Malignant glaucoma: disease course and treatment

Review article

  • Natalie Papachristoforou Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow http://orcid.org/0009-0006-8417-3794
  • Ismael Alsoubie Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow http://orcid.org/0000-0002-0974-3025
  • Anthony Ueno Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow http://orcid.org/0009-0008-6946-4096
  • Aneta Pyza Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow http://orcid.org/0009-0000-5318-1368
  • Julia Kaczmarek Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow http://orcid.org/0009-0001-2268-6547
  • Natalia Wolińska Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow http://orcid.org/0000-0003-0975-9163
  • Jakub Piórek Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow http://orcid.org/0009-0001-4744-1933
  • Katarzyna Sajak-Hydzik 1. Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow. 2. Clinical Opthalmology Department, Section ,,A", Provincial Opthalmological Hospital in Krakow http://orcid.org/0000-0002-1973-2717
  • Ilona Pawlicka 1. Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow. 2. Clinical Opthalmology Department, Section ,,A", Provincial Opthalmological Hospital in Krakow http://orcid.org/0000-0003-1556-7678
  • Agnieszka Piskorz 1. Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow. 2. Clinical Opthalmology Department, Section ,,A", Provincial Opthalmological Hospital in Krakow http://orcid.org/0000-0003-4553-0497
  • Maciej Kozak 1. Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow. 2. Clinical Opthalmology Department, Section ,,A", Provincial Opthalmological Hospital in Krakow http://orcid.org/0000-0001-7993-2588
  • Anna Maria Roszkowska 1. Faculty of Medicine and Health Sciences, Collegium Medicum, Andrzej Frycz Modrzewski Academy in Krakow. 2. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy http://orcid.org/0000-0002-8083-3437
DOI: https://doi.org/10.24292/01.OT.120624
Keywords: glaucoma, malignant glaucoma, intraocular pressure, aqueous misdirection syndrome, irido-zonulo-hyaloidotomy, irido-zonulo-hyaloido-vitrectomy

Abstract

Diagnosis of malignant glaucoma presents a challenge due to subtle symptoms in early stages of the disease, making increased intraocular pressure a pivotal indicator, often accompanied by inflammation and corneal edema. Diagnostic modalities, including ultrasound biomicroscopy and anterior segment optical coherence tomography, play crucial roles in visualizing anatomical changes in the ciliary body and anterior chamber. The classic slit lamp examination, complemented by tonometry, remains a fundamental diagnostic tool. A stepwise therapeutic approach is essential, beginning with pharmacological interventions aimed at intraocular pressure reduction and subsequent restoration of the anterior chamber configuration. The first stage of treatment is pharmacotherapy. Laser therapies, such as iridotomy and Nd:YAG laser treatment, address angle closure. In resistant cases, a surgical approach, such as irydo-zonulo-hialoidotomy may be considered.

Downloads

Download data is not yet available.

References

von Graefe A. Beiträge zur Pathologie und Therapie des Glaucoms. Archiv für Opthalmologie. 1869; 15: 108-252.

Pożarowska D. Malignant Glaucoma:new views on its etiopathogenesis and management, OpthaTherapy. 2019; 6(3): 160-7.

Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014; 311(18): 1901-11. http://doi.org/10.1001/jama.2014.3192.

Niżankowska H. Okulistyka. Podstawy kliniczne. PZWL, Warszawa 2007.

Szczeklik A. Interna Szczeklika. Medycyna Praktyczna, 2023.

Gupta D, Chen PP. Glaucoma. Am Fam Physician. 2016; 93(8): 668-74.

Rękas M, Krix-Jachym K, Żarnowski T. Evaluation of the Effectiveness of Surgical Treatment of Malignant Glaucoma in Pseudophakic Eyes through Partial PPV with Establishment of Communication between the Anterior Chamber and the Vitreous Cavity. J Ophthalmol. 2015; 2015: 873124. http://doi.org/10.1155/2015/873124.

Shahid H, Salmon JF. Malignant glaucoma: a review of the modern literature. J Ophthalmol. 2012; 2012: 852659. http://doi.org/10.1155/2012/852659.

Foreman-Larkin J, Netland PA, Salim S. Clinical Management of Malignant Glaucoma. J Ophthalmol. 2015; 2015: 283707. http://doi.org/10.1155/2015/283707.

Kahook Y, Noecker RJ. How do you diagnose and treat malignant glaucoma, Glaucoma Today. 2006; November/December: 40-42.

Krix-Jachym K, Żarnowski T, Rękas M. Risk Factors of Malignant Glaucoma Occurrence after Glaucoma Surgery. J Ophthalmol. 2017; 2017: 9616738. http://doi.org/10.1155/2017/9616738.

Park M, Unigame K, Kiryu J et al. Management of a patient with pseudophakic malignant glaucoma; role of ultrasound biomicroscopy. Br J Ophthalmol. 1996; 80(7): 676-7. http://doi.org/10.1136/bjo.80.7.676.

Dorairaj S, Chan I, Teng CC. Diagnosis and Management of Malignant Glaucoma. EyeNet Magazine. 2010; April.

Fekih O, Zgolli HM, Mabrouk S et al. Malignant glaucoma management: literature review. Tunis Med. 2019; 97(8-9): 945-9.

Liu X, Hu Y, Yang T et al. Impact of improved minimally invasive anterior vitrectomy on the prognosis of patients with malignant glaucoma. BMC Ophthalmology. 2024; 24(1). https://doi.org/10.1186/s12886-024-03310-2.

Kono M, Ishida A, Ichioka, S et al. APHAKIC pupillary block by an intact anterior vitreous membrane after total lens extraction by phacoemulsification. Case Reports in Ophthalmology. 2021; 12(3): 882-8. https://doi.org/10.1159/000520176.

Simmons RJ. Malignant glaucoma. Br J Ophthalmol. 1972; 56(3): 263-72. http://doi.org/10.1136/bjo.56.3.263.

Wright C, Tawfik MA, Waisbourd M et al. Primary angle-closure glaucoma: an update. Acta Ophthalmol. 2016; 94(3): 217-25. http://doi.org/10.1111/aos.12784.

Ruben ST, Tsai J, Hitchings RA. Malignant glaucoma and its management. Brit J Ophthalmol. 1997; 81: 163-7.

Chew RP, Irwan Chong A, Zamli AH et al. Successful Management of Malignant Glaucoma With Irido-Zonulo-Hyaloidotomy and Complete Pars Plana Vitrectomy. Cureus. 2022; 14(1): e21679. http://doi.org/10.7759/cureus.21679.

Tosi R, Kilian R, Rizzo C et al. A case of bilateral pseudophakic malignant glaucoma treated with a new variant of irido-zonulo-hyaloid-vitrectomy. Am J Ophthalmol Case Rep. 2022; 28: 101719. http://doi.org/10.1016/j.ajoc.2022.101719.

Debrouwere V, Stalmans P, Van Calster J et al. Outcomes of different management options for malignant glaucoma: a retrospective study. Graefes Arch Clin Exp Ophthalmol. 2012; 250(1): 131-41. http://doi.org/10.1007/s00417-011-1763-0.

Published
2024-06-30
How to Cite
1.
Papachristoforou N, Alsoubie I, Ueno A, Pyza A, Kaczmarek J, Wolińska N, Piórek J, Sajak-Hydzik K, Pawlicka I, Piskorz A, Kozak M, Roszkowska AM. Malignant glaucoma: disease course and treatment. Ophthatherapy [Internet]. 2024Jun.30 [cited 2026May15];11(2):200-5. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/3117
Issue
Vol 11 No 2 (2024)
Section
Surgery and laser therapy
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright: Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)