Thalassemia Intermedia: Masquerading as Neovascular Glaucoma
Purpose
To report a case of thalassemia intermedia presenting as neo-vascular glaucoma in a young female
Methods
A single case report. Detailed history, slitlamp examination, applanation tonometry with gonioscopy, disc photography and fluorescence angiography was performed along with initial medical management and detailed systemic evaluation by an internist. Special investigations like carotid Doppler imaging and Hb electrophoresis was also done. Subsequent surgical management involving trabeculectomy with intravitreal bevacizumab followed by Ahmed Glaucoma valve implantation was performed in RE and Augmented trabeculectomy in LE. Visual outcome and level of control of IOP was documented.
Results
Twenty year old lady presented with acute neo-vascular glaucoma in RE and chronic angle closure in LE along with advanced glaucomatous cupping and normal fluorescence angiography. IOP was reduced from 56mm Hg to 10mmHg in RE with surgical intervention. Visual acuity was improved in RE from counting finger to 6/9. Systemic examination, peripheral blood smear and Hb electrophoresis confirmed the diagnosis of thalassemia intermedia.
Conclusion
Chronic episodic anemia in thalassemia can masquarade as neovascular glaucoma posing challenges in management.