Iris Retraction Associated With Rhegmatogenous Retinal Detachment Syndrome and Hypotony

Campbell, David G.

doi:10.1001/archopht.1984.01040031177013

Cited by 26 publications

(13 citation statements)

References 19 publications

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“…The most widely accepted mechanism of IRS was described by Campbell [ 5 ]. Prior to Campbell, researchers hypothesized that IRS may occur due to vitreous retraction or lack of aqueous humor production [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other reports described increased risk for iris retraction and poor surgical prognosis in cases of retinal detachment with associated ciliochoroidal detachment [ 3 , 4 ]. In 1984, Campbell [ 5 ] was the first to name the condition IRS and proposed the most commonly accepted mechanism for the condition, in which seclusion of the pupil and egress of subretinal fluid are the drivers of iris retraction. However, debate remains regarding the mechanism of fluid egress that leads to hypotony, as Geyer et al [ 6 ] reported 2 cases of IRS associated with nonrhegmatogenous retinal detachment.…”

Section: Introductionmentioning

confidence: 99%

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Management of Iris Retraction Syndrome with Heterochromia and Retinal Detachment

Goebel

Crabtree

Altaweel³

2021

Case Rep Ophthalmol

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Iris retraction syndrome (IRS) is an uncommon condition caused by retinal detachment that is characterized by back bowing of the peripheral iris, leading to a deep anterior chamber. It is commonly associated with ocular hypotony, ciliochoroidal detachment, and anterior proliferative vitreoretinopathy. We describe a case of a 66-year-old man presenting with 2 weeks of right eye pain, redness, and iris heterochromia. The patient was diagnosed with IRS secondary to a chronic retinal detachment. Initial management with topical steroids and mydriasis allowed resolution of the iris retraction and heterochromia, normalization of intraocular pressure, and improvement of choroidal detachment. Subsequent vitrectomy with endolaser and oil tamponade led to successful detachment repair. Initial pharmacologic management allows a more controlled approach to the repair of retinal detachment associated with IRS. The patient’s presentation is consistent with the hydrodynamic hypothesis of IRS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of Iris Retraction Syndrome with Heterochromia and Retinal Detachment

Goebel

Crabtree

Altaweel³

2021

Case Rep Ophthalmol

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“…The definitive clinical findings of IRS included retraction of the peripheral iris, hypotony and rhegmatogenous retinal detachment (Hirschberg 1929;Graham 1958;Lindner 1936;Campbell 1984;Morinelli et al 1996). The pathogenesis of IRS remains controversial: vitreous retraction with zonular relaxation (Hirschberg 1929;Graham 1958) and proliferative vitreous retinopathy (Gottlieb 1972;Jarrett 1981) were suggested as being implicated.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of IRS remains controversial: vitreous retraction with zonular relaxation (Hirschberg 1929;Graham 1958) and proliferative vitreous retinopathy (Gottlieb 1972;Jarrett 1981) were suggested as being implicated. Campbell (1984) proposed a hydrodynamic theory to explain the findings whereby the retinal tears present in the rhegmatogenous retinal detachment expose the fluid of the eye to the choroidal and pigment epithelium pump. Thus, the rate of absorption of the fluid from the subretinal space exceeds the production of aqueous fluid, often suppressed by inflammation, resulting in the pulling of the iris into a retraction configuration.…”

Section: Discussionmentioning

confidence: 99%

“…I ris retraction syndrome (IRS) was originally described in the European literature over 40 years ago (Graham 1958) with only 3 reports of this condition appearing in American publications to date. IRS is defined by the triad of symptoms including backward bowing of the peripheral iris and rhegmatogenous retinal detachment (Hirschberg 1929;Graham 1958;Lindner 1936;Campbell 1984;Morinelli et al 1996). We present two cases in which the configuration of the iris retraction appeared together with an exudative nonrhegmatogeous retinal detachment.…”

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Iris retraction syndrome associated with nonrhegmatogenous retinal detachment

Geyer

Neudorfer

Rothkoff

et al. 1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To present the first documentation of iris retraction syndrome in eyes with nonrhegmatogenous retinal detachment. Patients and Methods: One patient with age-related macular degeneration and another with panuveitis developed exudative retinal detachment with iris retraction configuration. Ultrasound biomicroscopy was performed to investigate the anatomic relationship of structures in the anterior segment of the eye. Results: Ultrasound biomicroscopy demonstrated a severe backward bowing of the peripheral iris with irido-ciliary body and irido-zonular contact as well as broad iris lens touch. The iris retraction syndrome resolved after pupil dilation and disruption of the pupillary adhesions in both cases. The retinal detachment resolved several months later, without surgery. Conclusion:Iris retraction syndrome appears not to be exclusive to rhegmatogenous retinal detachment but can present in eyes with exudative -nonrhegmatogenous retinal detachment. Thus, when the configuration of the iris shows bowing in patients with retinal detachment, iris retraction syndrome should be considered and prompt pupil dilation should be carried out.Key words: iris retraction syndrome (IRS) -retinal detachment -ultrasound biomicroscopy (UBM), anterior-eye-segment-ultrasonography. Acta Ophthalmol. Scand. 1998: 76: 617-619 Copyright C Acta Ophthalmol Scand 1998. ISSN 1395-3907 I ris retraction syndrome (IRS) was originally described in the European literature over 40 years ago (Graham 1958) with only 3 reports of this condition appearing in American publications to date. IRS is defined by the triad of symptoms including backward bowing of the peripheral iris and rhegmatogenous retinal detachment (Hirschberg 1929;Graham 1958;Lindner 1936;Campbell 1984;Morinelli et al. 1996). We present two cases in which the configuration of the iris retraction appeared together with an exudative nonrhegmatogeous retinal detachment. We suspect that IRS is more common than believed and that more such cases may be detected as a result of greater awareness on the part of the physician who can then implement prompt and appropriate treatment to resolve the IRS. Case 1A 78-year-old man with a history of agerelated macular degeneration (AMD) was examined because of decreased vision in his right eye. The medical history and results of physical examination were noncontributory. Corrected vision was limited to counting fingers in the right eye and 1.0 (20/20) in the left eye. The intraocular pressure was 18 mmHg and the anterior segments were essentially normal in both eyes. Ophthalmoscopy revealed a subretinal haemorrhage in the posterior pole of the right eye. Fundus examination of the left eye showed macular drusen. Observation without treatment was recommended. Three months later, the condition of the left eye was unchanged; the visual acuity in the right eye had deteriorated to hand movements and the intraocular pressure dropped to 10 mmHg. Examination of the anterior segment of the right eye showed a clear cornea, an extremely deep ...

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