The Incidence and Risk Factors of Optic Nerve Damage of Posner-Schlossman Syndrome: A Meta-Analysis.

Objective: To explore the incidence and associated factors of glaucoma optic nerve damage (GOND) among patients with Posner-Schlossman syndrome. Methods: We retrieved relative studies till July 2022 using databases including PubMed, CNKI, VIP, and Wan-Fang. The retrieval terms include "Posner-Schlossman syndrome", "Glaucomatocyclitic Crisis", and "visual field". The Chinese retrieval terms were the corresponding Chinese terminologies for the English terms mentioned above. The outcomes were the incidence of GOND among PSS patients, the male proportion, patient age, the proportion of patients with single eye affected, disease duration, and intraocular pressure during the episode in patients with or without GOND. Review manager 5.3 was used for the analysis. Results: In total, 19 studies were included in our analysis. The pooled incidence of GOND among PSS patients was 0.26 (95% CI = 0.16-0.43). Age [MD = 11.3(5.86, 16.73); P < .0001], disease duration [MD = 4.27 (3.38, 5.16), P < .00001], and single or double eye affected [RR = 0.69 (0.49, 0.98), P = .04] were significantly associated with the development of GOND. Whereas, gender [RR = 1.09 (0.91, 1.29), P = .35] and intraocular pressure at episodes [MD = 2.66 (-0.38, 5.7), P = .09] were not significantly associated with GOND development. Conclusion: A fraction of PSS patients ultimately develop GOND so physicians should not be highly optimistic about the prognosis of PSS patients and timely and effective treatment is very important. Patients of higher age, those with double eyes affected, and suffering from a long disease duration might be at a greater risk of developing GOND.

Posner-Schlossman glaucomatocyclitic crisis.

In 1948, Posner and Schlossman first reported glaucomatocyclitic crisis, an uncommon form of glaucoma characterized by recurrent unilateral episodes of markedly elevated intraocular pressure (IOP) with mild idiopathic anterior chamber inflammation. The exact etiology of glaucomatocyclitic crisis is not clear. Although it is typically a self-limited condition, some cases with advanced optic nerve cupping and associated visual field loss have been reported. Diagnosis of Posner-Schlossman syndrome is difficult, and it may mimic a variety of ocular disorders. Treatment of this syndrome is directed towards controlling the inflammation and associated IOP elevation.

Unusual presentation of Amsler's sign in Fuchs' heterochromic uveitis.

Hyphema occurring after ocular paracentesis has been described as a classic feature of Fuchs' heterochromic uveitis (FHU) (Amsler's sign). We describe a case of hyphema occurring after peribulbar anesthesia in a patient with FHU. The bleeding occurred before the surgery began. Although the occurrence of this phenomenon does not preclude successful surgical outcomes, topical anesthesia may lower the risk preoperatively.

Effective treatment with topical cyclosporin A of a patient with Cogan syndrome.

The purpose of this report is to describe the effective treatment of severe anterior segment inflammation due to Cogan syndrome through the use of topical administration of cyclosporin A. A 47-year-old female patient had been experiencing headaches and difficulties with her vision. Subsequent examination revealed the sudden onset of bilateral conjunctival injection and swelling of bilateral auricles. Despite the multiple treatment (systemic and topical corticosteroid and antibiotic therapy), necrotizing scleritis had appeared bilaterally and the scleral wall was thinning. Topical administration of 1% cyclosporin A was applied to both eyes 4 times a day. After 2 months of this therapy, the epithelial tissue covered the necrotizing tissue and her symptom of ocular pain was relieved and her corrected visual acuity was improved. This is the first case exhibiting that topical cyclosporin A is an effective treatment for severe anterior segment inflammation associated with Cogan syndrome.