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Ocular Immunology and Inflammation Jul 2022To describe the iris changes in chronic recurrent Vogt-Koyanagi-Harada Disease (VKH).
PURPOSE
To describe the iris changes in chronic recurrent Vogt-Koyanagi-Harada Disease (VKH).
METHODS
Retrospective case series. Clinical features of 3 VKH patients who developed bilateral depigmentation of the iris are described.
RESULTS
Patients had delayed diagnosis and inadequately treated chronic recurrent VKH. Patient 1 presented with bilateral multiple contiguous small granulomatous iris stromal lesions, severe diffuse iris swelling more severe near the iris root, producing peripheral iris undulations. Diffuse iris atrophy and peripheral depigmentation subsequently developed. Patient 2 presented with peripheral iris depigmentation, atrophy of the ciliary zone iris stroma and sparing of the sphincter pupillae, giving a 'sunflower appearance.' Patient 3 had extensive iris depigmentation, atrophy, and transillumination defects involving the entire iris.
CONCLUSION
Uncontrolled bilateral diffuse granulomatous stromal iris inflammation leads to subsequent depigmentation, transillumination defects and atrophy, beginning in the peripheral iris. Sphincter pupillae is initially spared but complete iris atrophy may develop.
Topics: Atrophy; Humans; Iris; Iris Diseases; Retrospective Studies; Uveomeningoencephalitic Syndrome
PubMed: 33561370
DOI: 10.1080/09273948.2020.1870701 -
The New England Journal of Medicine Apr 2022
Topics: Anemia, Sickle Cell; Atrophy; Humans; Iris; Iris Diseases
PubMed: 35476653
DOI: 10.1056/NEJMicm2117234 -
QJM : Monthly Journal of the... Aug 2019
Topics: Adolescent; Female; Humans; Iris Diseases
PubMed: 30690575
DOI: 10.1093/qjmed/hcz025 -
Journal of Pediatric Ophthalmology and... 2023A 2-year-old girl with severe muscular dystrophy presented with unilateral eye pain and corneal clouding. She was found to have absent red reflex, hypotonia, cerebral...
A 2-year-old girl with severe muscular dystrophy presented with unilateral eye pain and corneal clouding. She was found to have absent red reflex, hypotonia, cerebral hypoplasia, and iris bombe on ultrasound biomicroscopy, a feature not previously reported in this syndrome. She responded favorably to surgical management. Iris bombe can be a cause of glaucoma in muscle-eye-brain disease. This highlights the importance of incorporating ultrasound biomicroscopy into the diagnostic algorithm of muscle-eye-brain disease and other types of congenital syndromic glaucoma. .
Topics: Female; Humans; Child, Preschool; Iris; Walker-Warburg Syndrome; Iris Diseases; Glaucoma; Microscopy, Acoustic
PubMed: 37478202
DOI: 10.3928/01913913-20230518-01 -
Seminars in Ophthalmology Jan 2011Iris cysts though uncommon, present diagnostic and therapeutic challenges. With the advent of better investigational modalities it is not so difficult to characterize... (Review)
Review
Iris cysts though uncommon, present diagnostic and therapeutic challenges. With the advent of better investigational modalities it is not so difficult to characterize iris cysts and differentiate them from uveal tumors. Management strategies however, are still not clearly defined and long term course especially of inclusion cysts of the iris remains dismal. In this review we present the classification, pathogenesis, differential diagnosis and management options along with long term clinical course of eyes with iris cysts.
Topics: Cysts; Humans; Iris Diseases
PubMed: 21275599
DOI: 10.3109/08820538.2010.541319 -
QJM : Monthly Journal of the... Jan 2020
Topics: Adolescent; Cysts; Female; Humans; Iris Diseases; Pigment Epithelium of Eye; Slit Lamp
PubMed: 31125089
DOI: 10.1093/qjmed/hcz113 -
Survey of Ophthalmology 2018Iris cysts, both primary and secondary, are a diagnostic and treatment challenge. Primary cysts arise either from the iris pigment epithelium or the iris stroma.... (Review)
Review
Iris cysts, both primary and secondary, are a diagnostic and treatment challenge. Primary cysts arise either from the iris pigment epithelium or the iris stroma. Posterior pigment epithelial cysts are subdivided according to their location as central, midzonal, and peripheral. Iris stromal cysts are classified either as congenital or acquired. Free-floating cysts are usually dislodged pigment epithelial cysts. Secondary cysts are classified according to the underlying cause as implantation cysts, drug-induced, uveitic, tumor-induced, parasitic, or as cysts associated with systemic disorders. Differential diagnosis is based on the clinical presentation and imaging. Ultrasound biomicroscopy is the gold standard for the imaging of iris cysts, combining excellent resolution with sufficient tissue penetration. Treatment of iris cysts depends largely on whether they become symptomatic or not. Symptoms include obstruction of the visual axis, corneal decompensation, secondary uveitis, and secondary glaucoma. Treatment options cover a range from simple observation to fine-needle aspiration (with or without intracystic injection of absolute alcohol or antimitotic agents), laser (argon, Nd:YAG), or surgical excision. In the past, the prevailing notion was that of a radical surgical intervention in the form of iridectomy or iridocyclectomy. Given the high rate of recurrence, a stepwise conservative approach is currently favored by most clinicians.
Topics: Cysts; Diagnosis, Differential; Diagnostic Techniques, Ophthalmological; Humans; Iris Diseases; Pigment Epithelium of Eye
PubMed: 28882598
DOI: 10.1016/j.survophthal.2017.08.009 -
Arquivos Brasileiros de Oftalmologia 2008The term plateau iris was first coined in 1958 to describe the iris configuration of a patient. Two years later the concept of plateau iris was published. In 1977, the... (Review)
Review
The term plateau iris was first coined in 1958 to describe the iris configuration of a patient. Two years later the concept of plateau iris was published. In 1977, the plateau iris configuration was classically defined as presurgical changes of an eye with a relative normal central anterior chamber depth, flat iris by conventional biomicroscopy, but displaying an extremely narrow or closed angle on gonioscopic examination. On the other hand, the plateau iris syndrome was defined as an acute glaucoma crisis in one eye with a relative normal central anterior chamber depth and patent iridotomy on direct examination, presenting angle closure confirmed by gonioscopic examination after mydriasis. In 1992, the anatomic aspects of plateau iris were studied using ultrasound biomicroscopy. Finally, plateau iris has been considered an anatomic variant of iris structure in which the iris periphery angulates sharply forward from its insertion point and then again angulates sharply and centrally backward, along with an anterior positioning of the ciliary processes seen on ultrasound biomicroscopy. The clinical treatment of plateau iris syndrome is carried out with topical use of pilocarpine. However, the definitive treatment should be fulfilled by performing an argon laser peripheral iridoplasty.
Topics: Gonioscopy; Humans; Iris Diseases; Laser Therapy; Microscopy, Acoustic; Miotics; Pilocarpine; Syndrome
PubMed: 19039479
DOI: 10.1590/s0004-27492008000500029 -
The Pan African Medical Journal 2018Congenital ocular colobomas are due to incomplete closure of the fetal fissure during organogenesis. Ocular involvement can be variable ranging from a simple hole in the...
Congenital ocular colobomas are due to incomplete closure of the fetal fissure during organogenesis. Ocular involvement can be variable ranging from a simple hole in the iris to a more severe involvement of the posterior pole (coloboma of the optic nerve, of the choroid, of the retina). We here report the case of a typical isolated bilateral iris coloboma. The study involved a 55-year old woman who discovered a typical inferonasal iris coloboma without involvement of the crystalline or of the posterior pole on ophthalmologic examination.
Topics: Coloboma; Female; Humans; Iris; Iris Diseases
PubMed: 30123404
DOI: 10.11604/pamj.2018.30.1.14505 -
JAMA Ophthalmology Sep 2016
Topics: Cysts; Female; Humans; Iris Diseases; Middle Aged; Stromal Cells; Ultrasonography
PubMed: 27442779
DOI: 10.1001/jamaophthalmol.2016.0924