Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report

Adie’s pupil is a neurological condition of unknown origin with unusual, asymmetric presentation known as anisocoria with the enlarged pupil failing to react to light. It is believed that this pupillary abnormality results from damage to the ciliary ganglion or postganglionic short ciliary nerves. A...

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Autores principales:	Satoko Akahane, Takao Hirano, Sayuri Shu, Toshinori Murata
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	adie’s pupil uveitis laser photocoagulation peripheral retinal nonperfusion Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/6ae43dc58d914dae9f0febf14080bac7
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spelling	oai:doaj.org-article:6ae43dc58d914dae9f0febf14080bac72021-12-02T12:40:23ZBilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report1663-269910.1159/000519506https://doaj.org/article/6ae43dc58d914dae9f0febf14080bac72021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/519506https://doaj.org/toc/1663-2699Adie’s pupil is a neurological condition of unknown origin with unusual, asymmetric presentation known as anisocoria with the enlarged pupil failing to react to light. It is believed that this pupillary abnormality results from damage to the ciliary ganglion or postganglionic short ciliary nerves. Affected individuals (usually female) may be symptomatic with photophobia or difficulty reading in the diseased eye. Although most Adie’s pupil cases are idiopathic, previous studies have associated photocoagulation and uveitis with symptom onset. To the best of our knowledge, there have been no reports of specific means of preventing Adie’s pupil. We describe a patient who experienced varying severities of Adie’s pupil after separate laser treatments of the ischemic peripheral retina for uveitis. Fluorescein angiography revealed peripheral retinal nonperfusion in the bilateral eyes of a 37-year-old Japanese female who had been suffering from posterior uveitis. To avoid proliferative changes, 360° laser photocoagulation of the retinal nonperfusion region located in the far periphery was first delivered to the left eye over 2 sessions. Soon after treatment, the patient complained of acute photophobia and blurred vision in the treated eye. Ocular examination revealed left pupil dilation and poor light sensitivity, although the pupil was reactive to a close stimulus. The left pupil also displayed positive denervation sensitivity based on the dilute pilocarpine (0.125%) test. Adie’s pupil was diagnosed based on these observations. Three months later, similar, albeit milder, findings were observed in her right eye after 360° peripheral laser photocoagulation that was more conservatively performed over 4 sessions. Four months after the first treatment, her subjective visual function had improved, and the pupil diameter had decreased to a normal size in both eyes without additional treatment. We encountered a patient whose severity of Adie’s pupil was apparently reduced by more conservative laser photocoagulation of the ischemic peripheral retina.Satoko AkahaneTakao HiranoSayuri ShuToshinori MurataKarger Publishersarticleadie’s pupiluveitislaser photocoagulationperipheral retinal nonperfusionOphthalmologyRE1-994ENCase Reports in Ophthalmology, Vol 12, Iss 3, Pp 909-914 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adie’s pupil uveitis laser photocoagulation peripheral retinal nonperfusion Ophthalmology RE1-994
spellingShingle	adie’s pupil uveitis laser photocoagulation peripheral retinal nonperfusion Ophthalmology RE1-994 Satoko Akahane Takao Hirano Sayuri Shu Toshinori Murata Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report
description	Adie’s pupil is a neurological condition of unknown origin with unusual, asymmetric presentation known as anisocoria with the enlarged pupil failing to react to light. It is believed that this pupillary abnormality results from damage to the ciliary ganglion or postganglionic short ciliary nerves. Affected individuals (usually female) may be symptomatic with photophobia or difficulty reading in the diseased eye. Although most Adie’s pupil cases are idiopathic, previous studies have associated photocoagulation and uveitis with symptom onset. To the best of our knowledge, there have been no reports of specific means of preventing Adie’s pupil. We describe a patient who experienced varying severities of Adie’s pupil after separate laser treatments of the ischemic peripheral retina for uveitis. Fluorescein angiography revealed peripheral retinal nonperfusion in the bilateral eyes of a 37-year-old Japanese female who had been suffering from posterior uveitis. To avoid proliferative changes, 360° laser photocoagulation of the retinal nonperfusion region located in the far periphery was first delivered to the left eye over 2 sessions. Soon after treatment, the patient complained of acute photophobia and blurred vision in the treated eye. Ocular examination revealed left pupil dilation and poor light sensitivity, although the pupil was reactive to a close stimulus. The left pupil also displayed positive denervation sensitivity based on the dilute pilocarpine (0.125%) test. Adie’s pupil was diagnosed based on these observations. Three months later, similar, albeit milder, findings were observed in her right eye after 360° peripheral laser photocoagulation that was more conservatively performed over 4 sessions. Four months after the first treatment, her subjective visual function had improved, and the pupil diameter had decreased to a normal size in both eyes without additional treatment. We encountered a patient whose severity of Adie’s pupil was apparently reduced by more conservative laser photocoagulation of the ischemic peripheral retina.
format	article
author	Satoko Akahane Takao Hirano Sayuri Shu Toshinori Murata
author_facet	Satoko Akahane Takao Hirano Sayuri Shu Toshinori Murata
author_sort	Satoko Akahane
title	Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report
title_short	Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report
title_full	Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report
title_fullStr	Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report
title_full_unstemmed	Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report
title_sort	bilateral adie’s pupil following laser treatment of the ischemic peripheral retina for uveitis: a case report
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/6ae43dc58d914dae9f0febf14080bac7
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Bilateral Adie’s Pupil following Laser Treatment of the Ischemic Peripheral Retina for Uveitis: A Case Report

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