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Spontaneous conjunctival filtering bleb

MedGen UID:
1693159
•Concept ID:
C5209225
•
Anatomical Abnormality
Synonyms: Conjunctival avascular cysts (filtering blebs); Spontaneous filtering bleb
 
HPO: HP:0020125

Definition

Avascular cystic elevations of the superior conjunctiva not related to ocular surgery or trauma. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSpontaneous conjunctival filtering bleb

Conditions with this feature

Facial dysmorphism-lens dislocation-anterior segment abnormalities-spontaneous filtering blebs syndrome
MedGen UID:
330396
•Concept ID:
C1832167
•
Disease or Syndrome
Traboulsi syndrome is characterized by dislocated crystalline lenses and anterior segment abnormalities in association with a distinctive facies involving flat cheeks and a beaked nose. Some affected individuals develop highly unusual nontraumatic conjunctival cysts (filtering blebs), presumably caused by abnormal thinning of the sclera (Patel et al., 2014).
See: Condition Record
Facial dysmorphism-lens dislocation-anterior segment abnormalities-spontaneous filtering blebs syndrome

Professional guidelines

PubMed

The surgical management of leaking filtering blebs.
Loane ME, Galanopoulos A
Curr Opin Ophthalmol 1999 Apr;10(2):121-5. doi: 10.1097/00055735-199904000-00008. PMID: 10537762
Management of leaking filtration blebs.
Tomlinson CP, Belcher CD 3rd, Smith PD, Simmons RJ
Ann Ophthalmol 1987 Nov;19(11):405-8, 411. PMID: 3322135
Trabeculectomy as treatment for glaucoma: a preliminary report.
Loewenthal LM
Ann Ophthalmol 1977 Sep;9(9):1179-86. PMID: 900738

Recent clinical studies

Etiology

Unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia.
Sanjuán P, Salvador-Culla B, Canut MI, Barraquer RI
Eur J Ophthalmol 2021 Mar;31(2):NP136-NP140. Epub 2019 Sep 17 doi: 10.1177/1120672119877159. PMID: 31530022
Efficacy and Safety of the Ab-interno Xen Gel Stent After Failed Trabeculectomy.
Karimi A, Hopes M, Martin KR, Lindfield D
J Glaucoma 2018 Oct;27(10):864-868. doi: 10.1097/IJG.0000000000001044. PMID: 30095602
Two cases of spontaneous filtering blebs, one idiopathic and one associated with Terrien marginal degeneration.
Munro M, McWhae J, Romanchuk K, Crichton A, Carter G, Ball A
Cornea 2014 Jul;33(7):752-4. doi: 10.1097/ICO.0000000000000132. PMID: 24831195
"Bleb window"-pexy for the management of symptomatic, oversized blebs.
Tabet R, Feldman RM, Bell NP, Lee DA
J Glaucoma 2009 Sep;18(7):546-51. doi: 10.1097/IJG.0b013e3181815a06. PMID: 19745670
Conjunctival advancement for late-onset filtering bleb leaks: indications and outcomes.
Budenz DL, Chen PP, Weaver YK
Arch Ophthalmol 1999 Aug;117(8):1014-9. doi: 10.1001/archopht.117.8.1014. PMID: 10448743

Diagnosis

Palladium-103 plaque radiation therapy for ciliary body melanoma through a functioning glaucoma filtering bleb.
Pathan AHK, Barash A, Tena LB, Finger PT
Eur J Ophthalmol 2018 Jan;28(1):119-122. doi: 10.5301/ejo.5001046. PMID: 28967074
Two cases of spontaneous filtering blebs, one idiopathic and one associated with Terrien marginal degeneration.
Munro M, McWhae J, Romanchuk K, Crichton A, Carter G, Ball A
Cornea 2014 Jul;33(7):752-4. doi: 10.1097/ICO.0000000000000132. PMID: 24831195
Conjunctival advancement for late-onset filtering bleb leaks: indications and outcomes.
Budenz DL, Chen PP, Weaver YK
Arch Ophthalmol 1999 Aug;117(8):1014-9. doi: 10.1001/archopht.117.8.1014. PMID: 10448743
Treatment of a spontaneous filtering bleb due to Terrien's marginal degeneration with injection of autologous blood.
Wong VA, Beiko G, Pavlin CJ, Rootman DS
Can J Ophthalmol 1995 Dec;30(7):377-9. PMID: 8963941

Therapy

Efficacy and Safety of the Ab-interno Xen Gel Stent After Failed Trabeculectomy.
Karimi A, Hopes M, Martin KR, Lindfield D
J Glaucoma 2018 Oct;27(10):864-868. doi: 10.1097/IJG.0000000000001044. PMID: 30095602
Surgical reduction of symptomatic, circumferential, filtering blebs.
Anis S, Ritch R, Shihadeh W, Liebmann J
Arch Ophthalmol 2006 Jun;124(6):890-4. doi: 10.1001/archopht.124.6.890. PMID: 16769845
Midterm follow-up of necrotic bleb excision and advancement of the fornical conjunctiva.
Hyung SM, Ahn DG
Korean J Ophthalmol 1999 Dec;13(2):85-91. doi: 10.3341/kjo.1999.13.2.85. PMID: 10761403
The surgical management of leaking filtering blebs.
Loane ME, Galanopoulos A
Curr Opin Ophthalmol 1999 Apr;10(2):121-5. doi: 10.1097/00055735-199904000-00008. PMID: 10537762
Conjunctival advancement for late-onset filtering bleb leaks: indications and outcomes.
Budenz DL, Chen PP, Weaver YK
Arch Ophthalmol 1999 Aug;117(8):1014-9. doi: 10.1001/archopht.117.8.1014. PMID: 10448743

Prognosis

A hyperdry amniotic membrane patch using a tissue adhesive for corneal perforations and bleb leaks.
Kitagawa K, Yanagisawa S, Watanabe K, Yunoki T, Hayashi A, Okabe M, Nikaido T
Am J Ophthalmol 2009 Sep;148(3):383-9. Epub 2009 May 23 doi: 10.1016/j.ajo.2009.03.030. PMID: 19464670
Midterm follow-up of necrotic bleb excision and advancement of the fornical conjunctiva.
Hyung SM, Ahn DG
Korean J Ophthalmol 1999 Dec;13(2):85-91. doi: 10.3341/kjo.1999.13.2.85. PMID: 10761403
Conjunctival advancement for late-onset filtering bleb leaks: indications and outcomes.
Budenz DL, Chen PP, Weaver YK
Arch Ophthalmol 1999 Aug;117(8):1014-9. doi: 10.1001/archopht.117.8.1014. PMID: 10448743
Trabeculectomy as treatment for glaucoma: a preliminary report.
Loewenthal LM
Ann Ophthalmol 1977 Sep;9(9):1179-86. PMID: 900738

Clinical prediction guides

A rare ocular complication of neisseria gonorrhoeae.
Gonçalves Dos Santos Martins T, Fontes de Azevedo Costa AL
Ir J Med Sci 2018 Aug;187(3):815-816. Epub 2018 Jan 18 doi: 10.1007/s11845-018-1740-2. PMID: 29349557
Two cases of spontaneous filtering blebs, one idiopathic and one associated with Terrien marginal degeneration.
Munro M, McWhae J, Romanchuk K, Crichton A, Carter G, Ball A
Cornea 2014 Jul;33(7):752-4. doi: 10.1097/ICO.0000000000000132. PMID: 24831195
Management of leaking filtration blebs.
Tomlinson CP, Belcher CD 3rd, Smith PD, Simmons RJ
Ann Ophthalmol 1987 Nov;19(11):405-8, 411. PMID: 3322135
Corneal hydrops in Terrien's marginal degeneration.
Soong HK, Fitzgerald J, Boruchoff SA, Sugar A, Meyer RF, Gabel MG
Ophthalmology 1986 Mar;93(3):340-3. doi: 10.1016/s0161-6420(86)33737-0. PMID: 3703501

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