PMC7275946_01
Gonioscopy images of both eyes with an ICA Grade 2-3 and sparse areas of fibrae latae. (a) View of one quadrant OS. (b) View of one quadrant OD. (c) View of a different quadrant OD. (d) Magnified view of a sector of the ICA OD showing foci of pigment (white arrow) within the trabecular meshwork and small foci of fibrae latae (white arrowhead) at the opening of the ICA.
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The gonioscopic evaluation (RetCam, Clarity Medical Systems, Pleasanton, CA, USA) of the right eye revealed a normal iridocorneal angle opening, ranging from grade 2 to 3 throughout the eye's circumference, and minimal pectinate ligament dysplasia characterized by a few small sectors of fibrae latae (Figure 1). IOP OS was 17 mmHg OS (10 mmHg OD) with normal anterior chamber depth, and similar findings to those noted at discharge. Indirect ophthalmoscopy revealed a normal fundus and gonioscopy of the left eye paralleled that of the right eye with a normal iridocorneal angle opening ranging from grade 2 to 3 throughout the eye's circumference and minimal pectinate ligament dysplasia characterized by a few small sectors of fibrae latae (Figure 1).
(a) Axial and (b) peripheral transverse sections of the enucleated canine globe (OS) imaged with high field 9.4 T MRI. Note the corneal stromal loss consistent with the patient's bacterial keratitis, the shallow anterior chamber with notable loss of aqueous humor, and the multifocal undulation of the neurosensory retina (white arrow) consistent with multifocal retinal detachment which occurred artifactually, subsequent to globe fixation and processing. The white asterisks denote the plastic drinking straw used for globe positioning during image acquisition.
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The optic nerve head appeared intact and unremarkable (Figure 2).
Histopathology images of the enucleated canine globe (OS) with hematoxylin and eosin (H&E) stain. (a) Image of the nondependent ICA demonstrating an open angle and lack of goniodysgenesis at 4x magnification, thus ruling out primary glaucoma as the cause of this patient's glaucoma. (b) Image of the dependent ICA demonstrating an open angle, lack of goniodysgeneis, moderate lymphoplasmacytic infiltrate in the iris, ciliary body, and trabecular meshwork, and mild preiridal fibrovascular membrane (PIFM) formation, viewed at 4x magnification. This very mild degree of inflammation is incongruent with an 8 month history of uveitis-driven glaucoma, thus supporting a differential cause for this patient's glaucoma, such as AHMS. (c) Image of the iris leaflet with scant lymphoplasmacytic infiltration and scant PIFM.
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Even after multiple deeper sections of the block, the iridocorneal angles appeared normal, and no lesions consistent with goniodysgenesis were identified (Figure 3).