in right eye, while the left eye was within normal limits. His intraocular pressure was 14 and 20 mm Hg in the right and left eye, respectively.

At presentation, there was shallowing of the anterior chamber well demonstrated by ASOCT, UBM, and IOL master (2.55 mm), with an increase in lens thickness (3.92 mm) on A-scan and ciliochoroidal effusion with ciliary body edema and anterior rotation of ciliary processes on UBM [Figure 1] and [Table 1], which returned to normal (ACD 3.68 mm and LT 3.63 mm) with improvement in VA to 6/9 on follow-up visit on day 10 [Figure 2]. Left eye was within normal limits [Figure 3].
Figure 1: (a) Infrared image of anterior segment of right eye (b) 16 mm radial scan ASOCT (DRI Triton, Topcon Inc., Japan) showing disappearance of ciliary sulcus with increased iris convexity and anterior lens capsular reflection (c) 6 mm ASOCT scan focused at limbus highlighting the angle structures, yellow dotted lines represent the mirror image of the corneal scan, yellow rectangular box showing obliterated ciliary sulcus (d) UBM (Ophthalmic Technologies, Toronto, Canada) showing shallow anterior chamber depth with forward bowing of iris with anteriorly rotated ciliary process (arrowhead) with ciliochoroidal effusion (star)

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Table 1: Clinical parameters at presentation and follow up

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Figure 2: At 2 weeks follow up (a) Infrared image of anterior segment of right eye (b) 16 mm radial scan ASOCT (DRI Triton, Topcon Inc., Japan) showing normal ciliary sulcus with iris convexity and anterior lens capsular reflection (c) 6 mm ASOCT scan focused at limbus highlighting the angle structures, yellow dotted lines represent the mirror image of the corneal scan, rectangular box showing reappearance of ciliary sulcus (d) UBM (Ophthalmic Technologies, Toronto, Canada) showing normal anterior chamber depth with normal convexity of iris, disappearance of ciliochoroidal effusion

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Figure 3: (a) Infrared image of anterior segment of left eye (b) 16 mm radial scan ASOCT (DRI Triton, Topcon Inc., Japan) showing normal ciliary sulcus with iris convexity and anterior lens capsular reflection (c) 6 mm ASOCT scan focused at limbus highlighting the angle structures, yellow dotted lines represent the mirror image of the corneal scan (d) UBM (Ophthalmic Technologies, Toronto, Canada) showing normal anterior chamber depth with normal convexity of iris

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  Discussion Top


Posttraumatic transient myopia varies between –4.75D and –5.25D.[1],[2] Various pathogenic mechanisms include increased anteroposterior thickness of lens,[1] an anterior shift of lens-iris diaphragm,[3] ciliary spasm,[4] and ciliochoroidal effusion with ciliary body edema.[5] The ciliochoroidal effusion and ciliary body edema results in anterior rotation of ciliary body and ciliary processes, resulting in narrowing or disappearance of the ciliary sulcus; reduces the distance between opposing ciliary processes, and slackens the lens zonules which result in increase in lens thickness and anterior shift of lens-iris diaphragm.[1]

Use of multimodal imaging complements the clinical findings and helps to better demonstrate the etiology of anterior segment changes post blunt trauma.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Steele CA, Tullo AB, Marsh IB, Storey JK. Traumatic myopia; an ultrasonographic and clinical study. Br J Ophthalmol 1987;71:301-3.  Back to cited text no. 1
    
2.
Ikeda N, Ikeda T, Nagata M, Mimura O. Pathogenesis of transient high myopia after blunt eye trauma. Ophthalmology 2002;109:501-7.  Back to cited text no. 2
    
3.
Kutner BN. Case report. Acute angle closure glaucoma in non-perforating blunt trauma. Arch Ophthalmol 1988;106:19-20.  Back to cited text no. 3
    
4.
Romem M, Isakow I, Dolev Z. Posttraumatic transient glaucoma and myopia. Am J Ophthalmol 1985;99:495.  Back to cited text no. 4
    
5.
Dotan S, Oliver M. Shallow anterior chamber and uveal effusion after non perforating trauma to the eye. Am J Ophthalmol 1982;94:782-4.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1]



 

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