Cases reported "Iris Diseases"

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1/45. Hamartomas of the iris and ciliary epithelium in tuberous sclerosis complex.

    Astrocytic hamartomas of the retina are the principal ocular manifestation of tuberous sclerosis complex. iris abnormalities are rare in tuberous sclerosis complex and include focal areas of stromal depigmentation and atypical colobomata. We describe 2 patients who were found on histopathological examination to have lesions consistent with hamartomas of the iris pigment epithelium and ciliary body epithelium. iris abnormalities, including pupillary irregularities, were noted on clinical examination prior to the development of iris neovascularization in both patients. These observations suggest that iris abnormalities, including atypical colobomas, may be caused by hamartomas of the iris pigment epithelium and ciliary epithelium in some patients with tuberous sclerosis complex. To our knowledge, hamartomas of tissues derived from the anterior part of the neuroectodermal optic cup have not been reported in cases of tuberous sclerosis complex.
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2/45. Intraocular lacrimal gland choristoma involving iris and ciliary body.

    PURPOSE: To describe clinical and pathologic features of an iridociliary lacrimal gland choristoma in which the diagnosis was made clinically and confirmed histopathologically. methods: Case report with clinical, ultrasound biomicroscopic, and histopathologic observations. RESULTS: We examined a 12-month-old male for a large iris mass that had been present since birth. We suspected it to be a lacrimal gland choristoma based on characteristic clinical features. The lesion was removed by iridocyclectomy, and the diagnosis of lacrimal gland choristoma was confirmed. CONCLUSION: Intraocular lacrimal gland choristoma has unique clinical features that should suggest the diagnosis.
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3/45. Demonstration of retroiridal extension of an epithelial membrane by ultrasound biomicroscopy: a clinicopathologic correlation.

    PURPOSE: To report the utilization of ultrasound biomicroscopy (UBM) in identifying the extension into the posterior segment of an epithelial membrane, as correlated by the histopathologic findings. METHOD: Case report. UBM findings before enucleation with histopathologic correlation. RESULTS: UBM demonstrated a membrane tracking from the posterior iris surface over the ciliary body and towards the retina. light microscopic examination disclosed the epithelial nature of this membrane. CONCLUSION: UBM can identify extension of an epithelial membrane into the posterior segment and thereby guide the approach to surgical management.
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4/45. Pupillary distortion and staphyloma following trans-scleral contact diode laser cyclophotocoagulation: a clinicopathological study of three patients.

    PURPOSE: To search for the cause of scleral thinning and pupillary distortion following trans-scleral contact diode laser cyclophotocoagulation (TCDLC). methods: We reviewed the records of 3 patients in whom there were complications of scleral thinning and pupillary distortion following TCDLC. One of the eyes was later enucleated, and we present the histopathological findings. Using the histopathological features in this patient, we discuss the possible pathogenesis of the scleral thinning and pupillary distortion. RESULTS: Case 1 is a 46-year-old white woman who following TCDLC in an area of clinically normal sclera developed a staphyloma. Case 2 is a 52-year-old white woman who following TCDLC in an area of scarred sclera developed mild thinning. Case 3 is an 85-year-old white man who following TCDLC developed pupillary distortion, and gonioscopy revealed damage to the peripheral iris. Histological examination of case 1 revealed the staphyloma covered by a thin layer of conjunctival epithelium, collagen and vitreous condensation. We also observed cicatricial cilary body contraction causing distortion of the pupil and lens. CONCLUSIONS: Therapeutic TCDLC can produce scarring of the iris root, anterior chamber angle, draining structures and ciliary body, and may result in pupillary distortion. Pre-existing scleral scars may predispose to scleral damage following TCDLC. We discuss a simple strategy to avoid this complication of TCDLC.
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5/45. Three-dimensional ultrasound findings of the posterior iris region.

    PURPOSE: The aim of this study was to assess the benefit of the three-dimensional ultrasound biomicroscopy in examination of the posterior iris and ciliary body. methods: Three-dimensional visualisation of the anterior eye section was achieved through extension of the existing ultrasound biomicroscope system (Humphrey Instruments). Visualisation of posterior iris and ciliary body pathologies in three patients was performed with a three-dimensional reconstruction technique of B-scans. RESULTS: The extended ultrasound system provided three-dimensional visualisation of alterations of the posterior iris region, i.e. iris cysts, ciliary body cysts and solid tumours of the ciliary body and iris. CONCLUSIONS: The three-dimensional ultrasound biomicroscopy yields extended diagnostic findings regarding iris and ciliary body pathology. This method offers an improved assessment of the posterior surface of the iris and the volume of the ciliary body. Furthermore, these data can be useful for procedures in computer simulation and calculation for a better understanding of the function of the ciliary body in the accommodation process.
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6/45. retinal detachment and phthisis bulbi after implantation of an iris prosthetic system.

    We report 2 eyes of 2 patients who developed persistent inflammation, hypotony, and total retinal detachment after secondary implantation of an iris prosthetic system (IPS) in association with cataract surgery. The first patient had an uneventful history of 16 years despite a retained intraocular glass foreign body and the second patient, of 38 years after sustaining penetrating corneoscleral injury with iris tissue loss. Both patients were thoroughly assessed clinically, and the enucleated globe in the first patient was examined by light microscopy. Both eyes had chronic inflammation with retrocorneal and cyclitic membrane formation around the artificial iris-lens diaphragm. These cases suggest that implantation of an IPS combined with cataract surgery can trigger decompensation of posttraumatic eyes that had been stable over a long period.
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7/45. Digital infrared photography assists in the detection of iris and ciliary body cysts.

    PURPOSE: To report a case that illustrates the utility of digital infrared photography in the detection of iris and ciliary body cysts in an asymptomatic patient. MATERIALS AND methods: Digital infrared photography of the iris was performed in both eyes of a 50-year-old white woman who presented with bilateral endothelial pigment dusting and subtle iris transillumination defects. RESULTS: Infrared photography revealed a pronounced, rounded patch of transillumination in the periphery of the left iris. Also observed were focal, rounded regions of reduced transmittance in the peripheral iris of both eyes. These findings suggested the presence of bilateral iris and ciliary body cysts. High-resolution ultrasound biomicroscopic images were consistent with this suspicion. CONCLUSIONS: Digital infrared photography of the iris may be useful in the detection and evaluation of iris and ciliary body cysts.
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8/45. Semicircular tumor of the iris and uveitis as unilocal manifestation of sarcoidosis.

    PURPOSE: To describe an unusual manifestation of sarcoidosis as a large tumor of the iris and ciliary body without any other involvement of the body. methods: We describe a 20-year-old female presenting with a granulomatous tumor of the right iris and ciliary body and concomitant uveitis. RESULTS: Extensive ocular and systemic workup revealed the tumor to be a large solitary sarcoid granuloma. As systemic steroids were not able to control the activity of the uveitis and granuloma, only the initiation of immunosuppressive therapy with cyclosporine A achieved a lasting remission. CONCLUSION: The possibility of an exclusively ocular sarcoidosis should always be kept in mind despite negative regular screening tests. In these cases, a biopsy should be considered and immunosuppressive agents like cyclosporine A should be evaluated in cases not responding to first-line treatment with systemic steroids.
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9/45. argon laser iridoplasty in the treatment of plateau-like iris configuration as result of numerous ciliary body cysts.

    PURPOSE: To report the use of argon laser peripheral iridoplasty in the treatment of plateau-like iris configuration as a result of iris and ciliary body cysts. DESIGN: Case report. methods: A 43-year-old male with plateau iris syndrome was demonstrated by high frequency ultrasound biomicroscopy (UBM), to have numerous iris and ciliary body cysts. Bilateral argon laser peripheral iridoplasty was performed. RESULTS: argon laser iridoplasty opened the drainage angle in both eyes. CONCLUSION: argon laser iridoplasty is an effective and safe treatment for plateau iris syndrome and may also prove valuable in the treatment of plateau-like iris configuration resulting from iridociliary cysts.
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10/45. Congenital nonpigmented epithelial iris cyst removed by block-excision.

    A 1-month-old white girl developed a rapidly progressing congenital nonpigmented iris cyst covering the pupil and displacing the lens and ciliary body. The cyst was completely removed using a modified block excision (9 x 3.5 mm). The tumor consisted of partially keratinizing cuboidal epithelium with goblet cells, which was covered by proliferating corneal endothelium on the outside. Histopathological, and scanning and transmission electron microscopic findings are described. The postoperative course is unremarkable for 1 year. To our knowledge this case is the first case of a congenital iris cyst successfully treated with block-excision.
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