Pediatric Orbital Tumors

June 5, 2023/

Plateau iris syndrome is a type of glaucoma that is characterized by an anatomically narrow angle between the iris and the trabecular meshwork, despite a deep anterior chamber. Here are some important points to keep in mind about the definition, clinical characteristics, ultrasound biomicroscopy findings, and treatment of plateau iris syndrome:

Definition:

  • Plateau iris syndrome is a type of glaucoma that is caused by an anatomically narrow angle between the iris and the trabecular meshwork, despite a deep anterior chamber.
  • This can lead to increased intraocular pressure (IOP) and optic nerve damage if left untreated.

Clinical Characteristics:

  • Patients with plateau iris syndrome typically have a deep anterior chamber centrally and a flat iris contour, giving the appearance of a “plateau” configuration.
  • Intraocular pressure may be elevated due to the narrowing of the angle, even in the absence of pupillary block.
  • Patients may also experience symptoms such as pain, redness, and blurry vision.

Ultrasound Biomicroscopy Findings:

  • Ultrasound biomicroscopy (UBM) can be used to visualize the angle anatomy in patients with plateau iris syndrome.
  • UBM may show a narrowed angle despite a deep anterior chamber, as well as anterior rotation of the ciliary body and the iris root.

Treatment:

  • The primary treatment for plateau iris syndrome is to reduce intraocular pressure (IOP) and prevent optic nerve damage.
  • Treatment may involve the use of topical and/or oral medications to lower IOP.
  • Laser peripheral iridotomy (LPI) may be performed to open up the angle and reduce IOP if there is an element of pupillary block. Argon laser iridoplasty can then be performed in addition to miotics.
  • In cases where medical and laser treatment are not effective, surgical intervention such as trabeculectomy may be necessary.

In conclusion, plateau iris syndrome is a type of glaucoma that is characterized by an anatomically narrow angle between the iris and the trabecular meshwork, despite a deep anterior chamber. Clinical characteristics include a deep anterior chamber centrally and a flat iris contour. Ultrasound biomicroscopy can be used to visualize the angle anatomy, while treatment may involve the use of medications, laser peripheral iridotomy, and surgical intervention to reduce intraocular pressure and prevent optic nerve damage.