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C.M. Andreoli, T.G. Chu, H.I. Covington, S. Mukai; Ultrastructural Examination of Aqueous From Eyes With Rhegmatogenous Retinal Detachments and Elevated Intraocular Pressures . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5494.
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Purpose: Intraocular pressure (IOP) elevation in eyes with rhegmatogenous retinal detachment was described by Schwartz (Schwartz’s syndrome). Photoreceptor outer segments are thought to play a role in the elevation of IOP in these cases (Schwartz–Matsuo syndrome). We analyzed aqueous samples of patients with rhegmatogenous retinal detachments and either elevated or normal IOP by electron microscopy. Methods: Aqueous samples (0.1 to 0.2 ml collected by paracentesis)of 8 eyes in 8 patients with rhegmatogenous retinal detachments were studied with electron microscopy. Two of the patients presented with markedly elevated intraocular pressures (51 and 78 mmHg). The remaining six patients had normal intraocular pressures. Results: Aqueous samples of the two patients with elevated intraocular pressures contained abundant photoreceptor outer segments in varying stages of degeneration. In the six samples from patients with normal pressures, exhaustive electron microscopic evaluation did not reveal any photoreceptor outer segments. Inflammatory cells, fibrin, or pigment granules were rarely seen or absent in all eight cases. Conclusions: These findings suggest that in cases of rhegmatogenous retinal detachments with markedly elevated intraocular pressure, photoreceptor outer segments may play a role in pressure elevation.
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