1/11. Clinical and histopathologic findings of iris nevus (Cogan-Reese) syndrome.PURPOSE: To report a case of Cogan-Reese syndrome. METHOD: Case report. A 37-year-old man presented with Cogan-Reese syndrome. RESULTS: visual acuity was 0.5 in the right eye and 1.0 in the left eye. There were corneal edema and pigmented nodules on the anterior surface of the iris, iris atrophy and ectropion uvea in the right eye. The intraocular pressure was 42 mmHg in the right eye and there was glaucomatous optic atrophy of the optic disk. trabeculectomy with mitomycin C has been performed as the intraocular pressure did not decrease with the maximum medical treatment. Electron microscopic examination of the trabeculum and the iris tissue revealed a lot of melanocytic cells in the stroma. CONCLUSION: trabeculectomy with mitomycin C might be effective in Cogan-Reese cases with glaucoma resistant to medical treatment.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/11. Gastric signet ring cell adenocarcinoma metastatic to the iris.PURPOSE: To report a case of gastric signet ring cell adenocarcinoma metastatic to the iris. methods: Case report. A 38-year-old man with a history of gastric signet ring cell adenocarcinoma presented with a white lacework-like mass on the iris of the left eye. RESULTS: Systemic medical evaluation demonstrated no other metastasis. Because of increased intraocular pressure, trabeculectomy and peripheral iridectomy were performed. histology of the iris specimen demonstrated metastasis of gastric signet ring cell adenocarcinoma to the iris. CONCLUSION: Gastric signet ring cell carcinoma can metastasize to the iris. Ophthalmologists should include this possibility in the differential diagnosis when encountering a patient with a history of gastric adenocarcinoma and an iris mass.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
3/11. Late normalization of melanocytomalytic intraocular pressure elevation following excision of iris melanocytoma.BACKGROUND: Melanocytoma of the iris is a rare tumor which may sometimes undergo necrosis that could result in elevated intraocular pressure through pigment dispersion. Only nine similar patients have been previously reported. methods: A 27-year-old woman presented with a dark brown iris stromal mass located between the 4 and 8 o'clock positions in the inferior quadrant. Her left visual acuity was 20/60. The tumor encroached on the lens and caused focal cataract. There was massive pigmented debris over the iridocorneal angle and the intraocular pressure was 42 mmHg. RESULTS: Fine needle aspiration biopsy did not suggest malignancy. A wide sector iridectomy was performed and histopathological examination of the lesion revealed melanocytoma of the iris. There was no ciliary body involvement. In the postoperative period, intraocular pressure, which persisted in the mid-twenties, was successfully lowered with topical dorzolamide and betaxolol drops. These drugs were continued for 2 years while the angle pigmentation gradually disappeared. There has been no documented glaucomatous damage to the optic nerve and visual fields. A year after the cessation of the drops, the left intraocular pressure stabilized and did not rise above 15 mmHg. Her left visual acuity remained 20/25. CONCLUSION: In contrast to previously reported cases, the normalization of intraocular pressure in this patient took 26 months, a period that could be associated with the self-clearing process of pigment from the iridocorneal angle. Close follow-up with medical treatment averted a pressure lowering surgical procedure in this case.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |
4/11. The Finger iridectomy technique: small incision biopsy of anterior segment tumours.AIMS: To develop a minimally invasive, maximally effective method to biopsy anterior segment tumours. methods: A 25 gauge aspiration cutter (vitrector) was used to biopsy anterior segment tumours. The probe was introduced under sodium hyaluronate 1% and through a 1 mm incision. Aspiration (600 mm Hg) cutting (300 cpm) was performed to obtain specimens for cytology and histopathology. RESULTS: Diagnostic material was obtained in nine of 10 (90%) cases. Diagnoses included iris naevus, iris stroma, malignant melanoma, melanocytoma, epithelial inclusion cyst, and sarcoid granuloma. All corneal wounds were self sealing. One patient developed a transient postoperative increase in intraocular pressure. Within the follow up of this study, no patients suffered intraocular haemorrhage, infection, cataract or vision loss. CONCLUSION: The Finger iridectomy technique was a minimally invasive and very effective biopsy technique. Aspiration cutting yielded relatively large pieces of tissue (and cells) used for cytopathological and histopathological evaluation. Small incision surgery allowed for rapid rehabilitation and no significant complications.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
5/11. iris melanoma: a case report and review.iris melanoma is a rare ocular tumour, which can be detected early in its development. This tumour is almost always unilateral and arises usually from a pre-existing naevus. Failure to detect it may be associated with morbid ocular and systemic complications, yet there are successful therapies to treat this condition, if detected early. The patient presented to the eye clinic with symptoms of occasional, brief loss of vision in his left eye for a few weeks prior to his visit. Slit-lamp examination revealed a mass on the inferior part of the iris of the left eye. Intra-ocular pressure measurements were RE 15 mmHg and LE 38 mmHg. It was found that a tumour had spread throughout the iris stroma and invaded the anterior chamber angle. Although enucleation would have been the treatment of choice in the past, the trend today in the treatment of a growing, large circumscribed iris tumour is to excise it. It was successfully excised by irido-cyclo-trabeculectomy.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
6/11. iris microhaemangiomas and idiopathic juxtafoveolar retinal telangiectasis.We describe a case of iris microhaemangiomas (iris vascular tufts) causing spontaneous hyphaema and where examination showed that the patient also had idiopathic juxtafoveolar retinal telangiectasis. A systematic search through pubmed, EMBASE and reference lists revealed a total of 90 reported cases of iris microhaemangiomas. To our knowledge, no previous reports have described concurrent findings of iris microhaemangiomas and idiopathic juxtafoveolar retinal telangiectasis in a patient. Both conditions are acquired vascular diseases, but their pathogenesis and aetiologies are unknown. iris microhaemangiomas are important clinically because they are occasionally a cause of spontaneous hyphaema and may induce transient elevation of intraocular pressure.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
7/11. Dedifferentiation potential of iris melanomas.A histopathological study was conducted on four cases in which a diffuse iris melanoma presented with glaucoma. drainage surgery was performed on three eyes for medically non-responsive raised intraocular pressure, and all cases eventually (within 2-7 years) required enucleation for secondary glaucoma. In the iridectomy specimens the tumour melanocytes were small, uniform in size and spindle shaped, while in the enucleation specimens the tumour cells were epitheliod and pleomorphic. The dedifferentiated tumour in the enucleated eyes spread extensively within the anterior chamber and anterior uvea. In three cases there was evidence of intrascleral spread. However, none of the patients has died from metastatic disease in the follow-up period of 2-6 years since enucleation.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
8/11. Mucinous adenocarcinoma metastatic to the iris, ciliary body, and choroid.A 67-year-old woman presented with signs of severe intraocular inflammation and secondary glaucoma. The initial diagnosis was uveitis, and an anterior chamber paracentesis with cytological study of the aspirate failed to establish an aetiological diagnosis. After three trabeculectomies had failed to control the intraocular pressure, the blind eye was enucleated. On histopathological examination a mucinous adenocarcinoma was found to cover diffusely the iris surface and to involve the ciliary body and peripheral choroid. The patient subsequently developed evidence of widespread metastatic disease and died shortly thereafter. Although a primary tumour was never found, histochemical and immunohistochemical studies of the enucleated eye suggested that the lesion originated in the gastrointestinal tract. In cases of intractable glaucoma and anterior chamber inflammation, metastatic carcinoma should be included in the differential diagnosis, and efforts should be made to substantiate the diagnosis by a systemic examination or a biopsy.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
9/11. iris cavernous hemangioma in a patient with recurrent hyphema.A 41-year-old woman presented with a hyphema in her right eye. Clinical examination revealed a vascular lesion of the iris that had enlarged over a 6-month period. The patient had no other evidence of ocular or cutaneous vascular malformations. Subsequently she experienced recurrent episodes of spontaneous hyphema, and there was objective evidence of growth of the lesion. Consequently, the lesion was excised by means of a sector iridectomy. Histopathological examination showed several large vascular compartments separated by thin, fibrous septa and lined by endothelium, consistent with a cavernous hemangioma. A benign iris melanocytic lesion was identified adjacent to the cavernous hemangioma. The intraocular pressure in the affected eye remained normal after the lesion was removed. After 6 months of follow-up no new hyphemas had developed. iris cavernous hemangioma should be added to the differential diagnosis of recurrent hyphema.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
10/11. Melanocytoma of the iris with rapidly developing secondary glaucoma.A 28-year-old woman with an upper nasal iris mass developed secondary glaucoma within a few months of presentation. Although the elevated pressure responded to medical therapy, in the interests of a definitive diagnosis as well as prevention of damage to the trabecular meshwork, surgical management was decided upon. Tumor excision was performed through a double-layered sclerolimbal flap. light and electron microscopic examinations of the tissue revealed a partially necrotic iris melanocytoma. Six months after surgery, the patient's best corrected visual acuity was 20/30 in the affected eye, and the intraocular pressure was 21 mmHg without therapy. The lens remained clear. The differential diagnosis and management of melanocytomas, particularly the role of biopsy, are discussed.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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