Iris Vascular Abnormality: Different Forms and Clinical Appearance

Introduction

Iris vascular abnormalities (IVAs) are rare benign lesions of the iris. They can be classified into capillary hemangiomas, cavernous hemangiomas, microangiomas, arteriovenous malformations, and iris varices [1]. Since the majority of IVAs is asymptomatic, they are being detected during routine slit lamp examinations, although some patients present with secondary complications at a later stage. The most frequent complications are hyphemas with or without an increase of intraocular pressure (IOP). These lesions can occasionally demonstrate rapid growth; commonly seen after the Valsalva maneuver. Arterial hypertension, diabetes mellitus, or bleeding disorder should be excluded. Most patients are referred following hyphema of unknown etiology or suspicious iris tumors. For diagnostic purposes, a complete ophthalmologic examination of both eyes is necessary. This should include measurements of best-corrected visual acuity (BCVA), IOP, and, if an IVA reached the corneal endothelium, an endothelial cell count (EC), as well as slit lamp examinations in miosis with gonioscopy in order to exclude angle involvement. Slit lamp photography, ultrasound biomicroscopy (UBM), anterior segment optical coherence tomography (AS-OCT), and, if possible, anterior segment fluorescein and/or indocyanine green angiography (AS-Angio) can be used for the evaluation of an IVA. In addition to the anterior segment documentation, a mydriatic fundus examination should be performed. Patients with IVA should be reviewed in an ocular oncology center for further assessment and treatment planning. Herein we describe a case series of four patients that presented at the Department of Ophthalmology, Essen University Hospital, Germany.

Publication History

Received: 17 July 2021

Accepted: 17 September 2021

Article published online:
21 October 2021

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