Iris Varix Simulating an Iris Melanoma

Abstract

I ris varix is rare and little is known about its clinical characteristics. We treated a thrombosed iris varix that simulated an iris melanoma. A 53-year-old man developed a dark brown iris mass and hyphema in his left eye. Ultrasound biomicroscopy revealed a circumscribed mass of the iris stroma. Because of suspicion for melanoma, it was removed by sector iridectomy. Histopathologic examination disclosed an extensive focus of stromal hemorrhage, partially surrounded by endothelial cells that showed immunoreactivity to vascular markers. The histopathologic diagnosis was thrombosed iris varix. Iris varix is a rare condition that should be included in the differential diagnosis of iris melanoma.

Vascular Tumors of the Iris in 45 Patients

“…In 1 case, varix removal by iridectomy confirmed the diagnosis (Figure 2E and F). 30 The series included 3 patients with microhemangiomatosis. It was bilateral and characterized by multiple dilated vascular channels arranged circumferentially around the pupillary margin.…”

Vascular Tumors of the Iris in 45 Patients

“…In 1 case, varix removal by iridectomy confirmed the diagnosis (Figure 2E and F). 30 The series included 3 patients with microhemangiomatosis. It was bilateral and characterized by multiple dilated vascular channels arranged circumferentially around the pupillary margin.…”

Iris Vascular Abnormality: Different Forms and Clinical Appearance

“…IVAs are benign vasculopathies without associated morbidity or risk of secondary malignant transformation. They are rare and can mimic malignant iris tumors, such as melanomas or metastatic lesions of dark coloration 2 , 3 . Reports in the literature suggest that a correct diagnosis can, in most cases, be based on a noninvasive examination alone and histopathological confirmation is not mandatory 4 .…”

Iris varix: 10-year experience with 28 eyes

“…Six of the nine varix-reported cases were male and we also found a slight male preponderance (male-to-female of 1:1.36). [91011121314151617]…”

“…In contrast to prior studies where ultrasonographic findings have included irregular, echo-dense mass in the iris stroma, in our study, iris varices have been shown to be moderately reflective mass, dotted with echolucent varix-related ultrasonographic cross-sections. [914] Though the involved iris stroma was marginally thickened, benign findings included a general respect for tissue planes (IPE and ciliary body).…”

“…More than half of the iris varix cases till date have been histopathologically diagnosed [Table 4]. [910121314] Iris hemangiomas tend to be lobulated, bleed recurrently into the anterior chamber, and leak dye on fluorescein iris angiography. [9] In addition, iris varix has been presumed as a clinical pointer to a forme-fruste iris melanoma or irido-ciliary melanoma.…”

Vascular Tumors of the Iris in 45 Patients

“…In 1 case, varix removal by iridectomy confirmed the diagnosis (Figure 2E and F). 30 The series included 3 patients with microhemangiomatosis. It was bilateral and characterized by multiple dilated vascular channels arranged circumferentially around the pupillary margin.…”

Iris Vascular Abnormality: Different Forms and Clinical Appearance

“…IVAs are benign vasculopathies without associated morbidity or risk of secondary malignant transformation. They are rare and can mimic malignant iris tumors, such as melanomas or metastatic lesions of dark coloration 2 , 3 . Reports in the literature suggest that a correct diagnosis can, in most cases, be based on a noninvasive examination alone and histopathological confirmation is not mandatory 4 .…”

Iris varix: 10-year experience with 28 eyes

“…Six of the nine varix-reported cases were male and we also found a slight male preponderance (male-to-female of 1:1.36). [91011121314151617]…”

“…In contrast to prior studies where ultrasonographic findings have included irregular, echo-dense mass in the iris stroma, in our study, iris varices have been shown to be moderately reflective mass, dotted with echolucent varix-related ultrasonographic cross-sections. [914] Though the involved iris stroma was marginally thickened, benign findings included a general respect for tissue planes (IPE and ciliary body).…”

“…More than half of the iris varix cases till date have been histopathologically diagnosed [Table 4]. [910121314] Iris hemangiomas tend to be lobulated, bleed recurrently into the anterior chamber, and leak dye on fluorescein iris angiography. [9] In addition, iris varix has been presumed as a clinical pointer to a forme-fruste iris melanoma or irido-ciliary melanoma.…”

Vascular Tumors of the Iris in 45 Patients

“…In 1 case, varix removal by iridectomy confirmed the diagnosis (Figure 2E and F). 30 The series included 3 patients with microhemangiomatosis. It was bilateral and characterized by multiple dilated vascular channels arranged circumferentially around the pupillary margin.…”

Iris Vascular Abnormality: Different Forms and Clinical Appearance

“…IVAs are benign vasculopathies without associated morbidity or risk of secondary malignant transformation. They are rare and can mimic malignant iris tumors, such as melanomas or metastatic lesions of dark coloration 2 , 3 . Reports in the literature suggest that a correct diagnosis can, in most cases, be based on a noninvasive examination alone and histopathological confirmation is not mandatory 4 .…”

Iris varix: 10-year experience with 28 eyes

“…Six of the nine varix-reported cases were male and we also found a slight male preponderance (male-to-female of 1:1.36). [91011121314151617]…”

“…In contrast to prior studies where ultrasonographic findings have included irregular, echo-dense mass in the iris stroma, in our study, iris varices have been shown to be moderately reflective mass, dotted with echolucent varix-related ultrasonographic cross-sections. [914] Though the involved iris stroma was marginally thickened, benign findings included a general respect for tissue planes (IPE and ciliary body).…”

“…More than half of the iris varix cases till date have been histopathologically diagnosed [Table 4]. [910121314] Iris hemangiomas tend to be lobulated, bleed recurrently into the anterior chamber, and leak dye on fluorescein iris angiography. [9] In addition, iris varix has been presumed as a clinical pointer to a forme-fruste iris melanoma or irido-ciliary melanoma.…”