Photoreceptor outer segments in aqueous humor: key to understanding a new syndrome

Retinal detachment with oral dialyses and tears of the nonpigmented epithelium of the ciliary body sometimes accompanies aqueous cells and high intraocular pressure with its marked fluctuation. The aqueous cells consist predominantly of photoreceptor outer segments which obstruct aqueous outflow at the trabecular meshwork and induce high intraocular pressure as ghost cells do in ghost cell glaucoma. A new clinical entity with the combination of these signs, namely, rhegmatogenous retinal detachment with "photoreceptor outer segment glaucoma" is designated as Schwartz-Matsuo syndrome in this report. The detection of photoreceptor outer segments in the anterior chamber indicates that a communication between subretinal space and aqueous humor has been established by some mechanism. The new syndrome should be included in differential diagnoses of iritis and glaucoma.