Light microscopic and electron microscopic histopathology of an iris microhaemangioma.

Abstract

SUMMARY A patient who had been observed to have an iris microhaemangioma (capillary haemangioma), confirmed on fluorescein iris angiography, came to cataract surgery. The lesion was excised at the time of surgery and submitted to light and electron microscopic study. It had the features of a hamartoma of the capillary haemangioma type, with its characteristics being specific for vessels seen in iris tissue.Iris microhaemangiomas (IMHs) (capillary haemangiomas) are vascular tufts usually found at the pupillary margin, but occasionally they are situated in the anterior stroma. Usually they are found in older people (over 60 years) and are better seen with an undilated pupil. Their association with diabetes mellitus, chronic obstructive airways disease, and myotonic dystrophy has been noted. 4

Don’t it make my blue eyes brown: heterochromia and other abnormalities of the iris

“…Indeed, Ferry 216 in an archival study concluded that the majority of tumours classified as haemangiomas were in fact juvenile xanthogranulomas, highly vascular melanomas or other non-vascular tumours. However, true vascular tumours and malformations of the iris have been reported in the literature and include capillary, [217][218][219][220] cavernous, [221][222][223][224][225][226] racemose, 227-231 microhaemangiomas, [232][233][234][235][236][237][238][239] and iris varix. [240][241][242][243] Capillary haemangiomas are paediatric malformations and appear to arise in association with either diffuse neonatal haemangiomatosis or peri-orbital capillary haemangiomas.…”

“…237,239,[247][248][249][250][251][252][253][254][255][256] Iris microhaemangiomas are thought to be hamartomas arising from the stromal blood vessels. 235 In 1983 Stur and Strasser 227 described a sectorial racemose arterio-venous malformation in a 32-year-old male. Since this report approximately 36 further cases of isolated iris arterial-venous malformation have been reported in the literature.…”

Spontaneous hyphaemas requiring a closer look

“…IM, also referred to as Iris Vascular Tufts or Cobb's haemangiomas, are very rare hamartomas of the stromal vasculature of the iris, first described in 1958 by Fechner 1 2. They are typically found in older patients (>50 years of age) except for cases associated with myotonic dystrophy, where they may occur in much younger patients 3.…”

“…Patients may complain of transient blurring of vision, pain associated with increased IOP or erythropsia, and may therefore be misdiagnosed as having amaurosis fugax, uveitis, Posner-Schlossman syndrome or ocular hypertension 5. Clinically, there may be a variety of findings including visible bleeding from a tuft, a visible hyphaema, red blood cells in the AC, raised IOP or visible tufts of thin, tightly coiled vessels seen at the pupillary margin up to 150 microns in size 2. Conversely, there may also hardly be any clinical findings, depending on when the patient presents, and this may lead to an inaccurate diagnosis.…”

Visual Outcome after Bilateral Implantation of Extended Depth of Focus Intraocular Lens in a Patient with Iris Microhemangiomas

“…They appear as nodular clusters of small, tightly coiled, thin-walled blood vessels localized at the pupillary border [2]. Usually bilateral, they mostly affect individuals older than 50 years [1,[3][4][5] and have been associated with certain systemic diseases including diabetes mellitus type II and myotonic dystrophy [5,6].…”