Zona pigment glaucoma and surgical treatment

Abstract

Zona Pigment Glaucoma (ZPG) commonly caused by uveitis with or without blockage pupil or obstructed trabecular meshwork. Accumulation of macrophages in severe inflammation over a short period of time may acutely obstruct the meshwork and result in transient elevation of intraocular pressure in association with exercise of dilation of pupil. In treating pigmentary glaucoma dapiprazole, an alpha-adrenergic blocking agent, was found to be effective and in preventing pressure spikes after exercise. Dapiprazole causes miosis without affecting accommodation. Laser iridotomy reduced the incidence of ocular hypertension in pigment dispersion syndrome, although the effect was less pronounced in persons older than 40 years of age. This paper reported two typical cases of ZPG that were treated by surgery. The first was a young man patient with mild IOP and HIV (+), and the second was an elderly patient with high IOP and HIV (+). Both patients with glaucoma were surgical treatment. Surgical treatment associated with medical treatment included: antiviral drug with steroid and acetazolamide that inhibits carbonic anhydrase making lower IOP. These 2 patients have normalized intraocular pressure but did not have restored vision. Their vision post operation is still blind. Some satisfying results were reported here after one-year follow-up. Some considerations on HZO were discussed in this paper for General Practitioners and Eye Doctors.