Iridoschisis—A Systematic Review

Abstract

Iridoschisis is a rare condition defined as a separation of the anterior iris stroma from the posterior stroma and muscle layers. In this paper, we review current data about the epidemiology, pathophysiology, clinical characteristics and differential diagnoses of this condition and discuss the specificity of surgical treatment of concomitant ocular diseases in iridoschisis patients. Iridoschisis may pose a challenge for both an ophthalmologist in an outpatient setting and an ophthalmic surgeon. Glaucoma, primarily angle-closure glaucoma, is the most often described condition concomitant to iridoschisis. Other ocular abnormalities found relatively often in iridoschisis patients include cataract, lens subluxation and corneal abnormalities. Special attention has been paid to potential complications of cataract surgery and prevention thereof. Beside addressing the practical aspects, we point to discrepancies and suggest topics for further investigation.

A case report on cataract surgery in eyes with bilateral inferior iridoschisis

“…The diagnosis of iridoschisis was made based on the clinical appearance, age of onset, laterality and whether the condition is progressive or with co-existent ACG. Similar to this, studies have revealed that the sixth to seventh decades of life are when iridoschisis typically manifests (Pieklarz et al, 2020;Schmitt, 1922;Loewenstein & Foster, 1945;Seth et al, 2018;Chen et al, 2017;Gogaki, Tsolaki, Tiganita, Skatharoudi, & Balatsoukas, 2011) although Pegu, Jain, and Dubey (2020) observed that the average age of presentation was 49 years or the fifth decade (Pegu et al, 2020).…”

“…Several studies (Pieklarz et al, 2020;Schmitt, 1922;Loewenstein & Foster, 1945;Gogaki et al, 2011;Pegu et al, 2020;Gomez Goyeneche et al, 2018;Mark et al, 2011) AGJSR that this distinctive inferior quadrants iridoschisis is found in combination with ACG or as an apparently idiopathic atrophy of old age. Although studies have demonstrated that inferior quadrant iris involvement, as found in our case, few investigations have shown superior quadrant iris involvement.…”

“…Iris stromal strands from the anterior layer float freely in the anterior chamber (AC). With normal sphincter and dilator muscle function, angle closure glaucoma (ACG) and cataract are frequently found in conjunction with it in the sixth to seventh decades of life (Pieklarz et al, 2020). The condition was first described by Schmitt in 1922 when he reported a case with anterior iris layer detachment (Schmitt, 1922).…”

Weather as a possible risk factor for massive ocular decompression retinopathy: A case report

“…The most common concomitant abnormality is angle-closure glaucoma, followed by corneal and lens disorders. 9 The described coincidence suggests that further observations of this entity can reveal its potential influence on the regulation of ocular blood flow.…”

Anterior segment optical coherence tomography of iridoschisis

“…3 4 It is necessary to follow-up with these patients to screen for such changes and treat them accordingly. 4 Learning points ► Iridoschisis usually presents as bilateral inferior atrophic patches of the iris. ► Anterior segment optical coherence tomography demonstrates the alterations in the affected iris vividly.…”