Bo Feng's research while affiliated with Capital Medical University and other places

Purpose Iridocorneal endothelial (ICE) syndrome is a rare condition, and unique characteristics in Chinese patients can make diagnosis difficult. Our purpose was to describe the clinical characteristics and variations of ICE syndrome in 58 consecutive Chinese patients. Methods The clinical data of consecutive patients with ICE syndrome who were seen between 2008 and 2011 at the glaucoma clinic of our ophthalmology department were retrospectively reviewed. The diagnostic criteria for ICE syndrome were a “hammered-silver” appearance of the corneal endothelium and specular microscopy showing ICE cells characterized by the absence of a hexagonal appearance, dark areas within the cells, and a light–dark reversal pattern. The general characteristics of the cornea, iris, pupil, and anterior chamber angles were compiled and examined. ResultsFifty-eight patients with ICE syndrome were identified: 26 had Chandler’s syndrome (CS), 23 Cogan-Reese syndrome, and nine progressive iris atrophy (PIA). The incidence of glaucoma was 98%. Twenty-three (39.7%) patients had atypical ICE syndrome. Intraocular pressure was relatively high in 13 patients with slightly damaged irises, while the corneal endothelium remained relatively intact. Slit lamp examination showed an intact iris in ten patients (17.2%), with massive deposition of black pigment in the anterior chamber angle. In the 25 patients in whom the anterior chamber angle was only partially closed, 80% of the anterior chamber angles were hyperpigmented. ConclusionsCS is the most common variation of ICE syndrome in Chinese patients, and PIA is the least common. A slight change or an intact iris under slit lamp examination is a characteristic of ICE syndrome.

To summarize the misdiagnosis and missed diagnosis of iridocorneal endothelial syndrome (ICE syndrome) and analyze the main reasons. Retrospective case series. The records of 65 patients (65 eyes) who were diagnosed to suffer from ICE syndrome in Beijing Tongren Hospital during Jan. 2008 to Dec. 2011 were studied retrospectively. The international diagnostic standards were used. The situations of misdiagnosis and missed diagnosis were evaluated and the main reasons and the related clinical characters were analyzed. The correct preliminary diagnosis was found in 9 cases (13.8%). Misdiagnosis included primary angle closure glaucoma (PACG) in 14 cases (21.5%), primary open angle glaucoma (POAG) in 14 cases (21.5%), uveitis in seven cases (10.8%), etc. The contralateral eye received operation or laser therapy in 12 of 56 cases who didn't get the correct preliminary diagnosis. There were many atypical and special presentations in our patients. There was no or mild atrophy of iris in 54 cases (83.1%). Secondary open angle glaucoma was found in eleven cases (16.9%). The maximal intraocular pressure (IOP) was ≥ 40 mmHg (1 mmHg = 0.133 kPa) in 41 cases (63.1%). And there was no corneal edema when the IOP is lower than 30 mmHg in 48 cases (73.8%). There is some abnormal black pigment in the anterior chamber angle in some cases. ICE syndrome is a disease with high rate of misdiagnosis or missed diagnosis. The main reasons of misdiagnosis and missed diagnosis include that ICE syndrome has many different clinical manifestations and the doctors pay little attention of to the atypical presentations of ICE cases.