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OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 9  |  Page : 1477

Ophthalmological signet ring sign by a glaucoma implant


Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, HKSAR, Hong Kong

Date of Web Publication22-Aug-2019

Correspondence Address:
Dr. Sunny Chi Lik Au
Department of Ophthalmology, 9/F, MO Office, Lo Ka Chow Memorial Ophthalmic Centre, Tung Wah Eastern Hospital, 19 Eastern Hospital Road, Causeway Bay
Hong Kong
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_470_19

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How to cite this article:
Au SC, Ko ST. Ophthalmological signet ring sign by a glaucoma implant. Indian J Ophthalmol 2019;67:1477

How to cite this URL:
Au SC, Ko ST. Ophthalmological signet ring sign by a glaucoma implant. Indian J Ophthalmol [serial online] 2019 [cited 2019 Nov 17];67:1477. Available from: http://www.ijo.in/text.asp?2019/67/9/1477/265118



A 58-year-old man with right eye uveitic glaucoma was successfully implanted an Ahmed valve (New World Medical, Rancho Cucamonga, CA, USA) to control his intraocular pressure. Glaucoma drainage device, with increasing popularity,[1] would show up on radiological imaging,[2] and be mistaken as foreign body,[3] especially with its size, superior location to the eye,[4] and heterogeneous radiodensity throughout. The Ahmed valve appears as a signet ring on computed tomography [Figure 1]. The difference in radiodensity of the polypropylene body from the remaining silicone part outlines its ring-shaped appearance. This is more obvious especially with 3D reconstruction [Figure 2], making it a signature of glaucoma implant.
Figure 1: Computer tomography of orbit showing the right eye implanted Ahmed valve (model FP7). Its radiopaque polypropylene body appears as a signet ring. 3D reconstruction was done with OsiriX. Note also evidence of right craniotomy over the skull bone

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Figure 2: Computer tomography of orbit with 3D reconstruction by OsiriX showing the right eye implanted Ahmed valve (model FP7) appearing as a ring. Note also evidence of right craniotomy over the skull bone

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Vinod K, Gedde SJ, Feuer WJ, Panarelli JF, Chang TC, Chen PP, et al. Practice preferences for glaucoma surgery: A survey of the American glaucoma society. J Glaucoma 2017;26:687-93.  Back to cited text no. 1
    
2.
Reiter MJ, Schwope RB, Kini JA, York GE, Suhr AW. Postoperative imaging of the orbital contents. Radiographics 2015;35:221-34.  Back to cited text no. 2
    
3.
Mabray MC, Uzelac A, Talbott JF, Lin SC, Gean AD. Ex-PRESS glaucoma filter: An MRI compatible metallic orbital foreign body imaged at 1.5 and 3T. Clin Radiol 2015;70:e28-34.  Back to cited text no. 3
    
4.
Leen MM, Witkop GS, George DP. Anatomic considerations in the implantation of the Ahmed Glaucoma valve. Arch Ophthalmol 1996;114:223-4.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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