Diffuse Iris Nevus Manifested by Unilateral Open Angle Glaucoma

Nik, Narieman A.; Hidayat, Ahmed A.; Fine, Ben S.

doi:10.1001/archopht.1981.03930010127017

Cited by 17 publications

(3 citation statements)

References 7 publications

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“…In the past, most cases were suspected to be malignant melanomas and subsequently enucleated9 10 and enucleation can still be indicated in cases with no visual potential, or when the possibility of iris melanoma cannot be excluded 11 12. However, melanocytomas are essentially benign tumours as shown in a study of 47 patients over 5 years,5 making enucleation not preferable in patients with visual potential.…”

Section: Discussionmentioning

confidence: 99%

Management of glaucoma in an eye with diffuse iris melanocytoma

Alves¹,

Fernandes

Menezes³

et al. 2010

British Journal of Ophthalmology

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A 68-year-old Caucasian male was referred for evaluation and follow-up of unilateral glaucoma resistant to control with topical medication. Corrected visual acuity was 20/20 in the right and 20/25 in the left eye. Biomicroscopy was normal and the intraocular pressure (IOP) was 14 mm Hg in the right eye. In the left eye, ciliary injection, a diffuse iris hyperchromia (figure 1A), discrete corneal oedema with the presence of sparse pigment deposits on the endothelium (figure 1B), and mild anterior chamber reaction (+/4+) were observed. The angle was obstructed inferiorly by the pigment deposition, while the parts of the angle that were visible showed increased pigmentation of the trabecular meshwork during gonioscopy. The iris surface was smooth and the crypts were absent. The pupil was round but fixed in medium mydriasis with a posterior synechia seen at 1 h. In addition, the lens had nuclear sclerosis and the IOP was measured at 58 mm Hg. Funduscopy disclosed increased cup-todisc ratio in the left (0.7) compared with the right eye (0.4), but was otherwise unremarkable.The patient's relevant medical history included controlled hypertension and a basal cell carcinoma in the left arm Education group.bmj.com on June 29, 2015 -Published by

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Section: Discussionmentioning

confidence: 99%

Management of glaucoma in an eye with diffuse iris melanocytoma

Alves¹,

Fernandes

Menezes³

et al. 2010

British Journal of Ophthalmology

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“…Trotz zytologisch benignem Zellbild zeigte der Prozess ein Wachstum sowie eine Ausbreitung in den Kammerwinkel und in das Trabekelwerk hinein mit Entwicklung eines sekundären Glaukoms. Dieses Wachstumsmuster von zytologisch benignen pigmentierten Iristumoren wurde in der Literatur bereits mehrfach beschrieben [10,14,17]. Die klinische Einordnung von pigmentierten Irisprozessen kann im Einzelfall sehr problematisch sein und endgültig nur durch eine Biopsie erfolgen.…”

Section: Discussionunclassified

Diffuser melanozytärer Nävus der Iris mit absolutem Glaukom1

Spraul¹,

Lang²

2001

Klin Monatsbl Augenheilkd

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“…Die Kombination von einem melanozytären Iristumor und einer Drucksteigerung ist deshalb zwar ein Indiz, aber noch kein Beweis für ein Irismelanom [30,61,79]. Sehr selten ist das Bild eines POWG aufgrund einer diffusen melanozytären Überwachsung des Trabekelwerkes im Rahmen eines Irisnävus, der als solcher nicht erkennbar ist [45]. Bei anterioren Melanozytomen wird die Glaukomentstehung dadurch begünstigt, dass die Tumorzellen (ähnlich wie bei malignen Neubildungen) eine verminderte Kohäsivität aufweisen und deshalb leichter abgeschwemmt werden.…”

Section: Vorbemerkungenunclassified

Neoplastische Sekundärglaukome

Jm¹,

Grüb²,

Schlote³

2005

Klin Monatsbl Augenheilkd

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With few exceptions all intraocular tumours can principally induce elevation of intraocular pressure (IOP). The frequency of IOP-elevation is mainly dependent on the biologic behaviour of the neoplasm (benign / malignant), its dimensions, localization, and its ability to provoke secondary changes like retinal detachment, hemorrhages, inflammation, and necroses. There are many and diverse pathomechanisms which may cause a "neoplastic glaucoma". The leading mechanisms are direct invasion of the chamber angle by tumour cells, rubeosis iridis, and forward displacement of the iris-lens-diaphragm with (lens induced) pupillary block. As intraocular tumours may have pressure-lowering effects too, eyes bearing a tumour may also be hypotonic or normotonic inspite of a "glaucomatous chamber angle morphology". The therapy of the tumour-induced glaucomas is hardly validated and generally follows the treatment of the other secondary glaucomas. However, filtration procedures are contraindicated when a malignant tumour is diagnosed or suspected. Because of the progress of tumour therapy with salvation of eyes which had to be enucleated in former times and prolongation of survival in some tumour entities (like Non Hodgkin's lymphoma and metastases) the significance of tumour-induced glaucomas will probably further increase in the future.

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Diffuse Iris Nevus Manifested by Unilateral Open Angle Glaucoma

Cited by 17 publications

References 7 publications

Management of glaucoma in an eye with diffuse iris melanocytoma

Management of glaucoma in an eye with diffuse iris melanocytoma

Diffuser melanozytärer Nävus der Iris mit absolutem Glaukom1

Neoplastische Sekundärglaukome

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