Introduction: To report three cases that developed acute angle-closure glaucoma on the background of hyponatremia due to COVID 19 infection.Methods: Data of patients with positive PCR result for COVID 19 infection and concurrent findings of acute angle-closure glaucoma were analysed retrospectively.Results: The common characteristic of all cases was positive PCR test for COVID 19 infection taken from the nasopharyngeal swab 4 or 5 days ago. Their serum sodium levels were lower than 135 mmol / L. At the initial ophthalmic examination, all cases had diffuse corneal edema with shallow anterior chambers and mid-dilated non-reacting pupils.The choroid was evaluated as normal by ocular ultrasonography. Intraocular pressures (IOP) of the first, second, and third cases were 35 mmHg, 44 mmHg, and 40 mm Hg, respectively. 5–10 cc/kg mannitol was given to all patients intravenously within 30 min. Simultaneously, they began to use oral acetazolamide, topical pilocarpine, beta-blocker, and prednisolone acetate drops.After stabilization of IOP, Neodymium-doped yttrium aluminum garnet;(ND: YAG) Laser iridotomy was performed on all patients. No additional fluid therapy was given to the patients other than mannitol, and it was determined that the blood sodium level remained at normal levels after diuresis.Discussion: Hyponatremia is the most common electrolyte disorder in COVID 19 infection. Hyponatremia may cause an angle-closure attack in patients with shallow anterior chamber angles.Therefore, one should be aware of the possibility of angle-closure glaucoma in patients who develop hyponatremia due to COVID 19 disease. Suspected patients should be referred to the ophthalmology department.
1 May 2015 in Journal of Diabetes and its Complications
Objectives: To evaluate anterior segment parameters measured by dual Scheimpflug corneal topography in pseudoexfoliative glaucoma (PEXG), primary angle-closure glaucoma (PACG), and healthy eyes. Materials and Methods: One hundred forty-three eyes of 86 patients were included in this study. Forty-seven eyes of 38 patients with PEXG, 30 eyes of 15 patients with PACG, and 66 eyes of 33 healthy subjects were evaluated. Patients who underwent previous ophthalmic surgery and contact lens wearers were excluded. After full ophthalmological examination, mean central corneal thickness (CCT), white-to-white horizontal corneal diameter (WTW), pupillary diameter (PD), anterior chamber volume (ACV), anterior chamber depth (ACD), and mean anterior chamber angle were measured by dual Scheimpflug corneal topography and compared between the three groups. Statistical analyses were done using Statistical Package for Social Sciences for Windows 18.0 program. Results: No statistical difference was found in mean age or gender among the study groups (p>0.05). There were also no statistical differences in CCT, WTW, or PD among the groups (p=0.568, p=0.064, p=0.321, respectively). ACV, ACD, and mean anterior chamber angle values were significantly lower in the PACG group compared to the other groups (p=0.000 for all). There was no statistically significant difference in these measurements between the PEXG and normal eyes. Conclusion: ACV and depth and mean anterior chamber angle were statistically different (lower) in PACG when compared with PEXG and healthy eyes. Dual Scheimpflug corneal topography can be used as an objective method for the measurement of anterior segment parameters in glaucoma.