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Transactions of the American Ophthalmological Society logoLink to Transactions of the American Ophthalmological Society
. 1985;83:304–315.

Arterial anastomosis with Schlemm's canal: a rare cause of secondary open-angle glaucoma.

C D Phelps
PMCID: PMC1298703  PMID: 3832532

Abstract

In four patients with open-angle glaucoma, blood was present in the region of Schlemm's canal. The blood had four characteristics that distinguished it from other more common causes of blood in Schlemm's canal: it was observed with a Zeiss goniolens, a lens that has no flange, and thus was not an artifact of the examination technique; the blood could not be expelled from Schlemm's canal by raising IOP with para-limbal suction unless the pressure in the eye exceeded the diastolic ophthalmic artery pressure level; as IOP approached this high level, the amount of blood in Schlemm's canal progressively decreased, eventually diminishing to a single point of reflux that was always in the same location; and at this point the blood pulsed in and out of Schlemm's canal with each beat of the heart. These findings suggest a pathological anastomosis between a deep limbal artery and Schlemm's canal. The high arterial pressure transmitted into Schlemm's canal could, in turn, lead to an elevation of IOP.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALFANO J. E., ALFANO P. A. Glaucoma and the superior vena caval obstruction syndrome. Am J Ophthalmol. 1956 Nov;42(5):685–696. doi: 10.1016/0002-9394(56)90509-8. [DOI] [PubMed] [Google Scholar]
  2. ASHTON N., SMITH R. Anatomical study of Schlemm's canal and aqueous veins by means of neoprene casts. III. Arterial relations of Schlemm's canal. Br J Ophthalmol. 1953 Oct;37(10):577–586. doi: 10.1136/bjo.37.10.577. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bellows A. R., Chylack L. T., Jr, Epstein D. L., Hutchinson B. T. Choroidal effusion during glaucoma surgery in patients with prominent episcleral vessels. Arch Ophthalmol. 1979 Mar;97(3):493–497. doi: 10.1001/archopht.1979.01020010243011. [DOI] [PubMed] [Google Scholar]
  4. DVORAK-THEOBALD G. Further studies on the canal of Schlemm; its anastomoses and anatomic relations. Am J Ophthalmol. 1955 Apr;39(4 Pt 2):65–89. doi: 10.1016/0002-9394(55)90154-9. [DOI] [PubMed] [Google Scholar]
  5. Dvorak-Theobald G. Schlemm's Canal: Its Anastomoses and Anatomic Relations. Trans Am Ophthalmol Soc. 1934;32:574–595. [PMC free article] [PubMed] [Google Scholar]
  6. Gaasterland D. E., Jocson V. L., Sears M. L. Channels of aqueous outflow and related blood vessels. 3. Episcleral arteriovenous anastomoses in the rhesus monkey eye (Macaca mulatta). Arch Ophthalmol. 1970 Dec;84(6):770–775. doi: 10.1001/archopht.1970.00990040772016. [DOI] [PubMed] [Google Scholar]
  7. Galin M. A., Baras I., Cavero R. Ophthalmodynamometry using suction. Arch Ophthalmol. 1969 Apr;81(4):495–500. doi: 10.1001/archopht.1969.00990010496006. [DOI] [PubMed] [Google Scholar]
  8. JOCSON V. L., GRANT W. M. INTERCONNECTIONS OF BLOOD VESSELS AND AQUEOUS VESSELS IN HUMAN EYES. Arch Ophthalmol. 1965 May;73:707–720. doi: 10.1001/archopht.1965.00970030709021. [DOI] [PubMed] [Google Scholar]
  9. Jocson V. L., Sears M. L. Channels of aqueous outflow and related blood vessels. I. Macaca mulatta (rhesus). Arch Ophthalmol. 1968 Jul;80(1):104–114. doi: 10.1001/archopht.1968.00980050106018. [DOI] [PubMed] [Google Scholar]
  10. Minas T. F., Podos S. M. Familial glaucoma associated with elevated episcleral venous pressure. Arch Ophthalmol. 1968 Aug;80(2):202–208. doi: 10.1001/archopht.1968.00980050204010. [DOI] [PubMed] [Google Scholar]
  11. Moses R. A., Hoover G. S., Oostwouder P. H. Blood reflux in Schlemm's canal. I. Normal findings. Arch Ophthalmol. 1979 Jul;97(7):1307–1310. doi: 10.1001/archopht.1979.01020020049011. [DOI] [PubMed] [Google Scholar]
  12. Murali R., Berenstein A., Hirschfeld A. Intraorbital arteriovenous malformation with spontaneous thrombosis. Ann Ophthalmol. 1981 Apr;13(4):457–459. [PubMed] [Google Scholar]
  13. Phelps C. D., Armaly M. F. Measurement of episcleral venous pressure. Am J Ophthalmol. 1978 Jan;85(1):35–42. doi: 10.1016/s0002-9394(14)76662-0. [DOI] [PubMed] [Google Scholar]
  14. Phelps C. D., Asseff C. F., Weisman R. L., Podos S. M., Becker B. Blood reflux into Schlemm's canal. Arch Ophthalmol. 1972 Dec;88(6):625–631. doi: 10.1001/archopht.1972.01000030627011. [DOI] [PubMed] [Google Scholar]
  15. Phelps C. D. The pathogenesis of glaucoma in Sturge-Weber syndrome. Ophthalmology. 1978 Mar;85(3):276–286. doi: 10.1016/s0161-6420(78)35667-0. [DOI] [PubMed] [Google Scholar]
  16. Phelps C. D., Thompson H. S., Ossoinig K. C. The diagnosis and prognosis of atypical carotid-cavernous fistula (red-eyed shunt syndrome). Am J Ophthalmol. 1982 Apr;93(4):423–436. doi: 10.1016/0002-9394(82)90132-5. [DOI] [PubMed] [Google Scholar]
  17. Podos S. M., Minas T. F., Macri F. J. A new instrument to measure episcleral venous pressure. Comparison of normal eyes and eyes with primary open-angle glaucoma. Arch Ophthalmol. 1968 Aug;80(2):209–213. doi: 10.1001/archopht.1968.00980050211011. [DOI] [PubMed] [Google Scholar]
  18. Schirmer K. E. Gonioscopic assessment of blood in Schlemm's canal. Correlation with glaucoma tests. Arch Ophthalmol. 1971 Mar;85(3):263–267. doi: 10.1001/archopht.1971.00990050265001. [DOI] [PubMed] [Google Scholar]
  19. Suson E. B., Schultz R. O. Blood in schlemm's canal in glaucoma suspects. A study of the relationship between blood-filling pattern and outflow facility in ocular hypertension. Arch Ophthalmol. 1969 Jun;81(6):808–812. doi: 10.1001/archopht.1969.00990010810010. [DOI] [PubMed] [Google Scholar]
  20. WEEKERS R., DELMARCELLE Y. Pathogenesis of intraocular hypertension in cases of arteriovenous aneurysm. AMA Arch Ophthalmol. 1952 Sep;48(3):338–343. doi: 10.1001/archopht.1952.00920010346009. [DOI] [PubMed] [Google Scholar]

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