ISSN: 1300-0365
Dil: Türkçe
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ORIGINAL RESEARCH ARTICLES |
Clinical And Ultrasonic Biomicroscopic Findings ın ıris Pigment Epithelial Cysts
Dr. Kaan GÜNDÜZ,a Dr. Banu HOŞAL,a Dr. Güler ZİLELİOĞLU,a Dr. Sibel DEMİRELa
aGöz Hastalıkları AD, Ankara Üniversitesi Tıp Fakültesi, ANKARA
Objective: To report the clinical, ultrasonic biomicroscopic imaging findings and follow-up data on iris pigment epithelial (IPE) cysts.
Material and Methods: Twelve patients with IPE cysts underwent complete ocular examination including visual acuity determination, intraocular pressure measurement, anterior segment biomicroscopy, gonioscopy, pupillary dilation, funduscopy. Transillumination and UBM examination were also performed.
Results: The mean age of the patients was 36.3 years, ranging from 18 to 64 years. Six patients were women and 6 were men. All patients were referred with the diagnosis of iris melanoma. Visual acuity was found to be decreased in 2 cases due to reasons other than the IPE cyst. In 11 eyes, there was localized bulging of the iris in the region of the IPE cyst and in one eye the IPE cyst was freely floating in the anterior chamber. Except for the eye with dislocated IPE cyst, the IPE cyst was located inferotemporally in 9 eyes, inferonasally in 1 eye, and inferior nasal-temporally in 1 eye. The cyst wall was visible in 8 of these 11 (72.7%) eyes. The IPE cysts were found to transilluminate and did not cause blockage of transmitted light. Based on the clinical and UBM features, the IPE cyst was of the peripheral (iridociliary) type in 9 eyes, midzonal type in 2 eyes, and dislocated type in 1 eye. The mean largest cyst diameter measured with UBM in 6 cases was 1.8 mm, ranging from 0.9 mm to 2.3 mm. Considering the clinical findings in 3 cases, the mean largest cyst diameter measured on clinical and UBM grounds was 3.9 mm, ranging from 0.9 mm ile 20 mm. In 2 eyes with peripheral cysts, the IPE cyst was bilobed on UBM examination. At a mean follow-up of 21.9 months (3-60 months), peripheral and midzonal IPE cysts remained stationary and no ocular complication was encountered. The dislocated IPE cyst spontaneously deflated after 36 months of followup.
Conclusion: IPE cysts cause bulging of the iris and may cause diagnostic confusion with iris melanoma. Pupillary dilation and observation of the cyst, transillumination, and UBM are important in diagnosis. IPE cysts do not require treatment since they are usually asymptomatic.Keywords: Iris pigment epithelial cyst, ultrasound biomicroscopy, transillumination, iris melanomaTurkiye Klinikleri J Ophthalmol 2006, 15:6-11
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