Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0595921 (intraocular pressure)
 11,750 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eleven cases of unilateral glaucoma are summarized. The typical presentations of these cases are (1) unilateral; (2) middle-aged women; (3) blurred vision; (4) corneal endothelial guttae (unilateral); (5) corneal edema; (6) stromal iris atrophy; (7) pupil abnormality; (8) peripheral anterior synechias;(9) elevated intraocular pressure; and (10) if previously diagnosed, the diagnosis is likely incorrect. Variations in these may occur. The disease can occur in men. Some patients may have nodular iris nevi. All of them represent the spectrum of Chandler's syndrome. Accurate diagnosis is important particularly in view of the optimistic prognostic implications for the fellow eye.
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PMID:The spectrum of Chandler's syndrome: an often overlooked cause of unilateral glaucoma. 30 13

Progressive essential iris atrophy, Chandler's syndrome, and the iris nevus (Cogan-Reese) syndrome are considered to be variations of a single disease process, which is characterized by abnormalities of the cornea, anterior chamber angle, and iris. In each variation, the typical patient is a white woman with unilateral disease, negative family history, and an onset of symptoms in early to middle adulthood. Since the membrane theory of Campbell suggests that the disease is a fundamental abnormality of the corneal endothelium, rather than the iris, the term "iridocorneal endothelial syndrome," as proposed by Yanoff, may be an appropriate inclusive term for the spectrum of disease, although further study of the pathogenesis is needed. For each variation of the disease, corneal edema and secondary glucoma are both treated primarily by medical or surgical reduction of the intraocular pressure, although penetrating keratoplasty is occasionally required for cases with advanced corneal edema.
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PMID:Progressive essential iris atrophy, Chandler's syndrome, and the iris nevus (Cogan-Reese) syndrome: a spectrum of disease. 48 59

A corneal button obtained from a 58-year-old woman with Chandler's syndrome was studied by light and electron microscopy. Clinically, the patient had mild unilateral glaucoma, slight changes in the iris, endothelial dystrophy, and corneal edema that was increasingly sensitive to intraocular pressure. Corneal pathology included loss of large numbers of endothelial cells with consequent exposure of Descemet's membrane. Endothelial cells demonstrated irregular shape, partial loss of tight junctions, and increased numbers of cytoplasmic filaments. Some endothelial cells appeared metaplastic or perhaps were replaced by cells from some source other than the cornea. Proliferation of cells was not apparent. A thin layer of acellular tissue, containing long-spacing collagen and 15-nm-wide fibrils, was interposed between normal Descemet's membrane and the endothelium. These observations suggest a basis for the corneal edema that distinguishes Chandler's syndrome from other forms of essential iris atrophy.
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PMID:Corneal decompensation in Chandler's syndrome. A scanning and transmission electron microscopic study. 50 78

The charts of 83 patients with iridocorneal endothelial (ICE) syndrome were retrospectively reviewed. Forty-two eyes of 42 patients had had filtering surgery, 37 of whom had had a trabeculectomy to reduce uncontrolled intraocular pressure. Twenty-four of these trabeculectomy patients required a second surgery, and 8 required a third surgery. The results are presented using a survival analysis. The success rates at one year of follow-up for the first, second, and third trabeculectomies were 64%, 79%, and 63%, respectively. Patients subclassified as having Chandler's syndrome, essential iris atrophy, and Cogan-Reese syndrome responded with approximately the same success rates within the first two years following their first surgery. The success rates for repeated surgeries are comparable with those of initial surgery in patients with primary open angle glaucoma. On the basis of this study, further surgery is recommended despite initial failure in this group of difficult patients.
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PMID:Surgical results in iridocorneal endothelial syndrome. 334 74

Chandler's syndrome is a particularly rare form of unilateral secondary glaucoma, in which--besides other symptoms--corneal epithelial edema occurs even when intraocular pressure rises slightly to above 20 mmHg. For 3 years now the authors have had a patient under observation whose condition corresponds to Chandler's syndrome. A remarkable feature of this case is that corneal edema occurred at physiological pressure levels. The symptoms and course are described; a brief differential diagnostic review is given and therapeutic possibilities are pointed out.
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PMID:[Chandler syndrome--a case report]. 349 27

Five patients (four men and one woman ranging in age from 30 to 41 years) with the iridocorneal endothelial syndrome (four with Chandler's syndrome and one with essential iris atrophy) underwent penetrating keratoplasty for complaints relating to diminished visual acuity or pain. After follow-up periods ranging from one year to four years and seven months (average, 2.7 years), postoperative visual acuities ranged from 20/15 to 20/30. No evidence of recurrence of the corneal abnormalities observed before grafting was apparent in the donor corneas at the last examinations. Two patients who required medical treatment for intraocular pressure control preoperatively also required adjuvant therapy postoperatively. These results suggested that penetrating keratoplasty is a relatively safe and effective procedure for patients with diminished vision or other complaints related to corneal abnormalities in the iridocorneal endothelial syndrome. It does not, however, restore to normal the iris and angle structures affected adversely by the progression of the corneal endotheliopathy and therefore other measures may be required to control intraocular pressure.
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PMID:Results of penetrating keratoplasty in the iridocorneal endothelial syndrome. 638 56

Iridocorneal endothelial (ICE) syndrome is a group of ocular conditions characterized by corneal proliferative endotheliopathy in which secondary corneal edema, peripheral anterior synechiae, and abnormalities of the iris stroma are the common features. The etiology remains unclear, but may be related to viral infection with Herpes simplex or Epstein-Barr virus. The pathogenesis of the ICE syndrome is believed to result from an abnormality of the corneal endothelial cells (causing corneal edema), with secondary spreading of the cells over the trabecular meshwork region (causing anterior synechiae and elevated intraocular pressure [IOP]) and across the surface of the iris (responsible for the formation of iris holes, pupillary distortion, and iris noduli). The disease complex, which includes essential iris atrophy, Chandler's syndrome, and iris nevus (Cogan-Reese) syndrome, is almost always unilateral, nonfamilial, and typically occurs in females during young adulthood. ICE syndrome is commonly progressive and frequently complicated by secondary glaucoma and corneal decompensation. In Chandler's syndrome, iris changes are less pronounced and corneal edema more frequent than in essential iris atrophy or Cogan-Reese syndrome. Glaucoma associated with ICE syndrome is often difficult to manage and is usually treated with medications and/or filtering surgery. Glaucoma filtering surgery is usually successful when done early, but may fail due to endothelialization of the fistula by the abnormal corneal endothelium.
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PMID:[Iridocorneal endothelial syndrome and glaucoma]. 1731 7