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2007 Series -  August 14, 2007 Lecture 20 of 52  NEXT»

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An aphakic, diabetic patient who previously had a vitreous hemorrhage two weeks ago presents with an IOP of 38 mmHg and layered cells in the anterior chamber.  These cells appear unusual at the slit lamp and you perform an anterior chamber aspiration and examine the cells under the microscope.

1.  These cells most likely represent:   
 

a. leukemic cell
b. macrophages and chronic inflammatory cells
c. old red blood cells
d.  RPE cells released into the anterior chamber from chronic diabetic retinopathy

2.  The most likely cause of the increased IOP is:  
 

a. neovascularization of the angle (NVA)
b. increased episcleral venous pressure from a hyperviscosity syndrome (from leukemia)
c. mechanical obstruction of the trabecular meshwork from these cells
d.  aqueous misdirection (so called “malignant glaucoma”)

3.  All of the following have been used to control IOP in this clinical condition EXCEPT: 
 
a. medical therapy - including topical beta-blockers and carbonic anhydrase inhibitors
b. anterior chamber irrigation
c. posterior vitrectomy to clear the blood if medical management fails
d. 

urgent argon laser trabeculoplasty with laser iridotomy

For answers to the above, click here on or after August 21, 2007.

 

 


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