Curled up trabecular meshwork – A simple cause

Aparna Rao; Sardar M Khan; Sujoy Mukherjee

doi:10.4103/IJO.IJO_2697_22

Users Online: 544

PHOTO ESSAY

Year : 2023 | Volume : 3 | Issue : 2 | Page : 560

Curled up trabecular meshwork – A simple cause

Aparna Rao, Sardar M Khan, Sujoy Mukherjee
Glaucoma Service, LV Prasad Eye Institute, MTC Campus, Patia, Bhubaneswar, Odisha, India

Date of Submission	14-Oct-2022
Date of Acceptance	04-Jan-2023
Date of Web Publication	28-Apr-2023

Correspondence Address:
Aparna Rao
Glaucoma Service, LV Prasad Eye Institute, MTC Campus, Patia, Bhubaneswar, Odisha - 751 024
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJO.IJO_2697_22

Abstract

Keywords: Ab-interno glaucoma surgery, GATT, Trabecular meshwork

How to cite this article:
Rao A, Khan SM, Mukherjee S. Curled up trabecular meshwork – A simple cause. Indian J Ophthalmol Case Rep 2023;3:560

How to cite this URL:
Rao A, Khan SM, Mukherjee S. Curled up trabecular meshwork – A simple cause. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Jun 10];3:560. Available from: https://www.ijoreports.in/text.asp?2023/3/2/560/374974

A 68-year-old male presented with redness in the right eye 1 week after surgery for open-angle glaucoma. Slit-lamp examination showed an intraocular pressure of 18 mmHg, few blood clots in the nasal angle, and inward curling of the trabecular meshwork (TM) toward the iris plane in parts of the superior angle with no angle recession in any quadrant [Figure 1]. Cut trabecular leaflet on anterior segment optical coherence tomography [Figure 1], with increased tissue thickness in the trabecular region suggested previous gonioscopic-assisted transluminal trabeculotomy (GATT).^[1],[2]

Figure 1: (a) Diffuse slit-lamp photograph of patient presenting with redness after surgery. (b) Curled up trabecular meshwork, parts of which were curled toward the iris (arrows) with open trabecular shelf (white arrows in b and c)

Click here to view

Discussion

With the increasing scope of GATT in glaucoma, curled trabecular meshwork needs to be differentiated from TM tear after trauma, which may also have pigmentation, pigment clumps, and angle recession, apart from a ripped/torn TM on gonioscopy. This possibly happens because of the forcefully ripped remnant of the trabecular shelf during GATT collapsing onto the iris, which has not been reported before.

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.

Acknowledgements

Hyderabad Eye Research Foundation is acknowledged.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Grover DS, Godfrey DG, Smith O, Feuer WJ, Montes de Oca I, Fellman RL. Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: Technique report and preliminary results. Ophthalmology 2014;121:855-61.
2.	Chen J, Wang YE, Quan A, Grajewski A, Hodapp E, Vanner EA, et al. Risk factors for complications and failure after gonioscopy-assisted transluminal trabeculotomy in a young cohort. Ophthalmol Glaucoma 2020;3:190–5.