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2007 Series : August 14, 2007

December 25, 2007  |  December 18, 2007  |  December 11, 2007  |  December 4, 2007  |  November 27, 2007  |  November 20, 2007  |  November 13, 2007  |  November 6, 2007  |  October 30, 2007  |  October 23, 2007  |  October 16, 2007  |  October 9, 2007  |  October 2, 2007  |  September 25, 2007  |  September 18, 2007  |  September 11, 2007  |  September 4, 2007  |  August 28, 2007  |  August 21, 2007  |  August 14, 2007  |  August 7, 2007  |  July 31, 2007  |  July 24, 2007  |  July 17, 2007  |  July 10, 2007  |  July 3, 2007  |  June 26, 2007  |  June 19, 2007  |  June 12, 2007  |  June 5, 2007  |  May 29, 2007  |  May 22, 2007  |  May 15, 2007  |  May 8, 2007  |  May 1, 2007  |  April 24, 2007  |  April 17, 2007  |  April 10, 2007  |  April 3, 2007  |  March 27, 2007  |  March 20, 2007  |  March 13, 2007  |  March 6, 2007  |  February 27, 2007  |  February 20, 2007  |  February 13, 2007  |  February 6, 2007  |  January 30, 2007  |  January 23, 2007  |  January 16, 2007  |  January 9, 2007  |  January 2, 2007

To see views enlarged, click on the individual pictures...

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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