Angle closure in highly myopic eyes due to unusual causes

Angle closure can occur in eyes with high myopia, although it is uncommon. A recent study found that causes of angle closure other than pupillary block are more common in high myopes than in the general population with angle-closure glaucoma.

Yaniv Barkana, MD, and colleagues at the New York Eye and Ear Infirmary identified 20 patients with angle-closure glaucoma and high myopia from a database of almost 18,000 patients. Inclusion criteria were a spherical equivalent of greater than –6 D and angle closure. The mean age of the patients at baseline was 52.9 years.

Angle closure diagnoses included primary pupillary block in nine patients, plateau iris configuration and syndrome in three patients, phacomorphic glaucoma in Weill-Marchesani syndrome in two patients, and malignant glaucoma secondary to scleral buckle in two patients. Also seen were pupillary block in an eye with keratoconus, pupillary block secondary to a pupillary membrane associated with retinopathy of prematurity, miotic-induced angle closure and Marfan syndrome, in one patient each.

The study is published in the February issue of Ophthalmology.