M E D I C U S - Shoqata e Mjekëve Shqiptarë të Maqedonisë-Hipokrati

The case management was:
� Both eyes corrected (spectacles)
� Close follow up to detect possibly future ocular complications (glaucoma, retinal
detachment, etc)
� Referred to cardiologist for evaluation.
Figure 5 Here ...
CONCLUSIONS
Figure 5 a- Left eye, the lack of the lens.
Figure 5 b- Fundoscopic view of the same eye.
Ocular complications are commonly found in Marfan‘s Syndrome. Among them
complete bilateral spontaneous posterior lens dislocation is a rare complication (8).
Posterior dislocation may be silent and rarely causes glaucoma or uveitis (9). Also
vitreous changes are well described in Marfan's Syndrome (10). Commonly observed
changes are liquefaction of the gel and posterior vitreous detachment (PVD). Presence of
fluid vitreous in the anterior chamber and PVD in our cases are in agreement with the
above description. Posterior dislocation of lens could have been augmented by the
disruption of anterior hyaloids face resulting in loss of support. Usually these cases tend
to have more severe vitreous and retinal pathologies.
Such complications as total rhegmatogenous retinal detachment, secondary
glaucoma, etc, need prompt and energetic treatment to minimize severe visual loss in
these patients.
Finally, we must emphasize the need (and duty) to refer the patients with
Marfan‘s Syndrome to cardiologic evaluation in order to decrease the morbidity and
mortality due to cardio-vascular complications (aorta aneurysm, mitral insufficiency, etc.)
REFERENCES
1. Harrison principles of internal medicine - 15 Edition 2001; 351-352.
2. Nelson LB, Maumence IH: Ectopia Lentis, Surv Ophthalmol 1982; 27:143-160
3. Feilder AR: Dislocated lenses: Paediatric Ophthalmolgy, Current aspects, Edited
by K. Wybar & D. Taylor. Marcel Dekkel Inc. Publ., Ch. 17, 1983; 169-170