1
|
Sims DT, Mattson NR, Huang LC, Lee MD, Bly RA, Gallagher ER, Baran FM, Cabrera MT. Hallermann-Streiff Syndrome in Concordant Monozygotic Twins With Congenital Cataracts, Exudative Retinal Detachments, and One Case of Corneal Perforation Requiring Keratoplasty. Cornea 2023; 42:899-902. [PMID: 37088900 PMCID: PMC10247501 DOI: 10.1097/ico.0000000000003286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 03/06/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE We describe the management of Hallermann-Streiff syndrome in monozygotic female twins with congenital cataracts, exudative retinal detachments, and 1 case of corneal descemetocele with associated dellen and subsequent perforation. METHODS This study was a case report and review of the literature. RESULTS Twins 1 and 2 exhibited all 7 cardinal characteristics of Hallermann-Streiff syndrome, presenting with spontaneous lenticular resorption, anterior uveitis, and glaucoma. They underwent bilateral cataract extraction with near total capsulectomy. Both twins experienced recurrent glaucoma, for which twin 1 underwent successful endocyclophotocoagulation in both eyes and twin 2 in the left eye alone. The fellow eye developed 2 sites of perilimbal corneal descemetoceles with associated dellen at the inferotemporal limbal corneal junction leading to spontaneous perforation of 1 site, requiring a full-thickness corneal graft. Both twins developed recurrent bilateral exudative retinal detachments unresponsive to oral prednisolone. Twin 1's last best-corrected visual acuity with aphakic spectacles was 20/260 in the right eye and 20/130 in the left eye at age 4 years and 8 months. Twin 2's last best-corrected visual acuity was 20/130 in each eye at age 4 years and 11 months, over a year after right eye penetrating keratoplasty. CONCLUSIONS We describe 2 rare cases of Hallermann-Streiff syndrome in monozygotic twins complicated by corneal perforation requiring penetrating keratoplasty in 1 eye of 1 twin. Although corneal opacities have been described in this condition, this is the first case of corneal descemetocele in Hallermann-Streiff syndrome. The cornea was stabilized with a relatively favorable visual outcome over 1 year later.
Collapse
Affiliation(s)
- Deion T. Sims
- University of Washington School of Medicine, Seattle, WA, USA
| | - Nicole R. Mattson
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Laura C. Huang
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Division of Ophthalmology, Seattle Children’s Hospital, Seattle, WA, USA
| | | | - Randall A. Bly
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, WA, USA
- Department of Otolaryngology, University of Washington, Seattle, WA, USA
| | - Emily R. Gallagher
- Division of Craniofacial Medicine, Seattle Children’s Hospital, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Francine M. Baran
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Division of Ophthalmology, Seattle Children’s Hospital, Seattle, WA, USA
| | - Michelle T. Cabrera
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Division of Ophthalmology, Seattle Children’s Hospital, Seattle, WA, USA
| |
Collapse
|
2
|
Akkina SR, Saurey TG, Middleton NA, Mattson NR, Brummet S, Phillips JO, Chambers CB, Moe KS, Mudumbai RC. Factors Associated with Ocular Injury in Orbital Fracture Patients: Who Requires Urgent Ophthalmic Evaluation? Facial Plast Surg Aesthet Med 2021. [PMID: 34569815 DOI: 10.1089/fpsam.2021.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Importance: Create validated criteria to identify orbital fracture patients at higher risk for significant ocular injuries. Objective: Determine history and physical examination findings in orbital fracture patients who are associated with ocular injury and warrant urgent assessment by an ophthalmologist. Design, Setting, and Participants: Retrospective chart review of 535 adult orbital fracture patients evaluated at a Level I emergency department between 2014 and 2017, without prior history of orbital fracture, ocular injury, or ocular/orbital surgery. Main Outcomes and Measure: Presence of ocular injury. Results: In total, 195 (36%) patients had an ocular injury. Those with and without ocular injury were compared in a multivariate logistic regression model including demographics, fracture characteristics, injury mechanism, and physical examination findings. Visual acuity change, radiographic retrobulbar hemorrhage, abnormal pupillary reaction, and inability to open the injured eye all had significant associations with ocular injury when other findings were controlled. Conclusion: This study shows a significant association between ocular injury and visual acuity change, retrobulbar hemorrhage, abnormal pupillary reaction, and inability to open the injured eye. These factors can help triage when to obtain an urgent ophthalmology consult.
Collapse
Affiliation(s)
- Sarah R Akkina
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Tate G Saurey
- Department of Ophthalmology, University of South Carolina, Columbia, South Carolina, USA
| | | | - Nicole R Mattson
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Shaye Brummet
- University of Washington School of Medicine, Seattle, Washington, USA
| | - James O Phillips
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | | | - Kris S Moe
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Raghu C Mudumbai
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| |
Collapse
|