Unsuccessful transscleral cyclophotocoagulation in oculocutaneous albinism

Abstract

Purpose: To report a case of unsuccessful transscleral cyclophotocoagulation in a patient with OCA1A tyrosinase-negative oculocutaneous albinism.

Observations: A 35-year-old Asian female with molecularly diagnosed OCA1A (tyrosinase-negative) oculocutaneous albinism and unilateral severe mixed mechanism glaucoma underwent transscleral cyclophotocoagulation on two separate occasions to treat elevated intraocular pressure. The intraocular pressure remained markedly elevated approximately 1 month following two separate treatments of transscleral cyclophotocoagulation while using high energy settings. The poor efficacy of both cyclophotocoagulation treatments was most likely due to a lack of melanin in the setting of oculocutaneous albinism.

Conclusions and importance: Cyclophotocoagulation in patients with oculocutaneous albinism is less likely to yield a desired lowering of intraocular pressure due to the absence of melanin.

Keywords: Cyclophotocoagulation; Glaucoma; Oculocutaneous albinism.

Fig. 1

A. External photograph demonstrating amelanotic features, including skin, hair, and irides. Her left eye has a conformer in place following enucleation. B. Complete transillumination of the right iris with underlying posterior chamber intraocular lens fully visible. C. Wide-field fundus photograph of non-pigmented retina.